Senior Healthcare Coding Compliance Auditor

Central Health; Austin (TX); On-site; USD 120,000 - 160,000; Full time

Job summary

Central Health in Austin, Texas seeks a Senior Compliance Coding Auditor to conduct independent coding, billing, documentation, and regulatory audits across ambulatory and specialty care practices. The position supports the organization's compliance program through risk-based auditing, monitoring, provider education, investigation of billing concerns, and development of corrective action plans.

The Senior Compliance Coding Auditor serves as a subject matter expert for professional fee coding,

Qualifications

• Associates Degree required, higher degrees accepted.
• 5+ years of progressively responsible professional coding experience.
• 2+ years of coding audit experience with provider education and documentation review.
• Strong knowledge of ICD-10-CM, CPT, HCPCS Level II, and NCCI edits, plus CMS rules.

Responsibilities

• Conduct retrospective and targeted audits of professional services.
• Review medical records for CPT/HCPCS/ICD-10-CM accuracy and medical necessity.
• Identify risks and develop corrective action recommendations.
• Monitor effectiveness of remediation and assist with audit plan development.
• Educate providers and staff on coding and billing requirements.

Skills

CPT coding

ICD-10-CM

HCPCS Level II

CMS regulations

NCCI edits

Regulatory compliance

Auditing

Data analysis

Communication

Education and training

Education

Associates Degree

Tools

Microsoft Excel

EHR systems

Auditing software

Compliance monitoring tools

Job description

Central Health in Austin, Texas seeks a Senior Compliance Coding Auditor to conduct independent coding, billing, documentation, and regulatory audits across ambulatory and specialty care practices. The position supports the organization's compliance program through risk-based auditing, monitoring, provider education, investigation of billing concerns, and development of corrective action plans.

The Senior Compliance Coding Auditor serves as a subject matter expert for professional fee coding,