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Compliance Coding Auditor-DRG

None • US • published 2026-10-01 21:59:21.742680

Description

**Job Summary** The Compliance Coding Auditor performs independent audits of coded medical records to evaluate accuracy, documentation integrity, and compliance with coding guidelines, regulatory requirements, and organizational policies. This role supports coding compliance and revenue integrity through audit activities, denial review and appeal support, and identification of documentation and coding risks. The Compliance Coding Auditor collaborates with coding, clinical, and revenue cycle stakeholders to improve coding accuracy, support audit readiness, and promote consistent application of coding standards across the organization. **Essential Functions*** Performs retrospective and concurrent coding audits to assess accuracy, completeness, and compliance with ICD\-10\-CM/PCS, CPT/HCPCS, DRG, and applicable regulatory requirements. * Reviews clinical documentation to ensure alignment with coded data, including evaluation of present on admission (POA), discharge disposition, and medical necessity. * Conducts denial reviews and validates coding and documentation to support appeal processes and reimbursement outcomes. * Develops and prepares audit findings, including detailed docume...

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