Logo for Prisma Health Urgent Care

Professional Coding Auditor

Role overview

Summary

The Professional Coding Auditor role focuses on reviewing clinical documentation and coding to ensure accuracy and compliance. You will collaborate with providers and coding teams to enhance coding quality and reimbursement, while also staying updated on coding regulations.

Qualifications

  • Active CPC or CCS coding certification through AAPC or AHIMA.
  • Relevant professional coding and/or coding auditing experience
  • 2+ years of medical billing experience
  • Experience with billing software and electronic medical records
  • Preferred: Urgent Care or Occupational Health billing experience

Responsibilities

  • Perform coding audits of provider documentation and assigned CPT and ICD-10 codes.
  • Evaluate whether clinical documentation supports the diagnoses and procedures billed.
  • Identify coding errors, documentation deficiencies, charge-capture issues, and opportunities for improvement.
  • Provide constructive, educational feedback to providers and coders.

Key facts

Hard skills

Other skills

  • Critical Thinking
  • Analytical Skills
  • Detail Oriented
  • Communication
  • Organizational Skills
  • Problem Solving

About the company

Prisma Health Urgent Care logo

Prisma Health Urgent Care

  • Medical Practices & Clinics
  • SME
  • 51–200
Prisma Health Urgent Care's mission is to help patients feel valued and well-cared for. We offer best-in-class urgent care services in greater Greenville, South Carolina, starting with certified medical providers specializing in urgent care medicine, clean, modern facilities, and convenient care options built specifically with our patients in mind.

Your match analysis

See how your profile stacks up against this role.

We compared the job requirements to your profile to show where you're strong and where you fall short.

Job description

Professional Coding Auditor

WellStreet Urgent Care is redefining the urgent care experience through patient-focused service, high-quality care, and strong partnerships with health systems. As a rapidly growing healthcare organization, we are building a national network of urgent care facilities and creating opportunities for talented professionals to make a meaningful impact.

If you’re an experienced medical coder who enjoys digging into documentation, identifying coding opportunities, and helping providers and coding teams improve accuracy, this could be a great opportunity to join our team.

About the Role

The Professional Coding Auditor reviews clinical documentation and coding to ensure accuracy, completeness, compliance, appropriate charge capture, and alignment between documentation and assigned CPT and ICD-10 codes.

This role goes beyond identifying errors—you’ll help educate providers and coders, identify trends, and partner with leadership to improve coding quality and reimbursement.

What You’ll Do

  • Perform coding audits of provider documentation and assigned CPT and ICD-10 codes.

  • Evaluate whether clinical documentation supports the diagnoses and procedures billed.

  • Identify coding errors, documentation deficiencies, charge-capture issues, and opportunities for improvement.

  • Review coding deliverables from professional coders, physicians, and other healthcare professionals.

  • Provide constructive, educational feedback to providers and coders.

  • Deliver education related to coding requirements, documentation standards, and regulatory updates.

  • Stay current on CMS, state, and payer coding regulations and requirements.

  • Collaborate with the Coding Supervisor and Regional Medical Directors to improve documentation and coding accuracy.

  • Perform charge entry and Charge Review activities as needed.

  • Identify trends such as undercoding or other recurring coding issues and recommend corrective actions.

  • Support error correction and process improvement initiatives.Meet established daily production and quality standards.

Required Qualifications

  • Active CPC or CCS coding certification through AAPC or AHIMA.

  • Relevant professional coding and/or coding auditing experience

  • 2+ years of medical billing experience.

  • Urgent Care or Occupational Health billing experience.

  • Experience working with insurance payers, A/R, revenue cycle processes, and denied claims.

  • Experience with billing software and electronic medical records.

  • Epic experience is a plus.

  • High school diploma or equivalent.

What Will Make You Successful

  • Strong understanding of medical coding and documentation requirements.

  • Excellent critical-thinking and analytical skills.

  • Ability to distinguish between a coding error and a documentation deficiency.

  • Strong attention to detail and commitment to accuracy.

  • Ability to communicate audit findings clearly and constructively.

  • Comfortable providing corrective feedback and educating providers and coders.

  • Strong organizational skills and ability to manage a high-volume workload.

  • Ability to identify coding trends and develop practical solutions.

  • Ability to stay current with coding changes and regulatory requirements.

  • Positive, collaborative attitude and ability to work effectively in a fast-paced environment.

Why Join WellStreet?

At WellStreet, we believe healthcare professionals should have the opportunity to do meaningful work while being part of a supportive, growing organization. We value people who bring energy, accountability, collaboration, and a genuine commitment to improving the patient experience.

If you’re a certified coding professional who enjoys auditing, problem-solving, and helping others improve, we’d love to hear from you!

#INDMISC

Related jobs

See all Auditor jobs

Other jobs at Prisma Health Urgent Care