Revenue Cycle Compliance Coder--Business Office-Provo

Position Summary

The Revenue Cycle Compliance Coder performs detailed reviews of clinical documentation and coding to ensure services are billed accurately and in compliance with payer and regulatory requirements. This role focuses on identifying trends and systemic risk, not just individual errors, and supports payer audit defense and provider education efforts.

• Conducts pre-bill and post-bill compliance audits across specialties and payers.
• Reviews E&M leveling, procedure coding, modifiers, and medical necessity.
• Identifies patterns of risk by provider, specialty, and service-line.
• Performs HCC coding review.
• Documents findings in a clear and defensible manner.
• Supports payer audits, refund requests, and internal investigations.
• Participates in provider and coder education based on audit findings.

• Three or more years of professional coding experience
• Prior experience performing coding or compliance audits
• Advanced knowledge of CPT, ICD 10 CM, HCPCS, modifiers, and payer policies
• Ability to interpret medical records and apply coding guidelines consistently
• Required
  
  Certifications:
  
  CPC or CCS required
• CIC strongly preferred
• Specialty certifications a plus

Monday - Friday 8am to 5pm Hybrid Position