Coding Auditor

Coding Education & Quality Auditors (CEQA)Revenue Cycle8 Hr Morning - AfternoonNortheast Georgia Health System is rooted in a foundation of improving the health of our communities.About the Role:Coding Education & Quality Auditors (CEQA) conduct coding/billing/documentation audits of all NGPG/NGHS Providers to determine organizational integrity of coding/billing for professional services, including detection and correction of documentation, coding and billing errors. Audits consist of evaluation of the adequacy and accuracy of documentation to support services billed including ICD-9/ICD10/CPT/HCSPCS and other third-party payer codes. CEQAs ensure the medical necessity of services, compliance with other documentation, coding and billing standards. CEQAs apply standardized audit scoring methodology to evaluate consistency of documentation and coding, and standardized audit findings methodology to report audit results. CEQAs communicate audit results to physicians, physician leadership, senior management, Compliance department and staff. CEQAs are required to provide physician and coder education, and make recommendations to management for corrective action. CEQAs serve as an institutional subject matters expert and resource on interpretation and application of documentation and coding rules and regulations. CEQAs assure the quality of the coding documentation fits service and codes, and any missing labels on documentation are corrected.Minimum Job QualificationsLicensure or other certifications: CPC and/or CCS-P Coding Certification. CPMA, CEMC or other Nationally recognized healthcare auditing certification required at hire, or required to obtain within 6 months of hire.Educational Requirements: High School Diploma or GED.Minimum Experience: Minimum of three (3) years of experience in a healthcare role involving the direct application of CPT, ICD-10-CM, and/or modifiers in coding, auditing, or documentation review. Specialized Skills & Proficiency Demonstrated ability to: Apply coding guidelines to complex, multi-specialty documentation. Identify errors, discrepancies, and compliance risks within medical records. Translate audit findings into clear, actionable feedback and process improvements. Additional Qualifications: Demonstrated experience educating providers and presenting to large audiences.Job Specific and Unique Knowledge, Skills and AbilitiesAdvanced knowledge of ICD-9, ICD-10, CPT, HCPCS coding principles and medical terminologyStrong understanding of coding policies, procedures, and regulatory/third-party requirementsAdvanced proficiency in Microsoft Office, including Excel and PowerPointAbility to communicate complex coding concepts to both technical and non-technical audiencesStrong data organization, analytical skills, and detailed reporting capabilitiesSkilled in developing and delivering presentations to diverse audiencesHighly organized, detail-oriented, and self-motivated, with the ability to work independently and collaborativelyBuilds strong relationships across teams, maintains a positive, professional demeanor, and supports a team-oriented work environmentEssential Tasks and ResponsibilitiesCoordinates and performs professional services documentation and coding audits for outpatient records (NGPG/NGHS)Reviews clinical documentation for completeness, accuracy, and data integrityAudits provider coding using ICD-10, CPT, HCPCS, and CMS guidelinesConducts daily audits for new, PRN, locum, and flagged providers until audit standards are metReviews findings with providers and recommends documentation and coding improvementsTrains and orients new providers on coding and documentation expectationsEnsures charts meet compliance standards and organizational policiesPrepares and delivers audit reports by provider and practiceTracks and follows up on provider improvement and complianceDevelops and delivers coding education, training programs, and updatesSupports denial management by reviewing CPT denials and implementing corrective actionsServes as a coding compliance resource, supports operational needs (claims, queues, escalations), and maintains ongoing professional developmentPhysical DemandsWeight Lifted: Up to 20 lbs, Occasionally 0-30% of timeWeight Carried: Up to 20 lbs, Occasionally 0-30% of timeVision: Moderate, Frequently 31-65% of timeKneeling/Stooping/Bending: Occasionally 0-30%Standing/Walking: Occasionally 0-30%Pushing/Pulling: Occasionally 0-30%Intensity of Work: Frequently 31-65%Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding, DrivingWorking at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals.NGHS: Opportunities start here.Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.