Provider Documentation & Billing Auditor - Limited Duration

Mary Free Bed; United States; Remote; USD 75,000 - 110,000; Full time

Job summary

Mary Free Bed Rehabilitation Hospital is seeking a Provider Documentation and Billing Auditor for a limited duration to support leave coverage. The role focuses on auditing provider documentation, coding, billing, and reimbursement practices to ensure compliance with federal/state laws, payer guidelines, and internal policies.

You will identify risks, monitor processes, and collaborate with clinical and revenue cycle leaders to strengthen controls and improve documentation accuracy.

Qualifications

• Bachelor’s degree or higher in health information management, healthcare administration, nursing or related field.
• 2-5 years of provider coding and billing experience in professional services.
• Extensive knowledge of E/M CPT ICD-10-CM HCPCS and payer requirements.
• Strong understanding of healthcare compliance policies and auditing principles.

Responsibilities

• Conduct audits of provider documentation, coding, and billing for compliance.
• Evaluate accuracy and adequacy of clinical documentation for billed services.
• Identify overpayments/underpayments and recommend corrective actions.
• Educate providers and staff on documentation and billing requirements.
• Maintain audit workpapers and collaborate with Compliance, revenue cycle, and clinical leadership.

Skills

Auditing

Healthcare compliance

Coding knowledge

Problem solving

Education

Bachelor's degree in HIM or health admin

Job description

Provider Documentation & Billing Auditor - Limited Duration# Mary Free Bed Rehabilitation Hospital## Provider Documentation & Billing Auditor - Limited DurationApply: Remote: Full time: Posted Today: JB103495**This is a limited duration role to cover for a leave of absence.** **Position is eligible for remote work within the United States.**## SummaryThe Provider Documentation and Billing Auditor is responsible for conducting independent audits, reviews, and monitoring activities related to provider documentation, coding, billing, and reimbursement practices across the Mary Free Bed system. This role evaluates compliance with organizational policies and procedures, federal and state laws and regulations, payer requirements, and applicable coding and billing standards to help ensure the integrity of provider services and revenue cycle operations. The Auditor assesses existing documentation, coding, and billing processes to identify compliance risks, control gaps, operational inefficiencies, and opportunities for improvement. Through audit findings, data analysis, and collaboration with clinical, operational, and provider leaders, the Auditor develops recommendations to strengthen internal controls, enhance documentation accuracy, improve billing compliance, and support appropriate reimbursement. A key responsibility of this position is to identify, investigate, correct, and help prevent documentation and billing issues through ongoing monitoring, education, and proactive compliance initiatives. The Auditor serves as a subject matter resource for providers, advanced practice providers, leadership, and staff regarding documentation integrity, coding accuracy, billing requirements, and regulatory expectations. The Provider Documentation and Billing Auditor plays a critical role in promoting a culture of integrity, accountability, and compliance throughout the organization by fostering awareness of regulatory requirements and supporting continuous improvement efforts. This position reports directly to the Compliance Officer.## Essential Job Responsibilities* Conduct audits and reviews of provider documentation, coding, billing, and reimbursement practices to assess compliance with applicable laws, regulations, payer requirements, and organizational policies.* Evaluate the accuracy, completeness, and adequacy of clinical documentation to ensure services billed are supported by the medical record and meet coding, billing, and medical necessity requirements.* Perform ongoing monitoring activities to identify compliance risks, billing vulnerabilities, coding trends, and opportunities for process improvement.* Review provider and advanced practice provider documentation for adherence to federal and state regulations, Medicare and Medicaid requirements, commercial payer guidelines, and industry standards.* Identify potential overpayments, underpayments, coding inaccuracies, documentation deficiencies, and other compliance concerns, and recommend appropriate corrective actions.* Collaborate with compliance team, providers, advanced practice providers, revenue cycle staff, operational leaders, and other departments to resolve identified issues and improve compliance performance.* Provide education and training to providers and staff regarding documentation requirements, coding standards, billing regulations, compliance expectations, and best practices.