Professional Billing Coding Auditor CPC

Clinical Management Consultants
April 4, 2021
Cupertino, CA
Job Type


An exciting career opportunity for Professional Billing Coding Auditor is now available with growing nonprofit hospital in beautiful, coastal and progressive Northern California!

The Professional Billing Coding Auditor will be part of not-for-profit hospital that provides services to the dynamic community of its surrounding neighborhoods. With over 100 year history of healing, the vision is a growing and diversified health care ministry distinguished by excellent quality and committed to expanding access to those in need.

The Physician Billing Coding Auditor will conduct complex audits for clinic based providers to ensure selected coded data, Evaluation and Management, and charge assignments are compliant with Official Coding Guidelines in ICD-10-CM coding conventions and CPT/HCPCS coding conventions.  The Professional Billing Coding Auditor will educate physicians to ensure that data within the legal medical record is coded efficiently and accurately for appropriate reimbursement and medical necessity to meet regulatory accreditation requirements for state and federal reporting. 

The Physician Billing Coding Auditor acts as liaison and works in conjunction with Patient Financial and Revenue Cycle teams to ensure coded data meets the national standards through collaborative discussion and with direct physician education.  The Professional Billing Coding Auditor will provide physician specific education based on the quality monitoring of claim denials and trends.  

The Professional Billing Coding Auditor will reconcile hospital base admissions for surgical charge-entry with appropriate CPT and modifier assignments in conjunction of global days in mitigating claim denials and unbundle reporting. The Physician Billing Coding Auditor will coordinate audits, follow-up physician reviews, and distributes work assignments among the internal and external professional auditing teams. 

The Professional Billing Coding Auditor will participate in clinic base onsite training and meetings at various clinic locations and provides general coding coverage. Ideal candidate for Professional Billing Coding Auditor will have 5 years experience in auditing and claim denial reviews in acute clinic and hospital setting with strong training background in outpatient clinic setting with direct 1:1 physician education preferred.  Certified Professional Coder (CPC) with AHIMA Certified Coding Specialist (CCS) credential preferred.

For more than 100 years, the Hospital has been a destination for ambitious job-seekers as well as patients, thanks to a unique combination of cutting-edge technology, outstanding patient care and a sense of community that extends way beyond the hospital grounds. As an independent, locally governed, not-for-profit hospital, we enjoy a unique environment and have a long history of contributing to the health and well being of this community. Join the team now!

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