Certified Coding Auditor

The Certified Professional Coder (CPC) serves as the primary liaison between the medical group and the external coding vendor.

This role ensures consistent communication, accurate and compliant coding practices, timely issue resolution, and alignment with organizational policies and payer requirements.

The Coding Liaison supports documentation integrity, monitors vendor performance, and acts as a subject matter expert for coding-related inquiries.

This role works closely with providers, clinical staff, and revenue cycle teams to review medical records, validate documentation completeness, apply correct CPT, ICD-10-CM, and HCPCS codes, and educate providers on documentation best practices.

Key Responsibilities Coding and Documentation Accuracy * Serve as the primary point of contact between the medical group and the outsourced coding vendor * Review, monitor, and validate coding accuracy and consistency between internal standards and vendor deliverables * Monitor vendor performance metrics such as accuracy, turnaround time, and compliance * Review outpatient and/or inpatient medical records to ensure documentation supports billed services * Identify documentation gaps and query providers for clarification when necessary * Serves as resource and subject matter expert to other medical billing staff * Research analyzes, recommends, and facilitates plans of action to correct discrepancies and prevent future coding errors.

Compliance and Quality Assurance * Participate in internal and external audits and provide corrective action recommendations * Stay current with coding updates, payer rules, and regulatory changes Provider and Staff Education * Educate providers on documentation requirements to support accurate coding and billing * Provide feedback and training on clinical documentation improvement (CDI) opportunities * Serve as a resource for coding and documentation questions from clinical staff * Provides ongoing training to staff as needed.

Reporting and Collaboration * Collaborate with revenue cycle, billing, compliance, and quality teams * Assist with denials management and coding-related appeals as needed * Medical Coder Qualifications/Skills: * Active AAPC certification (CPC) * 3+ years of medical coding experience.

* Strong knowledge of: * CPT, ICD-10-CM, and HCPCS coding guidelines * E/M coding (including 2021+ E/M guidelines if applicable) * CMS and major payer regulations * Preferred Qualifications * Proficiency in electronic health records (EHR) and encoder systems * Experience in hospital, multispecialty, or high-volume outpatient environments * Familiarity with auditing, compliance programs, and denial resolution * Excellent attention to detail and analytical skills * Strong written and verbal communication skills * Proficiency in Microsoft Office Product Suite.

St.

Joseph's Health is recognized for the expertise and compassion of its highly skilled and responsive staff.

The combined efforts of the organization's outstanding physicians, superb nurses, and dedicated clinical and professional staff have made us one of the most highly respected healthcare organizations in the state, the largest employer in Passaic County, and one of the nation's "100 Best Places to Work in Health Care".