Professional Coding Auditor

About The Role

The Professional Coding Auditor reviews clinical documentation and coding to ensure accuracy, completeness, compliance, appropriate charge capture, and alignment between documentation and assigned CPT and ICD-10 codes. This role goes beyond identifying errors—you’ll help educate providers and coders, identify trends, and partner with leadership to improve coding quality and reimbursement.

Responsibilities

• Perform coding audits of provider documentation and assigned CPT and ICD-10 codes.
• Evaluate whether clinical documentation supports the diagnoses and procedures billed.
• Identify coding errors, documentation deficiencies, charge-capture issues, and opportunities for improvement.
• Review coding deliverables from professional coders, physicians, and other healthcare professionals.
• Provide constructive, educational feedback to providers and coders.
• Deliver education related to coding requirements, documentation standards, and regulatory updates.
• Stay current on CMS, state, and payer coding regulations and requirements.
• Collaborate with the Coding Supervisor and Regional Medical Directors to improve documentation and coding accuracy.
• Perform charge entry and Charge Review activities as needed.
• Identify trends such as undercoding or other recurring coding issues and recommend corrective actions.
• Support error correction and process improvement initiatives.
• Meet established daily production and quality standards.

Requirements

• Active CPC or CCS coding certification through AAPC or AHIMA.
• Relevant professional coding and/or coding auditing experience.
• 2+ years of medical billing experience.
• Urgent Care or Occupational Health billing experience.
• Experience working with insurance payers, A/R, revenue cycle processes, and denied claims.
• Experience with billing software and electronic medical records.
• Epic experience is a plus.
• High school diploma or equivalent.

Skills

• Strong understanding of medical coding and documentation requirements.
• Excellent critical-thinking and analytical skills.
• Ability to distinguish between a coding error and a documentation deficiency.
• Strong attention to detail and commitment to accuracy.
• Ability to communicate audit findings clearly and constructively.
• Comfortable providing corrective feedback and educating providers and coders.
• Strong organizational skills and ability to manage a high-volume workload.
• Ability to identify coding trends and develop practical solutions.
• Ability to stay current with coding changes and regulatory requirements.
• Positive, collaborative attitude and ability to work effectively in a fast-paced environment.

Why Join WellStreet?

At WellStreet, we believe healthcare professionals should have the opportunity to do meaningful work while being part of a supportive, growing organization. We value people who bring energy, accountability, collaboration, and a genuine commitment to improving the patient experience.