Healthcare Coding & Billing Compliance Auditor

DaMar Staffing; Galveston (TX); On-site; USD 70,000 - 100,000; Full time

Job summary

DaMar Staffing seeks a qualified Auditor to assess coding accuracy, documentation adequacy, and reimbursement alignment across professional and hospital billing. You will audit both inpatient and outpatient records, ensuring compliance with CMS, MACs, RACs, and related regulations.

Required: Bachelor's degree or equivalent with at least four years of experience and AHIMA CCS certification. Strong knowledge of CPT/ICD-10-CM/HCPCS is essential.

Qualifications

• Bachelor's degree or equivalent and at least four years of relevant experience.
• Certified Coding Specialist (CCS) by AHIMA required.

Responsibilities

• Uses auditing software to conduct random or focused audits of professional and facility billing.
• Performs prospective and retrospective audits to ensure documentation supports billed services per CMS and MACs rules.
• Applies CPT, ICD-10-CM, ICD-10-PCS, DRG, and HCPCS knowledge to review billed services.
• Maintains awareness of regulations and coordinates with Billing Compliance to educate on issues.
• Reviews coding accuracy and ensures medical records support the services billed.

Skills

Auditing

Healthcare compliance

Coding guidelines

Education

Bachelor's degree or equivalent

AHIMA CCS certification

Tools

Auditing software

Job description

DaMar Staffing seeks a qualified Auditor to assess coding accuracy, documentation adequacy, and reimbursement alignment across professional and hospital billing. You will audit both inpatient and outpatient records, ensuring compliance with CMS, MACs, RACs, and related regulations.

Required: Bachelor's degree or equivalent with at least four years of experience and AHIMA CCS certification. Strong knowledge of CPT/ICD-10-CM/HCPCS is essential.