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Role Description

The Physician Auditor is responsible for conducting detailed audits of physician documentation, coding, and billing practices to ensure compliance with regulatory standards, payer guidelines, and organizational policies. This role plays a critical part in maintaining the integrity of clinical documentation and revenue cycle processes, identifying areas for improvement, and supporting education initiatives for providers.

• Audit physician documentation and coding for multi-specialty providers to ensure accuracy, completeness, and compliance with ICD-10-CM, CPT, HCPCS, E/M leveling, payer guidelines, and regulatory standards.
• Review medical records to validate billed services, medical necessity, and identify discrepancies, errors, or potential fraud.
• Prepare detailed audit reports with findings, recommendations, and corrective action plans.
• Provide education and feedback to physicians, clinical staff, and team members on documentation improvement, coding accuracy, and compliance best practices.
• Collaborate with coding, compliance, and clinical teams to resolve audit findings and support cross-functional projects.
• Utilize audit results to deliver data-driven insights to providers and management for performance improvement and retraining.
• Stay current with coding standards, payer policies, and healthcare regulations; maintain professional knowledge through workshops and publications.
• Participate in internal and external audits, including regulatory inspections.

Qualifications

• 5 years of experience in physician coding required
• 5 years auditing and/or clinical documentation improvement, Pro Fee setting required

Requirements

• One of the following certifications required:
• Registered Health Information Technician (RHIT)
• Certified Coding Specialist (CCS/CCS-P)
• Certified Professional Coder (CPC)
• Certified Professional Medical Auditor (CPMA)

Benefits

• Competitive wages
• Parental leave (4 weeks paid)
• Housing programs
• Childcare reimbursement
• Comprehensive Health Benefits:
• Medical
• Dental
• Vision
• Educational Programs:
• Tuition Assistance
• Existing Student Loan Repayment
• Specialty Certification Reimbursement
• Annual Supplemental Educational Funds
• Paid Time Off: Up to five weeks in your first year of employment and continues to grow each year.
• Retirement & Supplemental Insurance:
• 403(b) Retirement plan with immediate matching
• Life insurance
• Short and long-term disability
• Recreation Benefits, Wellness & More:
• Up to $1,000 annual wellbeing reimbursement
• Recreation discounts
• Pet insurance