Senior Auditor, Revenue Optimization (Remote)

North American Partners in Anesthesia•Saint Paul, MN

3d•$63,000 - $87,000•Remote

About The Position

The Senior Auditor, Revenue Optimization – Pod Captain serves as a senior subject matter expert and day-to-day functional leader within the Revenue Optimization Audit team. This role provides operational guidance, technical support, quality oversight, and coaching to Revenue Optimization Auditors while supporting the Manager in ensuring audit activities are completed accurately, consistently, and in accordance with departmental standards and applicable coding, billing, and regulatory requirements. The Pod Captain serves as a primary escalation resource for complex audit, coding, documentation, and workflow questions and assists with workload coordination, team development, onboarding, quality assurance, and process improvement initiatives. The position also performs and supports complex revenue optimization audits and uses audit findings and data analysis to identify revenue opportunities, compliance risks, documentation trends, and opportunities for operational improvement.

Requirements

High school diploma or equivalent required.
Current CPC or CCS certification, plus CPMA, CANPC, or an equivalent professional auditing or anesthesia coding certification.
Minimum of 5 years of professional medical coding, auditing, revenue integrity, or revenue cycle experience, including significant experience auditing anesthesia services.
Advanced knowledge of anesthesia coding, billing, documentation, and reimbursement requirements.
Demonstrated ability to interpret and apply CPT, ASA Crosswalk, ICD-10-CM, HCPCS, payer requirements, CMS guidance, and other applicable coding and billing regulations.
Demonstrated experience performing coding, documentation, revenue optimization, or compliance-focused audits.
Strong analytical skills with the ability to evaluate complex information, identify trends and root causes, and translate findings into actionable recommendations.
Demonstrated ability to provide technical guidance, coaching, training, and constructive feedback to peers and team members.
Strong written and verbal communication skills, including the ability to communicate complex audit and coding concepts clearly to technical and non-technical audiences.
Strong organizational and time-management skills with the ability to manage competing priorities, meet deadlines, and support multiple concurrent audit activities.
Demonstrated sound judgment, professionalism, discretion, and ability to appropriately escalate operational or compliance concerns.
Proficiency with Microsoft Excel and other Microsoft Office applications; ability to work effectively with audit, reporting, revenue cycle, and data analytics systems.
Ability to work independently in a remote environment while maintaining effective communication and collaboration with team members, leadership, and cross-functional stakeholders.

Nice To Haves

Prior experience serving as a team lead, senior auditor, subject matter expert, trainer, or similar functional leadership role
Experience conducting internal and/or external coding audits, revenue optimization audits, payer audits, or revenue integrity reviews.
Experience developing audit reports, presenting findings to leadership, and providing education based on audit results.
Experience analyzing audit data and identifying systemic revenue, coding, documentation, or workflow trends.

Responsibilities

Provide day-to-day functional leadership and technical support to Revenue Optimization Auditors.
Serve as a primary Subject Matter Expert (SME) for audit processes, coding and billing questions, departmental policies, and workflow requirements.
Provide guidance on complex cases, support workload coordination, reinforce departmental expectations, and escalate significant operational, performance, or compliance concerns to the Manager as appropriate.
Perform and support complex revenue optimization audits, including coding, billing, documentation, revenue integrity, and other assigned audit activities.
Evaluate records for accuracy, completeness, and adherence to applicable requirements while identifying under-coding, over-coding, missed billing opportunities, documentation deficiencies, and other potential revenue or compliance concerns.
Conduct scheduled quality assurance reviews of auditor work to evaluate accuracy, consistency, documentation, and adherence to established audit methodology, policies, and procedures.
Provide timely and constructive feedback, identify trends requiring additional education or process clarification, and communicate significant findings to management.
Develop, review, and present audit results and supporting examples to management and other stakeholders.
Summarize key findings, revenue opportunities, coding and documentation trends, compliance considerations, root causes, and recommended corrective or preventive actions.
Utilize available reporting and data analytics tools to analyze audit populations and large datasets, identify patterns and anomalies, and evaluate potential revenue integrity concerns, including under-coding, over-coding, missed charges, documentation deficiencies, and other billing opportunities or risks.
Provide coaching, education, and technical guidance to Auditors, Coders, Physicians, and other stakeholders, as appropriate, regarding audit findings, coding guidelines, documentation requirements, revenue cycle processes, and identified opportunities for improvement.
Support the onboarding and development of newly hired Revenue Optimization Auditors by providing workflow training, technical instruction, mentoring, case review, and ongoing feedback to promote successful transition into independent audit responsibilities.
Promote continuous improvement by identifying opportunities to strengthen audit methodology, standardize workflows, improve quality and efficiency, enhance reporting, and optimize revenue cycle outcomes.
Participate in departmental initiatives and special projects as assigned.
Coordinate and participate in team, departmental, and management meetings; communicate relevant operational updates; support resolution of escalated issues; and assist the Manager with departmental priorities, coverage needs, and other operational responsibilities as assigned.