Coding Quality Auditor & Specialist, HB Coding

Job Description

We are seeking an experienced Coding Quality Auditor & Specialist to support hospital-based coding operations in a fully remote environment. This role is responsible for driving coding accuracy, education, compliance, and quality improvement initiatives across hospital billing functions.
The ideal candidate will serve as a subject matter expert in coding quality, audit processes, clinical documentation integrity, and reimbursement methodologies. This individual will collaborate closely with coding leadership, providers, clinical documentation teams, and operational stakeholders to improve coding performance, maintain compliance standards, and support organizational quality metrics.

Earnings

N/A

Duties

• Develop and deliver coding education programs for coding staff, vendors, clinical documentation teams, and providers
• Create educational tools, presentations, and competency assessments to improve coding accuracy and documentation quality
• Analyze audit findings and dashboard trends to identify training opportunities and performance improvement initiatives
• Assist with onboarding and training of new coding staff
• Collaborate with operational and leadership teams to support strategic coding and documentation initiatives
• Monitor coding quality metrics and provide actionable feedback to leadership teams
• Conduct routine and targeted coding audits for internal staff, vendors, and AI-supported coding workflows
• Review coding accuracy, reimbursement integrity, charge posting, and edit resolution processes
• Perform follow-up audits and performance improvement reviews as needed
• Analyze audit data and recommend corrective action plans
• Support compliance-related audit activities and reimbursement validation efforts
• Assist with responses to payer and RAC audit requests when applicable

Requirements

• Minimum 5 years of coding experience or 2 years of coding audit experience
• Strong understanding of outpatient reimbursement methodologies and APC reimbursement
• Knowledge of coding quality metrics, clinical documentation integrity, and denial prevention strategies
• Experience with coding software and electronic health record systems
• Strong analytical, communication, presentation, and organizational skills
• education, training, or auditing experience

Preferred Qualifications

• Bachelor’s degree in a related field
• Experience supporting hospital outpatient coding operations
• Familiarity with quality metrics such as Vizient, PSI, CMS, AHRQ, and USNWR benchmarks

Additional Information

• 100% Remote
• Full-time opportunity
• No direct reports
• Collaborative, team-oriented environment
• Opportunity to work closely with coding leadership and operational stakeholders across a large healthcare setting

License / Certification

• RHIT, RHIA, or CCS certification
• Associate degree in a healthcare-related field