* Serve as a subject matter resource on provider documentation integrity, coding, billing compliance, reimbursement requirements, and regulatory developments.* Assist in the development, review, and revision of policies, procedures, and internal controls related to provider documentation, coding, billing, and compliance activities.* Maintain thorough and accurate audit workpapers, documentation, reports, and records in accordance with compliance and departmental standards.* Assist in monitoring changes in healthcare laws, regulations, payer guidance, coding requirements, and industry best practices, and assess organizational impact.* Promote a culture of integrity, ethical conduct, accountability, and regulatory compliance throughout the Mary Free Bed system. Perform other duties and special projects as assigned by the Compliance Officer. **We’ll embrace all people by:****T**reating everyone with dignity and respect.**O**pening more doors to opportunity for others to succeed.**G**rowing talent and people.**E**nsuring a welcoming experience for all we serve, regardless of origin, race, religion, disability, sexual orientation or socioeconomic status.**T**aking action against discrimination.**H**onoring our differences and how we collaborate.**E**ducating staff, patients and the communities we care for. Restoring hope and freedom, together.## Customer Service ResponsibilitiesDemonstrate excellent customer service and standards of behaviors as well as encourages, coaches, and monitors the same in team members. This individual should consistently promote teamwork and direct communication with co-workers and deal discretely and sensitively with confidential information.**Responsibilities in Quality Improvement**Contribute by identifying problems and seeking solutions. Promote patient/family satisfaction where possible; participates in departmental efforts to monitor and report customer service.## **Essential Job Qualifications*** Education: Bachelor’s degree or higher in health information management, healthcare administration, nursing or related field.* Experience: 2-5 years of provider coding and billing experience in professional services.Experience auditing:* Evaluation and Management (E/M) services* CPT coding* ICD-10-CM diagnosis coding* HCPCS Level II coding* Modifier usage* Medicare and commercial payer requirements* Documentation requirements supporting billed services * Extensive knowledge of healthcare compliance policies, programs, practices, standards and related compliance issues* Advanced knowledge of compliance and auditing principles, theories and concepts* Auditing, Compliance, Healthcare billing and/or coding certification preferred.* Knowledge of billing procedures and systems.* Demonstrated experience and success with customer service principles with a varying group of people* Possesses organizational, communication and complex problem-solving skills* Experience with computers and application software* Works independently and with minimal direction.* Works efficiently and with flexibility in high-stress and fast-paced situations.* Participates as a collaborative team member to maximize group effectiveness. Maintaining confidentiality of MFB Health records and systems## Physical Requirements for Essential Job Qualification**Levels**:* None (No specific requirements)* Occasionally (Less than 1/3)* Frequently (1/3 to 2/3)* Majority (More than 2/3)Remain in a stationary position: FrequentlyTraverse or move around work location: OccasionallyUse keyboard: MajorityOperate or use department specific equipment: OccasionallyAscend/Descend equipment or ladder: NonePosition self to accomplish the Essential Functions of the role: Occasionally Receive and communicate information and ideas for understanding: FrequentlyTransport, position, and/or exert force: *Up to 10 pounds:* Occasionally*Up to 25 pounds:* None*Up to 50 pounds:* None *Up to 75 pounds:* None*More than 100 pounds:* None*Other weight: Up to\\_\\_\\_ pounds* \\_\\_\\_\\_\\_ Other: \\_\\_\\_\\_\\_*Consistent with the Americans with Disabilities Act (ADA), it is the policy of Mary Free Bed Rehabilitation Hospital to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact the Talent Acquisition team at* *[e-mail]**.**Mary Free Bed is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, genetic information, veteran status, disability or other legally protected characteristic.*### About UsAt Mary Free Bed, we work towards putting everybody in motion. Fueled by our passion for innovative, integrated rehabilitation care, our teams work together to elevate everyone’s potential. Whether you’re here to ensure a safe environment at our hospitals, provide clinical care or help our patients navigate their next appointment, we’re united by the same mission: to restore hope and freedom through rehabilitation. Everyone plays an integral role in defining a better future for ourselves, our patients, and our communities. You included.