Healthcare Coding Auditor & Education Specialist

highmarkhealth; Pennsylvania; Hybrid; USD 70,000 - 100,000; Full time

Job summary

Allegheny Health Network is seeking a seasoned Coding Auditor to perform audits of medical records for coding accuracy and documentation quality. You will train staff, review DRG/APC structures, and ensure adherence to ICD-CM/ICD-PCS and CPT/HCPCS guidelines to support compliant coding.

Responsibilities include developing audit reports, presenting findings, and coordinating with external auditors and management to drive process improvements and education efforts across AHN facilities.

Qualifications

• High school diploma or GED is required.
• AAPC or AHIMA credentials (RHIT/CCS) for inpatient or outpatient.
• AAPC outpatient credentials (CPC/COC/CPMA) are required.
• 5 years hospital or physician coding/auditing experience; includes education techniques and methods.
• Deep knowledge of ICD-CM/ICD-PCS, CPT/HCPCS; DRG/APC structure and guidelines.

Responsibilities

• Plans, conducts audits and reports on coding, documentation and billing.
• Develops training materials and educates staff to address deficiencies identified in audits.
• Validates coding systems and ensures compliance with DRG/APC structure and regulatory requirements.
• Interacts with external auditors and management to improve documentation and processes.

Education

High school diploma or GED

AAPC/AHIMA credentials (RHIT/CCS, CPC/COC/CPMA)

Job description

Allegheny Health Network is seeking a seasoned Coding Auditor to perform audits of medical records for coding accuracy and documentation quality. You will train staff, review DRG/APC structures, and ensure adherence to ICD-CM/ICD-PCS and CPT/HCPCS guidelines to support compliant coding.

Responsibilities include developing audit reports, presenting findings, and coordinating with external auditors and management to drive process improvements and education efforts across AHN facilities.