Documentation & Coding Auditor - Billing Compliance
About The Position
The Documentation & Coding Auditor performs coding and documentation quality audits and provides feedback and education to coding and reimbursement specialists and coders. The position has no supervisory responsibilities. The role plans and performs proactive compliance activities, including risk-based audits, pre-bill or concurrent reviews, data monitoring, targeted education, policy or template reviews, and department consultations. It identifies and addresses billing compliance risks using audit trends, payer updates, denial patterns, regulatory changes, stakeholder feedback, and risk assessment results. The auditor also partners 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. The position may maintain or contribute to compliance tracking tools, prepare and present findings and information, and collaborate with providers, residents, coding staff, clinic administrators, leadership, and other stakeholders.
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, maintained throughout employment.
- Knowledge of CPT, ICD-CM, ICD-10, and HCPCS nomenclature.
Nice To Haves
- 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.
- Provide feedback and education to coding and reimbursement specialists and coders.
- 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 implementation of new services, workflows, locations, provider groups, or documentation tools to assess and reduce billing, coding, documentation, supervision, and reimbursement risks.
- Maintain or contribute to tracking tools, including 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.
- Collaborate with providers, residents, coding staff, clinic administrators, leadership, and other stakeholders.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Education Level
High school or GED
