Coding and Billing Auditor CBADE

Job Title: Coding and Billing Auditor

Location: Dover DE 19901
Work Type: Fully Onsite

Position Summary

The Coding and Billing Auditor is responsible for performing comprehensive data quality reviews of provider medical records to validate ICD-10 CPT coding and clinical documentation accuracy. This role ensures compliance with applicable coding reporting and documentation standards while supporting providers coders and revenue cycle staff through education and guidance. Professional physician coding experience is required with auditing experience preferred.

Responsibilities

• Perform detailed audits of provider (physician and mid-level) medical records to ensure accurate assignment of ICD-10 and CPT codes

• Validate principal and secondary diagnoses and procedures against clinical documentation

• Compile audit reports with analysis of findings and recommendations

• Ensure selected CPT codes appropriately support clinical documentation

• Meet or exceed established productivity benchmarks for medical record audits

Audit & Compliance Functions

• Conduct routine audits of established provider records on a biannual basis

• Maintain detailed audit logs

• Identify documentation gaps and coding discrepancies

• Ensure compliance with coding guidelines regulatory requirements and documentation standards

Provider & Staff Collaboration

• Communicate findings verbally and in writing with providers to clarify documentation and suggest improvements

• Educate providers coders and charge entry staff on coding guidelines and documentation best practices

• Develop and implement documentation support tools in collaboration with revenue cycle leadership

• Communicate the benefits of complete and accurate clinical documentation

Training & Support

• Train new revenue cycle team members on coding and documentation guidelines

• Assist revenue cycle leadership with evaluation of coding activities and staff performance as needed

• Perform hands-on coding support when required

• Participate in both formal and informal education initiatives for providers and staff

Additional Responsibilities

• Assist with revenue cycle improvement initiatives

• Perform other duties as assigned within the scope of the role

Required Qualifications

Education:

• Associate degree in a related field

Credential:

• Certified Professional Coder (CPC) required

Experience:

• Minimum of five (5) years of inpatient and outpatient coding experience

• Professional physician coding experience required

• Auditing experience preferred

Preferred Qualifications

Education:

• Bachelors degree in a related field

Credential:

• Certified Professional Coder (CPC)

Experience:

• Coding experience in a multi-specialty group practice setting

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About Navitas Healthcare LLC: It is a certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.