Medical Coding Auditor: Audit & Improve Reimbursement

WellStreet Urgent Care; Newnan (GA); On-site; USD 70,000 - 95,000; Full time

Job summary

WellStreet Urgent Care is seeking a Professional Coding Auditor to review clinical documentation and coding for accuracy, completeness and compliance, ensuring alignment between documentation and CPT/ ICD-10 codes. You will educate providers and coders, identify trends, and partner with leadership to improve coding quality and reimbursement.

In this role you will collaborate with the Coding Supervisor and Regional Medical Directors, perform charge entry when needed, and stay current with CMS,

Qualifications

• Active CPC or CCS coding certification through AAPC or AHIMA.
• Relevant professional coding and/or coding auditing experience.
• 2+ years of medical billing experience.
• Urgent Care or Occupational Health billing experience.
• Experience working with insurance payers, A/R, revenue cycle processes, and denied claims.
• Experience with billing software and electronic medical records.
• Epic experience is a plus.
• High school diploma or equivalent.

Responsibilities

• Perform coding audits of provider documentation and assigned CPT and ICD-10 codes.
• Evaluate whether clinical documentation supports the diagnoses and procedures billed.
• Identify coding errors, documentation deficiencies, charge-capture issues, and opportunities for improvement.
• Review coding deliverables from professional coders, physicians, and other healthcare professionals.
• Provide constructive, educational feedback to providers and coders.
• Deliver education related to coding requirements, documentation standards, and regulatory updates.
• Stay current on CMS, state, and payer coding regulations and requirements.
• Collaborate with the Coding Supervisor and Regional Medical Directors to improve documentation and coding accuracy.
• Perform charge entry and Charge Review activities as needed.
• Identify trends such as undercoding or other recurring coding issues and recommend corrective actions.
• Support error correction and process improvement initiatives.Meet established daily production and quality standards.

Skills

Critical thinking

Analytical skills

Attention to detail

Education

High school diploma or equivalent

Tools

Billing software

Electronic Medical Records

Epic

Job description

WellStreet Urgent Care is seeking a Professional Coding Auditor to review clinical documentation and coding for accuracy, completeness and compliance, ensuring alignment between documentation and CPT/ ICD-10 codes. You will educate providers and coders, identify trends, and partner with leadership to improve coding quality and reimbursement.

In this role you will collaborate with the Coding Supervisor and Regional Medical Directors, perform charge entry when needed, and stay current with CMS,