Certified Coding Auditor II

Job Summary

Conducting proactive audits and compliance investigations, the full-time remote Certified Coding Auditor II will identify and address billing and coding errors while ensuring adherence to healthcare regulations and coding guidelines.

Key responsibilities

• Initiate and perform coding and billing audits to detect potential errors and ensure compliance before claims submission
• Analyze billing and coding data to identify patterns of non-compliance and assess the accuracy of medical service documentation
• Prepare detailed audit reports summarizing findings and recommendations, and collaborate with departments to implement corrective actions

Required qualifications

• Associate's degree in a related field from an accredited institution or equivalent experience
• Minimum of four (4) years of progressively responsible work experience in billing and coding compliance
• Knowledge of coding conventions including ICD-10-CM/PCS, HCPCS, E&M, and CPT
• Ability to conduct detailed healthcare compliance audits and prepare comprehensive reports
• CCS, CCS-P, CPC, CIC, or COC certification required within 180 days of hire