Senior Healthcare Coding & Billing Auditor

Cape Cod Healthcare Inc.; Hyannis (MA); On-site; USD 80,000 - 105,000; Full time

Job summary

Cape Cod Healthcare Inc. is seeking a Coding and Billing Compliance Auditor to ensure accuracy and regulatory compliance across the health system. You will conduct audits, identify discrepancies, and educate staff to reduce risk and optimize reimbursement.

The role requires five years of physician coding auditing experience and current CCS/CPC/CCS-P certification, with strong knowledge of ICD-9/10, CPT, HCPCS and EHR/billing software.

Qualifications

• Ability to read, write and communicate in English
• Bachelor’s degree in Law, Healthcare, Compliance, Finance, Business, or Accounting or equivalent
• Minimum of five years’ experience in physician coding, including auditing experience
• Current certification: CCS or CPC or CCS-P
• Comprehensive knowledge of ICD-9/10, CPT, and physician billing requirements
• Proficiency with EHR and billing software
• Ability to develop and deliver training materials

Responsibilities

• Conduct regular audits of medical records, coding, and billing practices to ensure accuracy and compliance.
• Evaluate claims for compliance with ICD-10, CPT, HCPCS, and other coding standards.
• Present findings to leadership and compliance committees.
• Provide timely feedback and education to coders and staff on requirements.
• Develop and implement training programs on coding standards and updates.
• Collaborate with Revenue Cycle, HIM, CDI, and Compliance teams.
• Support external audits and respond to payer/government inquiries.

Skills

Auditing

Healthcare compliance

Coding standards

Training delivery

Interdepartmental collaboration

Education

Bachelor’s degree in Law, Healthcare, Compliance, Finance, Business, or Accounting

Five years’ physician coding auditing experience

CCS / CPC / CCS-P certification

Tools

EHR systems

Billing software

Job description

Cape Cod Healthcare Inc. is seeking a Coding and Billing Compliance Auditor to ensure accuracy and regulatory compliance across the health system. You will conduct audits, identify discrepancies, and educate staff to reduce risk and optimize reimbursement.

The role requires five years of physician coding auditing experience and current CCS/CPC/CCS-P certification, with strong knowledge of ICD-9/10, CPT, HCPCS and EHR/billing software.