{"id":1392886,"url":"https://alion.io/job/central-health-senior-compliance-coding-auditor-ch-remote","title":"Senior Compliance Coding Auditor CH (REMOTE)","company":{"id":1826968,"name":"Central Health","domain":"centralhealth.net","url":"https://alion.io/company/centralhealth-net","size_band":"51-200","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"iCIMS","truth_index":null},"role":"Finance","role_family":"Finance","seniority":"senior","employment_type":null,"work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Austin, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":{"min_usd":80000,"max_usd":152000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":4389},"experience_years_min":5,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Microsoft Excel","optional":false},{"name":"Microsoft Office","optional":false}],"status":"live","first_seen_at":"2026-09-28T12:28:09Z","employer_posted_date":"2026-09-28","last_verified_at":"2026-10-19T15:26:56Z","board_verified":true,"closed_at":null,"days_open":21,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":21},"description":"Overview\nReporting to the Director of Healthcare Compliance, the Senior Compliance Coding Auditor is responsible for conducting independent coding, billing, documentation, and regulatory compliance audits across ambulatory and specialty care practices. The position supports the organization's compliance program through risk-based auditing, monitoring, provider education, investigation of billing concerns, identification of revenue integrity risks, and development of corrective action plans. The Senior Compliance Coding Auditor serves as a subject matter expert for professional fee coding, documentation requirements, government and commercial payer regulations, and healthcare compliance standards. This role partners closely with physicians, advanced practice providers, practice leadership, revenue cycle, coding, clinical operations, and executive leadership to promote compliant billing and documentation practices.\nResponsibilities\nEssential Functions:\nAuditing and Monitoring\nConduct retrospective and targeted prospective compliance coding audits (i.e. baseline, routine periodic, monitoring, and focused) of professional services\nReview medical record documentation to validate CPT, HCPCS, ICD-10-CM, modifier assignment, medical necessity, and payer specific billing requirements\nIdentify coding, documentation, billing, and compliance risks and develop recommendations for improvement\nEvaluate compliance with CMS, Medicare Administrative Contractor (MAC), Medicaid, and commercial payer regulations\nConduct specialty specific audits including procedural, surgical, and evaluation and management (E/M) services\nReview provider documentation for completeness, accuracy, and support of services billed\nMonitor corrective action plans and validate effectiveness of remediation efforts\nParticipate in annual compliance risk assessments and coding audit plan development\nAnalyze audit findings and identify trends, patterns, and opportunities for focused monitoring activities\nWork closely with all departments, including but not limited to, Clinical Services, Nursing, Practice Leadership, Finance, IT, Training, Rev Cycle, and Billing to assist in accuracy of reported services and with chart reviews, as requested. Provider and Coding Education and Consultation\nCommunicate audit findings and recommendations to physicians, advanced practice providers, coders, leadership, and operational teams\nDevelop and deliver coding and compliance education programs for providers, coders, and staff\nProvide ongoing guidance regarding: o CPT and HCPCS coding o ICD-10-CM diagnosis coding o E/M documentation requirements o Modifier utilization o Medical necessity documentation requirements o Specialty specific coding and billing guidelines\nServe as a subject matter expert resource for regulatory and payer-related coding questions\nWork with the purchasing department to order and distribute annual coding materials for all clinical sites and departments.\nCompliance Program Support\nSupport implementation and maintenance of the organization’s compliance coding auditing and monitoring program\nParticipate in policy development and revision related to coding and billing compliance\nCollaborate with Revenue Cycle, Clinical Operations, Quality, Information Technology, Credentialing, Finance, and Legal teams as necessary to facilitate compliant coding and billing practices\nAdvise organization of government coding and billing guidelines and regulatory updates\nAssist with investigations involving coding, billing, documentation, and reimbursement concerns.\nMonitor regulatory updates and assess organizational impact.\nSupport compliance initiatives related to: o Medicare and Medicaid billing regulations o Commercial payer requirements o OIG compliance guidance o Documentation integrity o Revenue integrity\nEHR and Documentation Intergrity\nParticipate in the development and enhancement of EHR templates and programming and advise on coding compliance with payor guidelines. Reporting\nReport findings and recommendations to compliance and leadership.\nPrepare written audit reports, executive summaries, dashboards, and compliance metrics.\nPresent audit results and recommendations to leadership and designated committees.\nMaintain documentation supporting audit methodologies, findings, and corrective action activities. Perform other duties as assigned.\nKnowledge, Skills and Abilities:\nAdvanced knowledge and demonstrated proficiency in the application of ICD-10-CM, CPT®, and HCPCS Level II coding guidelines, conventions, and regulatory requirements.\nExtensive knowledge of medical terminology, anatomy and physiology, disease processes, pharmacology, and clinical documentation requirements.\nThorough understanding of Centers for Medicare & Medicaid Services (CMS) regulations, National Correct Coding Initiative (NCCI) edits, Office of Inspector General (OIG) compliance guidance, Medicare and Medicaid policies, and applicable payer-specific coding and billing requirements.\nStrong knowledge of healthcare compliance programs, auditing methodologies, reimbursement principles, and revenue integrity practices.\nDemonstrated ability to conduct complex coding and documentation audits, identify compliance risks, determine root causes, and recommend corrective actions.\nAbility to analyze coding, billing, and audit data; identify trends and patterns; and develop actionable recommendations for process improvement and risk mitigation\nStrong critical thinking, analytical, problem-solving, and decision-making skills.\nExceptional attention to detail, accuracy, and organizational skills, with the ability to manage multiple priorities and meet deadlines. \nExcellent verbal, written, presentation, and interpersonal communication skills, including the ability to educate providers, leadership, and staff on coding, documentation, and compliance requirements.\nProficiency in Microsoft Office Suite, including advanced Excel skills for data analysis and reporting. \nExperience utilizing electronic health records (EHRs), coding systems, auditing software, and compliance monitoring tools.\nAbility to collaborate effectively with clinical, operational, revenue cycle, and compliance stakeholders to support organizational compliance and revenue integrity objectives.\nAbility to interpret and apply evolving regulatory guidance, coding updates, and industry best practices to ensure organizational compliance and revenue integrity.\nQualifications\nEducation:\nAssociates Degree (higher degree accepted)\nRequired Work Experience:\nMinimum of 5 years of progressively responsible experience in professional coding with demonstrated expert knowledge of procedural and diagnostic coding. \nMinimum of 2 years of coding audit experience, including provider education, documentation review, and evaluation of coding accuracy and regulatory compliance. \nAdvanced knowledge of ICD-10-CM, CPT®, HCPCS Level II, National Correct Coding Initiative (NCCI) edits, Medicare Physician Fee Schedule, and applicable payer-specific billing and coding requirements. \nExtensive knowledge of federal and state healthcare compliance requirements, reimbursement methodologies, documentation standards, and audit processes. \nRequire License and Ceritifcations:\nCertified Professional Coder (CPC®) through 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