Coding / Audit Specialist

Under direct supervision of the Supervisor – Internal Audit, responsible for reviewing charges to ensure correct assignment of procedure and diagnosis codes and modifiers. Analyze denied claims and medical records to identify and correct coding errors, perform claim resubmission or appeals as needed.

Conduct audits of medical record documentation for accurate coding and compliance with guidelines and policies. Perform quality assessments and compliance audits related to billing and reimbursement.

Communicate findings to management and healthcare providers. Maintain confidentiality of all patient and business information. Adhere to policies, HIPAA, OSHA, and other regulatory standards.

Requirements:

• High School Diploma or GED required; Associates Degree in Health Information Management preferred.
• Certified Professional Coder (CPC) or Certified Coding Specialist – Physician Based (CCS-P) required.
• 1 to 3 years of physician coding and auditing experience preferred.
• Knowledge of medical billing, insurance payer guidelines, regulatory requirements, and electronic medical record systems.
• Strong organizational, communication, and problem-solving skills.

Benefits include 401(k), education reimbursement, holiday pay, paid life insurance, long term disability, and excellent time-off policies.