Community Health System

Coding Compliance Auditor

Community Health System  •  Fresno, CA (Onsite)  •  8 days ago
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Job Description

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.

Community Health System

About Community Health System

Community Health System is a private, not-for-profit, health system that employs more than 11,000 people. We've grown a lot since 1897 and we're not done yet.

We have affiliations of nearly 2,500 physicians, a partnership with UCSF Fresno, and one of central California's largest HMO health plans. Being a part of the Community family means being a part of the innovation that cares for more residents in the Central Valley than any other healthcare system in the area. And we do it for everybody, regardless of their ability to pay.

​​​​​​​If you want to be a part of a team that operates like a family and challenges each other to constantly improve and grow together, you belong here.

Industry
Healthcare & Social Services
Company Size
1,001-5,000 employees
Headquarters
Fresno, CA
Year Founded
Unknown
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