Healthcare Coding Education & Quality Auditor

nghs; Gainesville (GA); On-site; USD 60,000 - 90,000; Full time

Job summary

Northeast Georgia Health System is seeking a Coding Education & Quality Auditor (CEQA) to conduct coding/billing/documentation audits for NGPG/NGHS providers. The role ensures medical necessity, regulatory compliance, and supports continuous improvement through education and action plans.

Responsibilities include auditing with ICD-9/ICD-10/CPT/HCPCS, communicating results to physicians and leadership, and developing education programs while maintaining data integrity and program standards.

Qualifications

• Licensure or other certifications: CPC and/or CCS-P Coding Certification; CPMA, CEMC or other nationally recognized healthcare auditing certification required at hire or within 6 months.
• Educational requirements: High School Diploma or GED.
• Minimum experience: 3+ years in healthcare coding, auditing or documentation review with CPT/ICD-10-CM usage.

Responsibilities

• Coordinates and performs professional services documentation and coding audits for outpatient records.
• Reviews clinical documentation for completeness, accuracy and data integrity.
• Audits provider coding using ICD-10, CPT, HCPCS, and CMS guidelines.
• Delivers findings to providers and leadership and recommends improvements.
• Trains providers on coding/documentation expectations and supports education efforts.
• Ensures charts meet compliance standards and prepares audit reports by provider.

Skills

Coding knowledge

Regulatory understanding

Microsoft Office

Complex concepts explain

Data analysis

Presentation delivery

Team collaboration

Attention to detail

Education

CPC Certification

CCS-P Certification

CPMA or CEMC certification

High School Diploma or GED

Tools

Microsoft Office

Excel

PowerPoint

Job description

Northeast Georgia Health System is seeking a Coding Education & Quality Auditor (CEQA) to conduct coding/billing/documentation audits for NGPG/NGHS providers. The role ensures medical necessity, regulatory compliance, and supports continuous improvement through education and action plans.

Responsibilities include auditing with ICD-9/ICD-10/CPT/HCPCS, communicating results to physicians and leadership, and developing education programs while maintaining data integrity and program standards.