Senior Billing & Coding Compliance Auditor

Cape Cod Healthcare; Hyannis (MA); On-site; USD 87,000 - 125,000; Full time

Job summary

Cape Cod Healthcare in Hyannis, MA, is seeking a Coding and Billing Compliance Auditor to ensure accuracy and regulatory adherence across the health system. The role conducts audits, educates staff on coding requirements, and collaborates with Revenue Cycle, HIM, CDI, and Compliance teams to mitigate risk and optimize reimbursement.

Candidates should have five years of physician coding/auditing experience, CPC or CCS-P certification, and a strong understanding of ICD-10, CPT, and payer

Qualifications

• Bachelor’s degree or higher in Healthcare, Compliance, Finance, Business or Accounting or equivalent.
• Minimum of five years’ experience in physician coding, including auditing experience.
• Current certification: CPC or CCS-P; preferred specialty certifications in E/M CEMC or CPMA

Responsibilities

• Conduct regular audits of medical records, coding, and billing practices to ensure accuracy and compliance with federal, state, and payer regulations.
• Evaluate claims for compliance with ICD-10, CPT, HCPCS, and other coding standards; identify errors and discrepancies.
• Prepare comprehensive audit reports summarizing findings, trends, and recommendations; maintain documentation of audits and follow-up actions.
• Present findings to leadership and compliance committees; provide timely education to coders and staff.
• Develop, implement, and evaluate training programs addressing coding standards and updates; assist with external audits as needed.

Skills

CPC

CCS-P

Auditing

EHR software

Education

Bachelor’s degree in Healthcare/Compliance/Finance or related field

Tools

EHR systems

Job description

Cape Cod Healthcare in Hyannis, MA, is seeking a Coding and Billing Compliance Auditor to ensure accuracy and regulatory adherence across the health system. The role conducts audits, educates staff on coding requirements, and collaborates with Revenue Cycle, HIM, CDI, and Compliance teams to mitigate risk and optimize reimbursement.

Candidates should have five years of physician coding/auditing experience, CPC or CCS-P certification, and a strong understanding of ICD-10, CPT, and payer