Documentation & Coding Auditor - Billing Compliance

Military Spouse Jobs & VetJobs; Lubbock (TX); On-site; USD 55,000 - 75,000; Full time

Job summary

Military Spouse Jobs & VetJobs seeks a coding auditor to perform coding and documentation quality audits, provide feedback to coding and reimbursement specialists, and educate staff. This position has no supervisory responsibilities and focuses on compliance and accuracy.

The ideal candidate holds an active coding certification (AAPC/AHIMA), has five years of coding and reimbursement experience, and is proficient with CPT, ICD-CM, ICD-10, and HCPCS nomenclature.

Qualifications

• High School diploma or equivalent and five years of coding and reimbursement experience, including at least one year as a coding auditor.
• Active professional coding certification from AAPC or AHIMA, and certification to remain current during employment.
• Knowledge of CPT, ICD-CM, ICD-10, and HCPCS nomenclature.

Responsibilities

• 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, coding, documentation, supervision, and reimbursement risks before issues elevate by 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 tracking tools, such as 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.

Skills

Coding audits

Reimbursement knowledge

Auditing

Education delivery

Communication with staff

Education

High School diploma or equivalent

AAPC/AHIMA certification

Tools

CPT/ICD-CM/ICD-10/HCPCS nomenclature

Job description

Job Description

Performs coding and documentation quality audits, provides feedback to coding and reimbursement specialists, coders, and educates them. This job has no supervisory responsibilities.

Required Experience

High School graduate or equivalency and five (5) years of coding and reimbursement experience of which one (1) year may be as a coding auditor. Additional job-specific education may substitute for the experience.

Active professional coding certification from an accredited organization, e.g., American Association of Professional Coders (AAPC), American Health Information Management Association (AHIMA). Certification to remain current during term of employment. Knowledge of CPT, ICD-CM, ICD-10, and HCPCS nomenclature.

Preferred Experience

• 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.

Additional Qualifications/Responsibilities

• 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 before issues elevate by 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 tracking tools, such as 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.