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Provider Documentation, Billing Auditor
Mary Free Bed Rehabilitation Hospital. Conduct independent audits and reviews of provider documentation, coding, billing, and reimbursement practices .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in auditing provider documentation, coding, and billing practices while ensuring compliance with healthcare regulations and standards. Proficient in identifying compliance risks and recommending corrective actions to enhance documentation integrity and billing accuracy.
Highest-signal resume keywords
Provider Coding And Billing ExperienceAuditing Evaluation And Management (E/M) ServicesKnowledge Of Healthcare Compliance PoliciesAuditing CPT CodingAuditing ICD-10-CM Diagnosis Coding
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Auditing HCPCS Level II CodingAuditing Modifier UsageAuditing Medicare And Commercial Payer RequirementsKnowledge Of Billing Procedures And SystemsAdvanced Knowledge Of Compliance And Auditing Principles
Soft Skills
Organizational SkillsCommunication SkillsComplex Problem-Solving SkillsCustomer Service PrinciplesAbility To Work Independently
Tools & Technologies
Application SoftwareAudit WorkpapersDocumentation Systems
Certifications & Qualifications
Healthcare Billing And/or Coding Certification
Industry Keywords
Healthcare ComplianceRegulatory ComplianceDocumentation IntegrityBilling RegulationsCoding Standards
About the role
Key responsibilities & impact- Conduct independent audits and reviews of provider documentation, coding, billing, and reimbursement practices
- Evaluate clinical documentation accuracy, completeness, and adequacy against coding, billing, medical necessity, regulatory, payer, and organizational requirements
- Perform ongoing monitoring to identify compliance risks, billing vulnerabilities, coding trends, and process improvement opportunities
- Identify potential overpayments, underpayments, coding inaccuracies, documentation deficiencies, and other compliance concerns
- Recommend corrective actions and help prevent documentation and billing issues
- Collaborate with compliance staff, providers, advanced practice providers, revenue cycle staff, operational leaders, and other departments
- Provide education and training on documentation requirements, coding standards, billing regulations, compliance expectations, and best practices
- Serve as a subject matter resource on documentation integrity, coding, billing compliance, reimbursement requirements, and regulatory developments
- Assist with developing, reviewing, and revising policies, procedures, and internal controls
- Maintain accurate audit workpapers, documentation, reports, and records
- Monitor changes in healthcare laws, regulations, payer guidance, coding requirements, and industry best practices and assess organizational impact
- Promote integrity, ethical conduct, accountability, and regulatory compliance throughout the Mary Free Bed system
- Perform other duties and special projects assigned by the Compliance Officer
- Demonstrate excellent customer service, encourage and monitor service standards, promote teamwork, communicate directly, and handle confidential information sensitively
- Identify problems, seek solutions, and contribute to quality-improvement and customer-service monitoring efforts
- Report directly to the Compliance Officer
Requirements
What you’ll need- Bachelor’s degree or higher in health information management, healthcare administration, nursing, or related field
- 2–5 years of provider coding and billing experience in professional services
- Experience auditing Evaluation and Management (E/M) services
- Experience auditing CPT coding
- Experience auditing ICD-10-CM diagnosis coding
- Experience auditing HCPCS Level II coding
- Experience auditing modifier usage
- Experience auditing Medicare and commercial payer requirements
- Experience auditing documentation requirements supporting billed services
- Extensive knowledge of healthcare compliance policies, programs, practices, standards, and related compliance issues
- Advanced knowledge of compliance and auditing principles, theories, and concepts
- Knowledge of billing procedures and systems
- Demonstrated experience and success with customer service principles with a varying group of people
- Organizational, communication, and complex problem-solving skills
- Experience with computers and application software
- Ability to work independently and with minimal direction
- Ability to work efficiently and flexibly in high-stress and fast-paced situations
- Ability to participate as a collaborative team member
- Ability to maintain confidentiality of MFB Health records and systems
- Auditing, Compliance, Healthcare billing and/or coding certification preferred
Benefits
Comp & perks- Remote work within the United States
- Limited duration role covering a leave of absence
- Reasonable accommodation for qualified applicants or employees with disabilities
- Equal opportunity employment