Job Details:
Rady Children’s Hospital is seeking a Professional Surgical Coding Auditor for a casual position (subject to renewal on 10/24/2025). Working under the direction of the Supervisor and Director of Professional Billing & Coding, this role operates within the Revenue Cycle Center to review, audit, and ensure accuracy in professional billing and surgical coding claims. The position focuses on minimizing claim errors and denials while ensuring compliance with CCI and payer-specific coding edits (McKesson).
The incumbent will review surgical coding performed by departmental coders, identify trends in incorrect coding, and develop training materials and educational presentations for providers. They will also research CCI edits, payer updates, and coding regulations to provide accurate and current guidance to billing and coding teams. This position also involves coordinating workflows of surgical coding staff and assisting with claim error resolution and patient complaint processing.
Key Responsibilities:
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Review and audit provider and surgical coding for accuracy and compliance.
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Identify and document incorrect coding trends; develop and deliver training materials.
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Research CCI edits and payer-specific coding requirements.
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Provide education to coders and physicians on documentation and coding best practices.
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Monitor and report coding-related error and denial trends to Revenue Cycle Leadership.
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Coordinate workflows of surgical coding staff and mentor certified coders.
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Assist in resolving patient complaints related to billing and coding.
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Ensure compliance with federal and state coding regulations and hospital standards.
Minimum Qualifications:
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High School Diploma, GED, or equivalent.
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Certified Professional Coder (CPC) credential required.
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Minimum 2 years of experience in professional or surgical coding.
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Strong knowledge of ICD, CPT, and HCPCS coding systems.
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Ability to abstract information accurately from medical records and operative notes.
Preferred Qualifications:
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Associate’s Degree.
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3 years of experience in professional billing and coding within healthcare settings.
Salary Range:
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Expected hiring range: $30.96 to $42.57 per hour, depending on experience and qualifications.
Rady Children’s Hospital maintains pay equity and competitiveness through regular market reviews within the nonprofit healthcare sector.
About the Hospital:
Rady Children’s Hospital is a leading nonprofit pediatric healthcare organization dedicated to providing compassionate care, medical excellence, and innovation. The hospital fosters a collaborative and supportive environment that values education, quality, and continuous improvement.
Equal Opportunity:
Rady Children’s Hospital is an Equal Opportunity Employer committed to diversity and inclusion. All employment decisions are based on merit, qualifications, and organizational needs, without regard to race, color, religion, gender, national origin, age, disability, or veteran status.