Certified Coding Compliance Auditor

Job Summary

To ensure compliance and accurate reimbursement, the full-time remote Certified Coding Compliance Auditor will audit hospital inpatient, ambulatory surgery, and observation visits, serving as a clinical coding subject matter expert while providing training and support to coding specialists.

Key responsibilities

• Conduct audits of ICD-10 diagnostic and CPT-4 procedure codes for various patient encounters to ensure compliance with federal and state regulations
• Serve as an advisor and educator for Coding Specialists, facilitating communication between clinical documentation and coding teams
• Monitor and report on coding quality and productivity rates for coders, conducting specialized audits as necessary

Required qualifications

• High School diploma or equivalent with formal training in ICD-10-CM, ICD-10-PCS, and CPT-4 coding
• Minimum of two years of ICD-10-CM/ICD-10-PCS coding experience in a Level 1 Trauma hospital or four years of inpatient coding experience
• Two to three years of ambulatory coding experience
• Certification as a Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Inpatient Coder (CIC)