Auditor Coder Specialist

CommonSpirit Health • Tacoma, WA

3d

About The Position

The Auditor Coder Specialist conducts internal audits and billing compliance reviews to ensure adherence to quality standards, regulatory requirements, and coding guidelines. The role reviews provider E/M profiles, practice patterns, and prior audit findings to identify compliance risks, missed billing opportunities, and areas for improvement. It documents audit results, tracks risks and trends, and communicates findings and recommendations to stakeholders. The specialist also identifies educational opportunities, helps develop training materials and action plans, and answers coding questions from providers, managers, and billing teams. Additional duties include reviewing and correcting or appealing denied claims, recommending Epic edits and process improvements, and maintaining project work lists and auditing software.

Requirements

• Two years of related work experience involving ICD-10-CM and CPT coding in an acute or ambulatory care setting.
• Upon hire, one of the following certifications is required: Certified Coding Specialist, Certified Coding Specialist - Physician Based, or Certified Professional Coder.

Nice To Haves

• Work experience in provider coding/documentation auditing and/or provider training.

Responsibilities

• Conduct internal audits and billing compliance reviews for adherence to quality standards, regulatory requirements, and coding guidelines.
• Review provider E/M profiles, practice patterns, and previous audit findings to identify compliance risks, missed billing opportunities, and areas for improvement.
• Document audit results, track identified risks and trends, and communicate findings and recommendations to appropriate stakeholders.
• Identify educational opportunities and assist with developing training materials and action plans to improve provider documentation, coding accuracy, and billing compliance.
• Respond to coding questions through the Coding Helpline, advising providers, managers, and billing teams on CPT, ICD-10-CM, reimbursement, regulatory requirements, and documentation standards.
• Review and correct or appeal denied claims as assigned.
• Recommend Epic edits and process improvements to support coding accuracy and compliance.
• Maintain project work lists and auditing software according to established procedures.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed