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Coding Compliance Auditor

Community Health System

Fresno, California

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JOB DETAILS
SKILLS
Auditing, Billing, Billing Records, Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Clinical Study Publications, Clinical Validation, Community Health, Current Procedural Terminology (CPT), Diversity, Documentation, Financial Analysis, Healthcare, Healthcare Common Procedure Coding System (HCPCS), ICD-10, Information Technology & Information Systems, Medical Billing, Medical Records, Medical Terminology, Nursing, Quality of Care, Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Regulatory Compliance, Reimbursement, Scholarship, Tuition Reimbursement
LOCATION
Fresno, California
POSTED
2 days ago
Overview:

Opportunities for you! 

  • Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek 
  • Free Continuing Education and certification  
  • Tuition reimbursement, education programs and scholarships 
  • Vacation time starts building on Day 1, and builds with your seniority 
  • Free money toward retirement with a 403(b) and matching contributions 
  • Great food options with on-demand ordering 
  • Free parking and electric charging 

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. 

We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page. 

 

Responsibilities:
The Coding Compliance Auditor is a member of the Compliance Office and contributes to the Community Health System’s mission to better the lives of all those we serve. As a Coding Compliance Auditor, you will be responsible for conducting coding and documentation audits to ensure accurate code assignment, appropriate billing, integrity of the medical record, and compliance with federal and state healthcare program requirements.
 

The role requires a highly confident coder who can audit both facility coding and professional fees for partners, as well as audit other coders and physicians.

Qualifications:
Education
  • Associate's Degree in Business, Information Systems, Nursing, Health Care, or a related field required
  • Bachelor's Degree in Business, Information Systems, Nursing, Health Care, or a related field preferred
Experience
  • Experience performing medical record and billing audits/reviews, including clinical documentation, medical terminology, codes (CPT, HCPCS, ICD-10-CM, and revenue), and reviews for charge and reimbursement accuracy required
  • Knowledge of federal, state, and private payer guidelines required
 
One of the following is required:
  • 5 years of healthcare coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCS, if qualifying with an Associate’s Degree
  • 3 years of healthcare coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCS, if qualifying with a Bachelor’s Degree
  • Epic experience preferred
  • Experience with 3M or Optum is preferred
  • Experience completing a formal validation report after completing audits preferred. 
 
Licenses and Certifications:
  • One of the following is required:
    • CCS - Certified Coding Specialist
    • CCS-P - Certified Coding Specialist- Physician-based
    • CMAS - Certified Medical Audit Specialist
    • CPMA - Certified Professional Medical Auditor
    • CPC - Certified Professional Coder
  •  Additional certifications preferred:
    • RHIA - Registered Health Information Administrator
    • RHIT - Registered Health Information Technician
  • Two or more certifications preferred
Disclaimers:

• Pay ranges listed are an estimate and subject to change.
• If any bonuses are noted, they are only applicable to external hires meeting criteria.

About the Company

C

Community Health System

Community Health Systems, Inc. is a non-profit 501 (c) (3) 330 HRSA Grantee with Federally Qualified Health Center (FQHC) status. Established from the roots of Inland Empire Community Health Center in Bloomington, CHSI has grown with community health centers in the counties of Riverside, San Bernardino, and San Diego. These centers have been developed in accordance with standards established for safety net providers by the U.S. Department of Health and Human Services (HHS), the Health Resources Services Administration (HRSA), the Public Health Service (PHS), and the Bureau of Primary Health Care (BPHC).

As such, services are offered to the neediest in each community - the un-insured and under-insured, the working poor, those with limited ability to pay, the homeless, and the indigent. Services are provided at discounted (sliding fee scale) rates for those who qualify based on gross annual income and family size.

COMPANY SIZE
10,000 employees or more
INDUSTRY
Healthcare Services
FOUNDED
1985
WEBSITE
http://www.chs.net/

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