Coding Auditor
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Job Description
Professional Coding Auditor auditing clinical documentation and CPT/ICD-10 coding for WellStreet Urgent Care. Improving compliance, charge capture, reimbursement, and provider coding quality.
Responsibilities:
- Perform coding audits of provider documentation and assigned CPT and ICD-10 codes
- Evaluate whether clinical documentation supports the diagnoses and procedures billed
- Identify coding errors, documentation deficiencies, charge-capture issues, and opportunities for improvement
- Review coding deliverables from professional coders, physicians, and other healthcare professionals
- Provide constructive, educational feedback to providers and coders
- Deliver education related to coding requirements, documentation standards, and regulatory updates
- Stay current on CMS, state, and payer coding regulations and requirements
- Collaborate with the Coding Supervisor and Regional Medical Directors to improve documentation and coding accuracy
- Perform charge entry and Charge Review activities as needed
- Identify coding trends such as undercoding and recommend corrective actions
- Support error correction and process improvement initiatives
- Meet established daily production and quality standards
Requirements:
- Active CPC or CCS coding certification through AAPC or AHIMA
- Relevant professional coding and/or coding auditing experience
- 2+ years of medical billing experience
- Urgent Care or Occupational Health billing experience
- Experience working with insurance payers, A/R, revenue cycle processes, and denied claims
- Experience with billing software and electronic medical records
- High school diploma or equivalent
- Strong understanding of medical coding and documentation requirements
- Excellent critical-thinking and analytical skills
- Ability to distinguish between a coding error and a documentation deficiency
- Strong attention to detail and commitment to accuracy
- Ability to communicate audit findings clearly and constructively
- Comfortable providing corrective feedback and educating providers and coders
- Strong organizational skills and ability to manage a high-volume workload
- Ability to identify coding trends and develop practical solutions
- Ability to stay current with coding changes and regulatory requirements
- Positive, collaborative attitude and ability to work effectively in a fast-paced environment
Benefits:
- Full-time remote work arrangement
- Opportunity to do meaningful work in a supportive, growing organization
- Opportunities to educate providers and coding teams and contribute to professional improvement
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