Senior Healthcare Coding & Compliance Auditor

Central Health; Austin (TX); Remote; USD 110,000 - 150,000; Full time

Job summary

Central Health is seeking a Senior Compliance Coding Auditor to conduct independent professional coding, billing, and documentation audits across ambulatory practices. You will lead risk-based audits, provider education, and corrective action planning while collaborating with leadership to ensure compliant billing and documentation practices.

The role requires CPC certification and substantial experience in ICD-10-CM, CPT, HCPCS, and payer-specific guidelines, with a focus on accuracy and

Qualifications

• Associates Degree required; higher degrees accepted.
• Minimum 5 years of professional coding experience (procedural and diagnostic).
• Minimum 2 years of coding audit experience with provider education.
• Certified Professional Coder (CPC) required.

Responsibilities

• Conduct retrospective and targeted prospective compliance coding audits for professional services.
• Review documentation to validate CPT, HCPCS, ICD-10-CM, modifiers, and medical necessity.
• Identify risks and develop corrective action recommendations.
• Evaluate compliance with CMS, MAC, Medicaid, and commercial payer regulations.
• Educate providers and staff on coding and documentation requirements.
• Prepare audit reports, dashboards, and leadership presentations.

Skills

ICD-10-CM coding

CPT coding

HCPCS Level II coding

Auditing

Regulatory compliance

Data analysis

Education & training

EHR systems

Communication skills

Excel data analysis

Education

Associates Degree

Tools

Auditing software

EHR systems

Microsoft Excel

Billing systems

Job description

Central Health is seeking a Senior Compliance Coding Auditor to conduct independent professional coding, billing, and documentation audits across ambulatory practices. You will lead risk-based audits, provider education, and corrective action planning while collaborating with leadership to ensure compliant billing and documentation practices.

The role requires CPC certification and substantial experience in ICD-10-CM, CPT, HCPCS, and payer-specific guidelines, with a focus on accuracy and