Job Summary
We are seeking a highly skilled Coding and Billing Auditor to join our team. This fully onsite role requires a Certified Professional Coder (CPC) with extensive physician coding experience. The ideal candidate will have a strong background in auditing, coding across multiple specialties, and providing regular feedback and education to physicians and staff.
Key Responsibilities
- Perform data quality reviews on provider records to validate ICD-10 codes, CPT codes, and clinical documentation.
- Audit physician and mid-level provider records for accuracy of diagnoses and procedures, ensuring compliance with reporting and documentation requirements.
- Compile detailed reports with analysis of findings from medical record audits.
- Maintain audit logs and consistently meet established productivity targets.
- Communicate with providers to validate observations and recommend improvements in documentation.
- Collaborate with the Revenue Cycle Manager to design and implement tools supporting physician documentation.
- Develop and deliver formal and informal education sessions for providers, coders, and charge entry personnel.
- Train new revenue cycle team members on coding and documentation guidelines.
- Assist the Revenue Cycle Manager with evaluation of coding activities and staff performance.
- Perform coding procedures as needed and provide ongoing support to the billing staff.
- Carry out other duties as assigned within the scope of responsibilities.
Required Qualifications
- Associate’s degree in a related field.
- Certified Professional Coder (CPC) credential.
- Minimum of 5 years of inpatient and outpatient coding and auditing experience.
- Strong knowledge of professional physician coding in a medical office-based setting.
Preferred Qualifications (if any)
- Bachelor’s degree in a related field.
- Experience coding in a multi-specialty group practice setting.
- Prior auditing experience.
- Experience interacting regularly with physicians to provide feedback and education.
Certifications (if any)
- Certified Professional Coder (CPC) – required.
- Additional coding or auditing certifications – preferred.