Coding Auditor

Coding Specialist #E# Professional Based (PB)

Southern New Hampshire Health has been a cornerstone of the region since 1893, delivering high-quality, compassionate care close to home. Anchored by Southern New Hampshire Medical Center, a 188-bed, DNV-accredited hospital in downtown Nashua with a Level III-N trauma center, Level II Special Care Nursery, and Magnet designation for nursing excellence, we offer a full spectrum of services from primary care to advanced diagnostics and specialized treatments. Our medical staff includes over 500 providers from Foundation Medical Partners and local practices. Foundation Medical Partners, our multi-specialty group, spans 70+ practices across southern New Hampshire and northern Massachusetts, providing coordinated, patient-centered care to thousands each year.

About the Job

The Coding Specialist PB is responsible for analyzing professional (physician and advanced practice provider) encounters and related documentation to assign accurate ICD-10-CM, CPT, and HCPCS codes. This role ensures compliance with current coding guidelines, regulatory requirements, and payer-specific rules while supporting timely and compliant coding to optimize reimbursement and minimize denials. The Coding Specialist PB collaborates closely with providers, clinical staff, and revenue cycle partners and issues queries as needed to ensure documentation supports accurate code assignment.

What You’ll Do

Review and analyze professional medical records, including office visits, hospital-based professional services, and outpatient encounters. Assign accurate ICD-10-CM, CPT, and HCPCS codes. Apply appropriate CPT modifiers, units, place of service indicators, and payer-specific billing rules. Abstract and enter coded data into Epic and other professional billing and coding systems. Ensure compliance with official coding guidelines, regulatory requirements, payer policies, and organizational standards. Maintain a minimum coding accuracy rate of 95% and meet established productivity benchmarks. Review, investigate, and resolve claim edits and coding-related errors. Validate provider documentation and query providers for clarification or additional detail when needed. Serve as a subject matter expert for professional coding, including E/M services, procedure coding, and modifier usage. Collaborate with providers, clinical staff, educators, and revenue cycle teams to resolve coding and documentation issues. Monitor and communicate coding and documentation trends impacting professional billing and compliance. Stay current on coding updates, regulatory changes, and professional billing requirements. Participate in audits, education, training, and continuous improvement initiatives. Perform other duties as assigned.

Who You Are / Requirements

Education: High School diploma or equivalent required. Associate degree in Health Information Management or a closely related field preferred. Certification (Required at Time of Hire): Certified Coding Specialist (CCS), or Certified Professional Coder (CPC), or Certified Coding Specialist Physician-Based (CCS-P). Additional HIM certifications (RHIT, RHIA) preferred. Experience: Minimum of two (2) years of professional coding experience in a multispecialty physician setting. Experience with ICD-10-CM, CPT, and HCPCS coding systems. Knowledge & Skills: Knowledge of professional coding guidelines and compliant coding practices. Knowledge of medical terminology, anatomy, physiology, and regulatory compliance (CMS, HIPAA). Proficiency with Epic and coding/encoder software preferred. Strong analytical, problem-solving, written, and verbal communication skills.

Why You’ll Love Us

Southern NH Medical Center is a 5-time Magnet designated hospital. Health, dental, prescription, and vision coverage for full-time & part-time employees. Medical, dental, and vision coverage. Life insurance. Short- and long-term disability. Flexible Spending Accounts (FSA). Competitive pay. Tuition Reimbursement. Nursing Student Loan Paydown Program. 403(b) Retirement Savings Plan. Education & Paid training courses for continued career progression. & So much more!