Healthcare Coding Compliance Auditor

Paycom; Southlake (TX); On-site; USD 70,000 - 100,000; Full time

Job summary

GI Alliance is seeking a Compliance Auditor to research and analyze medical records, validate coding, and prepare reports with corrective action recommendations. You will examine claims for compliance, identify fraud risks, and provide second-level billing reviews to ensure adherence to regulations and policies.

Interaction with physicians about documentation and coding is expected. The role requires updating knowledge of ICD-10, CPT, and HCPCS coding, plus strong proficiency in Microsoft

Qualifications

• High School Diploma or GED required.
• AAPC CPC certification required; CPMA within 1 year preferred? stated in doc.
• Proficient with ICD-10, HCPCS II and CPT codes; knowledge of billing guidelines.

Responsibilities

• Audits physician charts to identify incorrect coding and prepares reports.
• Examine claims for compliance with billing guidelines and identify fraud risks.
• Report coding patterns and suggest corrective actions to management.
• Research errors or missing documentation to ensure accurate coding.
• Provide second-level review of billing for compliance with policies.
• Interact with physicians on policies, procedures, and documentation.
• Verify medical record documentation (electronic and handwritten).
• Assign ICD-10, HCPCS/CPT codes for diagnoses and procedures in inpatient/outpatient settings.

Skills

Word

Excel

PowerPoint

ICD-10

CPT/HCPCS

Regulatory knowledge

Education

High School Diploma/GED

AAPC CPC certification

Tools

Microsoft Office

Job description

GI Alliance is seeking a Compliance Auditor to research and analyze medical records, validate coding, and prepare reports with corrective action recommendations. You will examine claims for compliance, identify fraud risks, and provide second-level billing reviews to ensure adherence to regulations and policies.

Interaction with physicians about documentation and coding is expected. The role requires updating knowledge of ICD-10, CPT, and HCPCS coding, plus strong proficiency in Microsoft