Medical Coding Auditor & Compliance Specialist

Wilmington Health; Wilmington (NC); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Wilmington Health in Wilmington, NC seeks a Coding Auditor to perform medical record and coding compliance reviews, ensuring internal controls meet CMS, AHIMA, AMA standards and regulatory requirements.

The role conducts audits, presents findings, and supports Providers with documentation improvements while helping develop clinic-wide coding policies and training programs.

Qualifications

• High school diploma or equivalency.
• CCS-P or CPC certification required.
• AAPC or AHIMA certification preferred.

Responsibilities

• Conduct internal audits and prepare detailed audit reports.
• Provide feedback to Providers on documentation improvements.
• Review and update coding and documentation policies.
• Educate clinic staff on documentation and coding compliance.
• Interact with Providers and clinic staff to ensure policy compliance.

Skills

CCS-P

CPC

AAPC AHIMA certs

Education

High school diploma

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Coding Auditor - 3147 S 17th St - Full Time

Compliance Full Time Wilmington, NC, US

30+ days ago Requisition ID: 2998

About Wilmington Health

Since 1971, Wilmington Health has been committed to the care and health of our community in Wilmington as well as all of Southeastern North Carolina. Wilmington Health is structured as a multi-specialty medical practice with primary care providers integrated into the system. In this way, Wilmington Health is able to provide a comprehensive and coordinated approach to the care of all our patients. Wilmington Health is committed to using collaborative, evidence-based medicine in providing the highest quality of care to the patients we serve.

Purpose:

The Internal Auditor is responsible for conducting regular medical record and coding compliance audits across a multispecialty medical practice to evaluate coding accuracy, and compliance with CPT, ICD-CM, and CMS guidelines.

This position partners with providers, managers, and directors to identify educational opportunities for documentation and coding improvement.

• Perform coding audits for E/M services and procedures across multiple specialties by ensuring services billed are supported.
• Apply current CPT, ICD-10-CM, CMS and payer coding guidelines to audit findings.
• Identify coding discrepancies, documentation gaps, compliance risks, and opportunities for improvement.
• Provide one-on-one and group education to providers regarding coding and documentation best practices.

QUALIFICATIONS

• Strong knowledge of CPT and ICD-10-CM guidelines.
• Experience working within a multispecialty medical practice
• The ability to understand documentation and coding requirements across specialties.
• Excellent verbal and written communication skills
• The ability to work independently and manage multiple audits

Required:

• CPC or CCS-P Coding Certification
• Experience with physician professional-fee auditing

Preferred:

• Additional certifications CPMA, CRC, or other relevant coding/auditing certification

ADA Physical Demands:

Rarely (Less than .5 hrs/day) Occasionally (0.6 – 2.5 hrs/day) Frequently (2.6 – 5.5 hrs/day) Continuously (5.6 – 8.0 hrs/day)