Coding and Billing Auditor - CBADE

NavitasPartners•Dover, DE

16h•Onsite

About The Position

The Coding and Billing Auditor is responsible for performing comprehensive data quality reviews of provider medical records to validate ICD-10, CPT coding, and clinical documentation accuracy. This role ensures compliance with applicable coding, reporting, and documentation standards while supporting providers, coders, and revenue cycle staff through education and guidance. Professional physician coding experience is required, with auditing experience preferred.

Requirements

Associate degree in a related field
Certified Professional Coder (CPC) – required
Minimum of five (5) years of inpatient and outpatient coding experience
Professional physician coding experience required
Auditing experience preferred

Nice To Haves

Bachelor’s degree in a related field
Certified Professional Coder (CPC)
Coding experience in a multi-specialty group practice setting

Responsibilities

Perform detailed audits of provider (physician and mid-level) medical records to ensure accurate assignment of ICD-10 and CPT codes
Validate principal and secondary diagnoses and procedures against clinical documentation
Compile audit reports with analysis of findings and recommendations
Ensure selected CPT codes appropriately support clinical documentation
Meet or exceed established productivity benchmarks for medical record audits
Conduct routine audits of established provider records on a biannual basis
Maintain detailed audit logs
Identify documentation gaps and coding discrepancies
Ensure compliance with coding guidelines, regulatory requirements, and documentation standards
Communicate findings verbally and in writing with providers to clarify documentation and suggest improvements
Educate providers, coders, and charge entry staff on coding guidelines and documentation best practices
Develop and implement documentation support tools in collaboration with revenue cycle leadership
Communicate the benefits of complete and accurate clinical documentation
Train new revenue cycle team members on coding and documentation guidelines
Assist revenue cycle leadership with evaluation of coding activities and staff performance as needed
Perform hands-on coding support when required
Participate in both formal and informal education initiatives for providers and staff
Assist with revenue cycle improvement initiatives
Perform other duties as assigned within the scope of the role