Medical Coding Auditor: CPT/ICD Compliance & Revenue Integrity

Providence St. Joseph Health; Anaheim (CA); On-site; USD 62,000 - 95,000; Full time

Benefits offered by this job

Health benefits

401(k) retirement plan with employer-m

Paid time off

Job summary

Providence Medical Foundation is seeking a Coding Auditor to review patient care documentation for CPT/ICD coding compliance and payor policies. You will work under the Director Provider Network Performance to ensure accurate and compliant billing across services.

The role requires a coding background with 3+ years of experience in multiple specialties and physician/clinic billing, plus AHIMA/AAPC certifications. Strong Microsoft Office skills are expected.

Qualifications

• Associate degree or relevant work experience in medical offices (insurance, coding, billing, registration).
• National Certification from AHIMA or American Health Information Management Association (AHIMA) or AAPC at hire.
• 3 years of professional coding experience in multiple specialties (HCC coding, primary care, oncology, infusion, neurology, OB/GYN, cardiology, endocrinology, rheumatology, general surgery).
• 3 years of physician/clinic billing experience.
• Experience with Microsoft Office suite.

Responsibilities

• Perform coding audits of patient care billing documentation to ensure adherence with CPT/ICD guidelines and payor policies.
• Contribute to Provider Network Performance operations and quality initiatives.
• Support compliance with federal, state, and payor policies in coding and billing.

Skills

Medical coding

HCC coding

Billing

Office documentation

Education

Associate's Degree in Coding

AHIMA/AAPC Certification (various)

Other relevant coding certifications

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Providence Medical Foundation is seeking a Coding Auditor to review patient care documentation for CPT/ICD coding compliance and payor policies. You will work under the Director Provider Network Performance to ensure accurate and compliant billing across services.

The role requires a coding background with 3+ years of experience in multiple specialties and physician/clinic billing, plus AHIMA/AAPC certifications. Strong Microsoft Office skills are expected.