External Auditor Physician

Scope

Pro fee coder with a minimum of 3 years’ experience auditing EM and procedures across multiple specialties in particularly radiology, neuro and ortho at a trauma 1 facility. Epic experience required and Codify experience preferred.  Schedule will be M-F preferably between 8am and 5 pm CST, be the start time can be flexible within reason.  For the first week of training candidates would need to be available 8a-5p CST

Core Coding & Audit Expertise

• Advanced proficiency in CPT, HCPCS Level II, and ICD-10-CM coding guidelines
• Strong expertise in Evaluation & Management (E/M) coding (office, hospital, consults, ED, critical care)
• Extensive experience auditing procedure-based coding across multiple specialties (e.g., cardiology, orthopedics, radiology, neurosurgery, general surgery)
• In-depth knowledge of NCCI edits, MUEs, modifier usage, and bundling/unbundling rules
• Ability to evaluate and validate medical necessity and accurate code assignment

Multi-Specialty Audit Experience

• Proven experience auditing professional fee coding across multiple specialties, such as:
  • Orthopedics
  • Cardiology
  • Radiology
  • Neurology/Neurosurgery
  • General Surgery
  • Internal Medicine / Hospitalist
• Ability to quickly interpret specialty-specific documentation and apply appropriate coding rules

Compliance & Regulatory Knowledge

• Strong knowledge of CMS guidelines, payer policies, and federal/state compliance requirements
• Familiarity with OIG Work Plan, audit risk areas, and regulatory updates
• Experience supporting internal and external audits, including payer audits and RAC reviews
• Ability to identify coding trends, compliance risks, and revenue leakage

Audit & Quality Management Skills

• Experience conducting retrospective and concurrent coding audits
• Ability to calculate and report accuracy rates, error categorization, and financial impact
• Skilled in developing audit reports, scorecards, and executive summaries
• Experience creating and delivering education and feedback to coders and providers
• Strong focus on continuous quality improvement and audit calibration processes

Documentation Review & Clinical Knowledge

• Strong understanding of clinical documentation requirements to support both E/M and procedural services
• Ability to identify documentation gaps and provide actionable recommendations
• Working knowledge of medical terminology, anatomy, physiology, and disease processes across specialties

Communication & Leadership Skills

• Ability to clearly communicate audit findings, rationale, and coding guidelines to stakeholders
• Experience collaborating with providers, coding teams, CDI, and operational leadership
• Strong presentation skills for delivering education sessions and audit results
• Ability to mentor and guide coders to improve quality and compliance performance

1. 3 + years' experience auditing pro fee across multiple specialties
2. Epic experience
3. Prefer Codify experience
4. Able to work M-F with the majority of the shift between 8a-5p CST
5. Able to pick up new workflows and technology easily
6. Able to ramp up productivity in 4 weeks
7. Maintain 95% accuracy in all coding
8. Good written and verbal communication

Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com

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