California Licensed Coding Auditor

Job Summary

Performing quality reviews and audits remotely, the California Licensed Coding Auditor will ensure compliance with DRG validation, ICD-10/PCS, and CPT coding guidelines while contributing to process improvements and acting as a subject matter expert in coding practices.

Key responsibilities:

• Conduct regular quality reviews and audits for hospital inpatient, outpatient, and professional fee coding, facilitating the coder audit appeal process as needed
• Prepare detailed audit reports that outline findings, recommendations, and corrective actions while assisting team members with coding questions
• Identify educational opportunities for coding staff and maintain up-to-date knowledge of coding guidelines, quality standards, and regulatory changes affecting the audit process

Required qualifications:

• High School Education/GED or equivalent required; Associate's/Technical Degree preferred
• Five years of acute care inpatient, outpatient coding experience, and/or professional fee coding required
• Three years of coding auditing/monitoring experience preferred
• Certified Coding Specialist credential (CCS) through AHIMA or AAPC required
• Expert-level knowledge of medical coding practices and concepts