Coding and Billing Auditor

Position Title: Coding and Billing Auditor

Location: Dover, DE

Pay Range: $53,000.00 – $81,000.00 (annual salary)

Start Date: 02/16 (or later)

Employment Type: Full-Time

Work Environment: Fully onsite

The Coding and Billing Auditor is responsible for performing detailed data quality reviews of provider medical records to ensure accurate ICD-10 and CPT coding and compliant clinical documentation. This role audits physician and mid-level provider records for accuracy of diagnoses and procedures, educates providers and staff on documentation and coding standards, and supports revenue cycle operations. The position requires extensive professional physician coding experience and regular interaction with providers to deliver feedback and education.

• Perform audits of medical records to ensure accurate CPT and ICD-10 coding assignments

• Validate that selected codes are fully supported by clinical documentation

• Compile detailed audit reports, including findings, trends, and recommendations

• Consistently meet established productivity targets for record audits

• Conduct biannual audits of established provider medical records

• Maintain audit logs and documentation tracking

• Communicate verbally and in writing with providers to clarify findings and recommend more specific or complete documentation

• Collaborate with the Revenue Cycle Manager to design and implement tools supporting physician documentation improvement

• Develop and deliver both formal and informal provider education related to coding guidelines and documentation requirements

• Communicate the importance and benefits of complete and accurate clinical documentation

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

• Assist the Revenue Cycle Manager with evaluations of coding activities and staff performance as needed

• Perform professional coding duties as required

• Provide ongoing coding support to billing and coding staff

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

• Associate Degree in a related field

• Certified Professional Coder (CPC) – required

• Minimum of five (5) years of inpatient and/or outpatient professional physician coding experience

• Auditing experience preferred

• Significant experience coding professional claims in a medical office-based setting

• Experience interacting directly with physicians to provide feedback, education, and documentation guidance

• Strong knowledge of ICD-10, CPT, and clinical documentation standards

• Bachelor’s Degree in a related field

• Coding experience within a multi-specialty group practice setting

• Strong analytical and attention-to-detail skills

• Ability to interpret complex medical documentation and coding guidelines

• Effective verbal and written communication skills

• Ability to educate and influence providers regarding documentation best practices

• Strong organizational skills with the ability to manage multiple audits simultaneously

• Ability to work independently in a structured, compliance-driven environment

• Benefits available to full-time employees after 90 days of employment

• 401(k) plan with company match available after 1 year of service