Coding Compliance Auditor

If you are an energetic individual who enjoys being part of a collaborative and talented team then a rewarding career with Northeast Georgia Health System is where you want to be!

Coding Compliance Auditors conduct coding/billing/documentation audits of all Northeast Georgia Physician Groups to determine organizational integrity of coding/billing for professional services, including detection and correction of documentation, coding, and billing errors. Audits consist of evaluation of the adequacy and accuracy of documentation in support of services billed, including ICD-9/ICD-10/CPT/HCPCS and other third-party payor codes. Medical necessity of services, reimbursement overpayments and underpayments, and compliance with other documentation, coding and billing standards. Coding Compliance Auditors evaluate the adequacy and effectiveness of internal and operational controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to professional fee documentation, coding and billing, including federal and state regulations and guideline, CMS and other third party payor billing rules, and OIG compliance standards. Coding Compliance Auditors apply standardized audit scoring methodology to evaluate consistency of documentation and coding, and standardized audit findings methodology to report audit results. Coding Compliance Auditors communicate audit results to physicians, physician leadership, senior management and staff, provide physician and coder education and make recommendations for management corrective action. Coding Compliance Auditors serve as institutional subject matters experts and authoritative resources on interpretation and application of documentation and coding rules and regulations, and conduct enterprise risk assessments of potential and detected coding compliance deficiencies.
Professional Certification from an accredited program is required within 2 years of employment. The following certifications are acceptable: CEMC and/or CPMA as a Certified Professional Medical Auditor (CPMA) by the American Academy of Professional Coders (AAPC), CPC (Certified Professional Coder), CCS-P (Certified Coding Specialty), RHIA (Registered Health Information Administrator), RHIT (Registered Health Information Technician). Once obtained, employee must maintain Certification as a condition of continued employment.
Minimum of 5 years of experience comparable to that of a Compliance Auditor and demonstrated competency in knowledge, interpretation and application of documentation, coding and billing rules or medical defense strategies sufficient to carry out the duties and responsibilities of a Compliance Auditor, including but not limited to meeting standards related to audit productivity, audit accuracy rate, timeliness of assignments, education/presentation competencies, and professionalism.

More Awards and Accolades.
Ranked in the Top 10% in the nation by CareChex for Stroke Care, Cancer Care, Pneumonia Care and Surgical Care, the System is the recipient of numerous accolades including:

  • Georgia's #1 Surgery Hospital by CareChex
  • Georgia's #1 Heart Hospital by CareChex - 12 years in a row
  • Georgia's #1 Women's Hospital by CareChex
  • Georgia's #1 Pulmonary Hospital
  • One of Metro Atlanta's Top Workplaces for the 7th year in a row

More Choices.
The Blue Ridge Mountains are less than a 30-minute drive and Lake Sidney Lanier is next door. Whatever setting suits your mood, you'll find it right here.

  • 47 public parks
  • 8 championship golf courses
  • 34 tennis courts
  • 10 marinas

Atlanta, with its abundance of sports including the Atlanta Braves, Hawks, Falcons, and Georgia Swarm, as well as entertainment attractions, is less than an hour to the south.

We value diversity and always hire equally and equitably.

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