About Us

At Alteva RCM, we're dedicated to helping healthcare providers thrive through expert revenue cycle management, strategic insight, and innovative solutions. We're always looking for passionate, driven professionals who want to make a meaningful impact, grow their careers, and be part of a collaborative team committed to excellence.

Position Summary

The Coding Auditor conducts routine coding audits across assigned specialties, coders, and client accounts to assess coding accuracy, documentation sufficiency, and compliance with applicable coding guidelines and payer requirements. This role is responsible for producing well-documented audit findings, supporting corrective action follow-through, and contributing to the department's compliance monitoring and education efforts. The Coding Auditor works closely with the Senior Coding Auditor and Coding Audit Manager to develop technical skills, deliver consistent audit quality, and grow into an increasingly independent contributor within the audit program.

Key Responsibilities

Audit Execution

Conduct routine coding audits across assigned specialties and client accounts, reviewing clinical documentation and coded encounters for accuracy, documentation alignment, and compliance with applicable guidelines
Evaluate the relationship between clinical documentation and reported codes, including code selection, sequencing, modifiers, units, and other applicable coding elements
Apply ICD-10-CM, CPT, HCPCS, modifier rules, and payer-specific requirements to audit findings; support audit determinations with appropriate authoritative coding, regulatory, and payer references in accordance with departmental guidance
Complete assigned audit volumes within established turnaround expectations and quality standards
Perform assigned audits independently within established departmental guidelines and audit methodology. Escalate complex or unclear coding scenarios, matters requiring advanced interpretation, policy determination, or resolution of conflicting guidance to the Senior Coding Auditor
Participate in audit calibration activities to promote consistency and accuracy in audit interpretation and application of coding guidelines

Finding Documentation & Reporting

Document audit findings with accuracy and clarity, including discrepancy identification, root cause classification, and corrective recommendations
Prepare individual audit reports and summary submissions in accordance with department templates and standards
Maintain organized, complete audit records and files in accordance with department documentation requirements
Compile audit data for submission to the Coding Audit Manager for trend analysis and reporting

Corrective Action & Education Support

Communicate audit findings to audited coders in a professional, constructive, and guideline-grounded manner
Provide individualized coding feedback and assist with audit-driven education, including development of written feedback, reference materials, and participation in team huddles or education sessions
Assist in re-auditing previously identified findings to assess corrective action effectiveness
Identify patterns in assigned audit findings and report observations to the Coding Audit Manager and Senior Coding Auditor

Compliance Monitoring & Confidentiality

Remain current with applicable coding guidelines, payer updates, and regulatory requirements relevant to assigned specialties
Flag potential compliance risks or emerging accuracy issues identified during audit activity to the Senior Coding Auditor or Coding Audit Manager
Support audit readiness activities and contribute to audit program documentation as directed
Maintain confidentiality and safeguard protected health information in accordance with HIPAA, organizational policies, and applicable regulatory requirements

Key Performance Indicators

Audit completion rate and turnaround time against assigned schedule
Audit finding accuracy and documentation quality (validated through supervisor review and calibration)
Escalation timeliness and appropriateness