Surgical Coding Auditor

Alteva RCM

13d•$80,000 - $100,000

About The Position

The Coding Auditor conducts routine coding audits across assigned specialties, coders, and client accounts to assess coding accuracy, documentation sufficiency, and compliance with applicable coding guidelines and payer requirements. The role produces documented audit findings, supports corrective action follow-through, and contributes to compliance monitoring and education efforts. The Coding Auditor works with the Senior Coding Auditor and Coding Audit Manager to develop technical skills, maintain consistent audit quality, and become an increasingly independent contributor to the audit program. The position includes reviewing clinical documentation and coded encounters; evaluating code selection, sequencing, modifiers, units, and other coding elements; documenting and reporting findings; providing constructive feedback and education support; and identifying trends or potential compliance risks. The auditor maintains confidentiality of protected health information and follows HIPAA, organizational policies, and applicable regulatory requirements.

Requirements

Active CPMA certification and at least one of the following: CPC, CCS, RHIT, or RHIA.
At least 5 years of surgical coding experience.
At least 1 year of coding audit experience.
Proficiency in Microsoft Office applications, including Excel, Word, and Outlook.
Ability to multitask, prioritize workload, and meet deadlines in a fast-paced environment.
Strong communication and interpersonal skills.
Exceptional attention to detail and organizational skills.
Ability to work independently while contributing to a team-oriented environment.
Demonstrated problem-solving skills and a proactive, solution-driven approach.

Nice To Haves

2 or more years of coding audit experience preferred.
Experience with reporting and data analysis tools preferred.

Responsibilities

Conduct routine coding audits across assigned specialties and client accounts, reviewing documentation and coded encounters for accuracy, alignment, and compliance.
Evaluate code selection, sequencing, modifiers, units, and other applicable coding elements against clinical documentation.
Apply ICD-10-CM, CPT, HCPCS, modifier rules, and payer-specific requirements, supporting audit determinations with appropriate authoritative references and departmental guidance.
Complete assigned audit volumes within established turnaround expectations and quality standards.
Perform audits independently within established guidelines and methodology, and escalate complex, unclear, or policy-level matters to the Senior Coding Auditor.
Participate in audit calibration activities to promote consistent and accurate interpretation of coding guidelines.
Document audit findings, discrepancies, root causes, and corrective recommendations clearly and accurately.
Prepare individual audit reports and summary submissions using department templates and standards.
Maintain organized and complete audit records and files in accordance with department requirements.
Compile audit data for submission to the Coding Audit Manager for trend analysis and reporting.
Communicate audit findings to audited coders professionally and constructively, grounded in applicable guidelines.
Provide individualized coding feedback and assist with audit-driven education, including written feedback, reference materials, team huddles, and education sessions.
Re-audit previously identified findings to assess corrective action effectiveness.
Identify patterns in audit findings and report observations to the Coding Audit Manager and Senior Coding Auditor.
Remain current with coding guidelines, payer updates, and regulatory requirements relevant to assigned specialties.
Flag potential compliance risks or emerging accuracy issues to the Senior Coding Auditor or Coding Audit Manager.
Support audit readiness activities and audit program documentation as directed.
Maintain confidentiality and safeguard protected health information in accordance with HIPAA, organizational policies, and applicable regulatory requirements.