Healthcare Coding & Reimbursement Auditor

Avera Health; Sioux Falls (SD); On-site; USD 42,000 - 63,000; Full time

Benefits offered by this job

PTO on day 1

Up to 5% retirement matching

Career development & mentorship

Inclusive employer

Job summary

Avera Health is seeking an Auditor to support health information management, coding review, and reimbursement processes across hospitals and clinics in Sioux Falls. You will audit charts, review ICD-10 and CPT coding, and present findings to improve accuracy and compliance.

You will partner with HIM, coding teams, physicians, and billing staff to educate on findings, ensure regulatory compliance, and maintain data integrity across multiple sites.

Qualifications

• Associate's in Health Information Management or related field.
• RHIA, RHIT, CCS, CCS-P, CIC, COC, CPC and CRC AHIMA/AAPC credentials upon hire.
• 4–6 years of multi-specialty coding, coding auditing, or related quality assurance work with ICD-10 and CPT.

Responsibilities

• Audits hospital/clinic coded charts and prepares written reports with findings and recommendations.
• Analyzes financial impact after audits across PPS, CAH and Professional Physician services.
• Provides and coordinates education to coders, physicians, and staff on coding and billing findings.
• Presents in-service education to coders, physicians, and committees as needed.
• Acts as liaison between HIM and billing departments across facilities.
• Keeps apprised of CMS and regional contractor requirements to minimize audit risks.

Skills

Coding auditing

Effective communication

Team collaboration

Attention to detail

Education

Associate's in Health Information Management

RHIA certification

RHIT certification

CCS certification

CCS-P certification

CIC certification

COC certification

CPC certification

CRC certification

Bachelor's in Health Information Management

Job description

Avera Health is seeking an Auditor to support health information management, coding review, and reimbursement processes across hospitals and clinics in Sioux Falls. You will audit charts, review ICD-10 and CPT coding, and present findings to improve accuracy and compliance.

You will partner with HIM, coding teams, physicians, and billing staff to educate on findings, ensure regulatory compliance, and maintain data integrity across multiple sites.