Healthcare Coding & Compliance Auditor

CommonSpirit Health; Tacoma (WA); Presencial; USD 70.000 - 95.000; Jornada completa

Descripción de la vacante

Virginia Mason Franciscan Health is seeking an Auditor Coder Specialist to safeguard financial integrity and regulatory compliance across the facility. You will conduct comprehensive audits of financial records, processes, and coding accuracy, identify risks, and provide actionable recommendations to enhance performance and prevent fraud.

You will review provider E/M profiles, respond to coding questions, and help develop training materials to improve documentation and billing compliance,

Formación

• Two years of ICD-10-CM and CPT coding in acute/ambulatory care settings.
• Certification as a coding specialist required upon hire (or equivalent).
• Certification in physician-based coding preferred at hire or equivalent.
• Certification as a CPC (Certified Professional Coder) upon hire.
• Experience in provider coding/documentation auditing is a plus.

Responsabilidades

• Performs internal audits and billing compliance reviews to ensure adherence to standards and guidelines.
• Reviews E/M profiles and practice patterns to identify compliance risks and opportunities for improvement.
• Documents audit results, tracks risks and trends, and communicates findings to stakeholders.
• Develops training materials and action plans to improve documentation and coding accuracy.
• Responds to coding questions and provides guidance on CPT/ICD-10-CM and reimbursement requirements.
• Reviews and corrects denied claims; suggests Epic edits and process improvements.
• Maintains project work lists and auditing software per procedures.

Conocimientos

ICD-10-CM coding

CPT coding

Auditing

Regulatory compliance

Educación

Certified Coding Specialist

Certified Coding Specialist - Physician Based

Certified Professional C coder

Herramientas

Epic

Descripción del empleo

Virginia Mason Franciscan Health is seeking an Auditor Coder Specialist to safeguard financial integrity and regulatory compliance across the facility. You will conduct comprehensive audits of financial records, processes, and coding accuracy, identify risks, and provide actionable recommendations to enhance performance and prevent fraud.

You will review provider E/M profiles, respond to coding questions, and help develop training materials to improve documentation and billing compliance,