Coding and Compliance Auditor

Job Description Summary

The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements.

Job Description

Job Responsibilities:

Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process.   

• Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes.   

• Perform prospective and retrospective audits to validate medical necessity and documentation supporti...