[Remote] 1099 Surgery Auditor

Note: The job is a remote job and is open to candidates in USA. Pinnacle 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. 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 Skills • 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 • 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 Overview • Pinnacle seeks to help hospitals, health systems, physician groups and other health care organizations improve their clinical performance. It was founded in 1998, and is headquartered in Centennial, Colorado, USA, with a workforce of 201-500 employees. Its website is https://askphc.com/. Apply tot his job Apply To this Job