Coding Auditor
Nashville, TN Revenue Cycle
Job Type

Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Nashville and Middle Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state.

There are a number of reasons why TOA is an employer of choice; here are a few of them:

  • Stability- TOA has been in Middle Tennessee since 1926 and has expanded to nearly 20 locations!
  • Impact- TOA’s team members use our careers – whether in our clinics or our business office – to make a positive difference in the community by building relationships and helping patients live their best life.
  • Work Environment- The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement.
  • Total Rewards- TOA offers competitive salaries based on the current Middle Tennessee wage market, plus a comprehensive suite of benefits, including Medical, Dental, Paid Time Off, and more. Our 401(k) plan provides a company match, safe harbor match and profit sharing match to go along with your contributions.

The position provides auditing services to ensure accurate and ethical coding of documentation and claims generation. The auditor/coding specialist assist in providing educational training and understanding to physicians, mid-levels, clinical personnel, and revenue cycle teams. The auditor/coding specialist will have effective communication skills via verbal and written and will be able to speak with providers and clinical team members confidently.

  • Follows the direction of the Coding Manager with regards to all assigned coding duties
  • Perform physician documentation audits and reviews of medical records and charges to ensure compliance with coding standards
  • Perform mid-level documentation audits and reviews of medical records and charges to ensure compliance with coding standards
  • Perform evaluation and management, surgical, and ancillary service audit and reviews of medical records and charges to ensure compliance with coding standards
  • Provide education/training to providers, clinical team members, coding team members and other individuals on the revenue cycle team
  • May assist in the development and documentation of an effective auditing program
  • May conduct periodic meeting with providers or mid-level providers to include: chart reviews, coding reviews for over/under coding patterns, coding patterns in general and code specific revenue enhancement opportunities
  • Perform pre-bill & post bill audits of new providers and mid-levels, as they join Tennessee Orthopedics Alliance
  • May assist in payer audits and retrospective audits requiring pay backs to either commercial or governmental payers
  • May assist with new on-boarding of providers on new physician audits, documentation review, spot auditing and coding accuracy
  • Provide coding education in regards to orthopedic ancillary services, modifiers, and bundling of services
  • Must know and understand CRT and RAC processes
  • May assist in or conduct special audit as requested by leadership
  • Travel within middle TN required - as needed to complete provider feedback meetings and new provider training
  • Education: High School or Equivalent, Bachelors preferred
  • Minimum of 1 year medical auditing experience
  • Certification/Licensure: CPC or CCS-P certification or equivalent required
  • CPMA auditing certification or equivalent required
  • Experience conducting coding education
  • Orthopeadics coding preferred but not required

TOA is an equal opportunity employer. TOA conducts drug screens and background checks on applicants who accept employment offers.