Pro Fee Coding Auditor — Audit, Educate & Improve

AAPC; Fairfield (CA); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Medical insurance

Education reimbursement

Retirement plan

Job summary

NorthBay Health is seeking a Professional Fee Coding Auditor to audit professional fee coding across Ambulatory/Hospitalist, Surgery, and ED ProFee, ensuring CPT/HCPCS/ICD-10-CM accuracy and payer rule compliance.

The role involves resolving pre-bill edits, reviewing post-billing denials, and educating coders and physicians based on audit findings to strengthen coding workflows and documentation integrity.

Qualifications

• Minimum 5 years of professional fee coding across multiple specialties.
• Minimum 3 years of auditing and edit-resolution experience.
• Strong knowledge of CPT, HCPCS, ICD-10-CM and payer policies.
• Proficiency with encoders and common coding/billing software.

Responsibilities

• Audit professional fee coding across Ambulatory/Hospitalist, Surgery, and ED ProFee.
• Resolve pre-bill coding edits and validate CPT/HCPCS/ICD-10-CM accuracy.
• Review post-billing denials and coordinate corrective actions with teams.
• Develop coder and physician education based on audit findings.
• Ensure compliance with CMS, AMA, OIG, and payer policies.

Skills

CPC

CCS-P

CPMA

Auditing

Healthcare coding

Education

Associate's or Bachelor's preferred

High School diploma preferred

Tools

3M encoder

EHR systems

Microsoft Office

Job description

NorthBay Health is seeking a Professional Fee Coding Auditor to audit professional fee coding across Ambulatory/Hospitalist, Surgery, and ED ProFee, ensuring CPT/HCPCS/ICD-10-CM accuracy and payer rule compliance.

The role involves resolving pre-bill edits, reviewing post-billing denials, and educating coders and physicians based on audit findings to strengthen coding workflows and documentation integrity.