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Shs Cdi Pb Coding Auditor-Prov Svcs

Job in Chicago, Cook County, Illinois, 60290, USA
Listing for: Sinai Chicago
Contract position
Listed on 2026-10-13
Job specializations:
  • Healthcare
    Medical Billing and Coding, Medical Records
Salary/Wage Range or Industry Benchmark: 90000 - 120000 USD Yearly USD 90000.00 120000.00 YEAR
Job Description & How to Apply Below
Position: 3464 - SHS CDI PB CODING AUDITOR-PROV SVCS
See JD

Key Responsibilities
  • Perform comprehensive provider-side (professional billing) coding audits for inpatient and outpatient physician services
  • Review and validate E&M levels of service in accordance with current coding guidelines
  • Validate medical necessity based on Medicare, Medicaid, and commercial payer requirements
  • Audit and validate ICD-10-CM, ICD-10-PCS (as applicable), CPT, and HCPCS coding for professional services
  • Evaluate physician documentation to ensure accurate code assignment and appropriate level of care
  • Conduct charge validation, charge entry review, and charge correction recommendations
  • Identify documentation gaps, coding discrepancies, and compliance risks
  • Provide real-time and retrospective provider education to improve documentation and coding practices
  • Collaborate with CDI, Revenue Cycle, Compliance, and Billing teams to ensure alignment
  • Review and interpret Explanation of Benefits (EOBs) and assist with coding-related denial resolution
  • Support denial prevention initiatives and revenue integrity strategies
  • Ensure compliance with HIPAA regulations and organizational policies
  • Utilize Epic EMR and related systems for audit workflows and reporting
  • Participate in internal audits, quality reviews, and performance improvement initiatives
  • Maintain detailed audit documentation, reporting, and productivity metrics
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