Senior Healthcare Coding Compliance Auditor

Central Health; Northern (KY); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Central Health is seeking a Senior Compliance Coding Auditor to conduct independent coding and billing audits across ambulatory and specialty care practices. The role supports the organization’s compliance program through risk-based auditing, education, and investigation of billing concerns.

The position requires advanced knowledge of ICD-10-CM, CPT, HCPCS, and E/M documentation, with experience in evaluating regulatory requirements and implementing corrective actions.

Qualifications

• Associates Degree (or higher) required or equivalent.
• Minimum 5 years of professional coding experience with procedural and diagnostic coding.
• At least 2 years of coding audit experience, with provider education and documentation review.
• CPC certification or equivalent credential preferred.

Responsibilities

• Auditing and monitoring of professional services across ambulatory and specialty care.
• Review documentation for CPT, HCPCS, ICD-10-CM and modifier accuracy.
• Identify coding and billing risks and recommend corrective actions.
• Ensure compliance with CMS, MAC, Medicaid, and commercial payer rules.
• Develop and deliver coding and compliance education for providers and staff.
• Collaborate with Revenue Cycle, IT, Finance, and Legal teams to support compliant practices.

Skills

Coding expertise

Regulatory compliance

Analytical thinking

Effective communication

Education

Associates Degree (or higher)

Tools

EHR systems

Auditing software

Excel

Job description

Central Health is seeking a Senior Compliance Coding Auditor to conduct independent coding and billing audits across ambulatory and specialty care practices. The role supports the organization’s compliance program through risk-based auditing, education, and investigation of billing concerns.

The position requires advanced knowledge of ICD-10-CM, CPT, HCPCS, and E/M documentation, with experience in evaluating regulatory requirements and implementing corrective actions.