Documentation & Coding Auditor - Billing Compliance

Military Spouse Corporate Career Network • Lubbock, TX

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About The Position

Performs coding and documentation quality audits and provides feedback and education to coding and reimbursement specialists, coders, and other relevant staff. This role has no supervisory responsibilities. The auditor plans and performs proactive compliance activities, identifies and addresses billing compliance risks, collaborates with departments on new services and workflows, maintains compliance tracking tools, and prepares and presents audit findings and recommendations.

Requirements

• High school graduation or equivalency and five years of coding and reimbursement experience, of which one year may be as a coding auditor; additional job-specific education may substitute for experience.
• Active professional coding certification from an accredited organization, such as AAPC or AHIMA; certification must remain current during employment.
• Knowledge of CPT, ICD-CM, ICD-10, and HCPCS nomenclature.
• Experience conducting risk-based and retrospective documentation and coding audits.
• Experience in an academic medical center, physician group practice, hospital, or other complex healthcare organization.
• Experience developing and delivering documentation, coding, and billing compliance education to physicians, advanced practice providers, residents, coders, and other staff.
• Experience preparing formal audit reports, identifying root causes, recommending corrective actions, and conducting follow-up monitoring.

Responsibilities

• Perform coding and documentation quality audits and provide feedback to coding and reimbursement specialists, coders, and other staff.
• Plan and perform proactive compliance activities, including risk-based audits, pre-bill or concurrent reviews, data monitoring, targeted education, policy or template reviews, and department consultations.
• Identify and address billing compliance risks using audit trends, payer updates, denial patterns, regulatory changes, stakeholder feedback, and risk assessment results.
• Partner with departments before new services, workflows, locations, provider groups, or documentation tools are implemented to assess and reduce billing, coding, documentation, supervision, and reimbursement risks.
• Maintain or contribute to issue logs, risk registers, work plan trackers, audit dashboards, corrective action trackers, education trackers, consultation logs, and reporting calendars.
• Prepare and present ideas, findings, and information to appropriate staff.
• Work collaboratively with providers, residents, coding staff, clinic administrators, leadership, and other stakeholders.
• Prepare formal audit reports, identify root causes, recommend corrective actions, and conduct follow-up monitoring.
• Develop and deliver documentation, coding, and billing compliance education to physicians, advanced practice providers, residents, coders, and other staff.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED