Pinnacle Healthcare Consulting ยท 5 hours ago
1099 Surgery Auditor
United States
Full-time
Remote
Mid LevelPinnacle Healthcare Consulting is seeking a 1099 Surgery Auditor to ensure the accuracy, compliance, and integrity of surgical billing and documentation processes. The auditor will conduct detailed audits of surgical claims and work independently to analyze complex surgical data while providing actionable recommendations to improve billing practices.
Business DevelopmentHealth CareHospitalInformation Technology
Responsibilities
Review and audit surgical claims and related documentation for accuracy, completeness, and compliance with applicable coding standards and regulations
Analyze medical records to verify that surgical procedures are properly documented and coded according to current guidelines
Identify discrepancies, errors, or potential fraud in surgical billing and report findings with detailed explanations and recommendations
Collaborate with healthcare providers, billing teams, and compliance officers to resolve audit findings and implement corrective actions
Maintain thorough records of audit activities and prepare comprehensive reports to support internal and external reviews
Qualification
Required
Proven experience in medical auditing, specifically related to surgical procedures and billing
Strong knowledge of CPT, ICD-10, and HCPCS coding systems relevant to surgery
Familiarity with healthcare compliance regulations such as HIPAA and Medicare/Medicaid billing requirements
Excellent analytical skills with attention to detail and accuracy
Ability to work independently as a 1099 contractor with strong time management and organizational skills
Preferred
Certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
Experience working with electronic health records (EHR) and medical billing software
Background in healthcare compliance or risk management
Prior experience auditing surgical claims for insurance companies or healthcare providers
Strong communication skills for effectively liaising with clinical and administrative staff
Company
Pinnacle Healthcare Consulting
Pinnacle seeks to help hospitals, health systems, physician groups and other health care organizations improve their clinical performance.
Founded in 1998
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
David White
Principal, Partner & Founding Member
Recent News
24-7 Press Release Newswire
2025-09-04
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