Home and Stone Investments · 2 weeks ago
Professional Billing (PB) Auditor – Surgical Specialty
St. Petersburg, FL
Full-time
Onsite
Entry, Mid Level
2+ years expHome and Stone Investments is seeking a Professional Billing (PB) Auditor – Surgical Specialty to provide ongoing audit support for hospital-based physician billing with a focus on complex surgical services. The role involves auditing professional fee claims to ensure accurate coding, regulatory compliance, and risk mitigation, while also supporting continuous improvement and education for coding staff.
Financial Services
Responsibilities
Perform retrospective and/or concurrent audits of professional billing surgical claims
Review operative reports and supporting documentation to validate appropriate CPT, HCPCS, and ICD-10-CM code assignment
Validate modifier usage and bundling in accordance with NCCI edits and payer guidelines
Identify surgical coding trends, compliance risks, and opportunities for improvement
Provide clear, educational feedback to professional billing coders related to surgical coding accuracy
Document audit findings and recommendations in accordance with established audit standards
Support internal and external audit preparedness related to professional fee surgical services
Ensure compliance with CMS, AMA, and payer-specific billing regulations
Qualification
Required
Minimum 2+ years of professional billing auditing experience with a focus on surgical services
Strong knowledge of CPT (Surgery section), ICD-10-CM, modifiers, and NCCI edits
Experience auditing hospital-based physician surgical billing claims
Strong written and verbal communication skills with the ability to provide constructive audit feedback
Preferred
CPC, CPMA, or equivalent certification preferred
Company
Home and Stone Investments
Interessé par l'immobilier en Floride? LLC enregistrée à St Petersburg (USA), H &SI est une société d'investissement immobilier à Tampa (floride), dont l'activité est l'achat de biens immobiliers (maisons, terrains, petits immeubles) pour les restaurer et les louer.
2-10 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase