Coding Quality Assurance Auditor

Novant Health; North Carolina; On-site; USD 85,000 - 115,000; Full time

Benefits offered by this job

Medical, dental, vision & life保险

Retirement fund with matching

Tuition assistance

Flexible work schedule after training

Job summary

Novant Health is seeking an experienced medical coder auditor to join the RCS Coding Department. You will perform coding audits, assess ICD-9-CM/ICD-10-CM usage, CPT and HCPCS codes, and ensure compliance with auditing policies.

The role requires 5+ years of coding experience and 2+ years of coding audit experience, with strong knowledge of coding principles and payer regulations. A CPC/CCS/RHIT certification is preferred, and a flexible schedule is offered after training.

Qualifications

• CPC/CCS or RHIT certification required.
• High school diploma or GED required.
• 5+ years professional coding experience in core areas.
• 2+ years auditing experience for coding compliance/accuracy.
• Extensive knowledge of ICD-9-CM/ICD-10-CM, CPT and HCPCS.
• Knowledge of reimbursement systems and payer regulations.

Responsibilities

• Perform coding audit activities for the NHmg RCS Coding Department.
• Audit use of ICD-9-CM, ICD-10-CM, CPT and HCPCS codes and modifiers.
• Document and report issues identified during auditing processes and support the team.

Skills

Analytical skills

Strong communication

Medical terminology

Audit experience

Education

CPC/CCS/RHIT certification

High School Diploma or GED

Tools

ICD-9-CM

ICD-10-CM

CPT

HCPCS

Job description

What We Offer

• Comprehensive benefits include medical, dental, vision, and life insurance.
• Retirement fund with matching contributions.
• Tuition assistance for qualifying team members.
• A flexible work schedule after initial training.

What You'll Do

• Perform coding audit activities for the NHmg RCS Coding Department.
• Conduct audits that include assessments of proper use of ICD-9-CM, ICD-10-CM, CPT and HCPCS codes, modifiers, NCCI usage and all other applicable coding guidelines.
• Support the coding department by proactively auditing the team according to the RCS audit policy, and documenting/reporting issues identified during auditing processes.

What We're Looking For

Required

• CPC, CCS or RHIT certification.
• High School Diploma or GED.
• 5+ years of professional coding experience (in all core areas).
• 2+ years of auditing experience for coding compliance/accuracy.
• Extensive knowledge of ICD-9-CM, ICD-10-CM, CPT and HCPCS coding principles and guidelines.
• Extensive knowledge of reimbursement systems.
• Extensive knowledge of federal, state, and payer specific regulations and policies pertaining to documentation, coding, and billing.
• Excellent verbal and written communication skills and the ability to effectively communicate with coding team members, providing positive constructive feedback from audit results.
• Advance level knowledge of medical terminology.
• Proven analytical ability and organizational skills necessary to organize/assess quality assurance based on data analysis.

Preferred

• CPMA certification.
• Strong surgical coding experience is key for this role.
• In depth background and knowledge of medical documentation, fraud, abuse, and penalties for documentation and coding violations based on government guidelines.
• Scope and statistical sampling methodologies, medical record auditing skills, and abstraction ability.
• Quality assurance and coding risk analysis.

Why Choose Novant Health?

At Novant Health, we believe remarkable care starts with compassion for our patients, our communities, and each other. We value belonging, courage, personal growth, and teamwork, creating a space where everyone is respected, supported, and safe to show up as their full selves.