Role OverviewAs a Senior Coding Quality Auditor, you will lead retrospective coding audits to verify adherence to internal standards and federal regulations, including those set by CMS, Medicaid, OIG, and HCFA. Based in Warrenville, IL, this full-time position offers hybrid work flexibility with occasional travel to other locations.
Key Responsibilities
- Perform in-depth audits of medical coding to ensure compliance with regulatory requirements and organizational policies
- Identify gaps in documentation and coding practices, then recommend corrective actions and process enhancements
- Review charge data, insurance claims, and payment records to confirm accuracy and timeliness in billing workflows
- Report findings to management and collaborate with compliance teams on investigations involving provider groups
- Develop and maintain auditing schedules to support consistent, timely reviews
- Stay up to date with changes in ICD-10, CMS guidelines, and federal and state regulations
- Educate clinical and administrative staff on coding standards and documentation best practices
- Support professional development through participation in training, conferences, and industry organizations like AAPC or AHIMA
Qualifications
Candidates must hold a high school diploma and possess either CPC or CCS-P certification. A minimum of three years of coding and auditing experience, along with at least five years in a hospital or clinical environment, is required.
Strong analytical thinking, written and verbal communication, and organizational abilities are essential. Proficiency with Microsoft Office, particularly Excel, Word, and PowerPoint, is expected. The ideal candidate interacts professionally with all levels of staff and handles sensitive situations with objectivity.
Work Environment & Benefits
This position operates in a hybrid model, combining remote and on-site work with required travel to various locations. Benefits include performance-based salary increases, comprehensive health coverage, tuition reimbursement, retirement plans with company match, paid time off, wellness initiatives, and opportunities for professional advancement.
The organization values inclusion, collaboration, and excellence in patient care, fostering a workplace where every team member can grow and contribute meaningfully.
