Community Health System

Regional hospital network delivering medical care

Coding Compliance Auditor

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

Full-timeFresno, CA, USANo salary listedIn-person

About the Job

Requirements

An Associate's Degree in Business, Information Systems, Nursing, Health Care, or a related field is required.
Experience performing medical record and billing audits or reviews, including clinical documentation, medical terminology, CPT, HCPCS, ICD-10-CM, and revenue codes, and reviews for charge and reimbursement accuracy is required.
Knowledge of federal, state, and private payer guidelines is required.
Either five years of healthcare coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCS, if qualifying with an Associate's Degree, or three years of healthcare coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCS, if qualifying with a Bachelor's Degree, is required.
One of the following certifications is required: Certified Coding Specialist (CCS), Certified Coding Specialist–Physician-based (CCS-P), Certified Medical Audit Specialist (CMAS), Certified Professional Medical Auditor (CPMA), or Certified Professional Coder (CPC).

Responsibilities

Conduct coding and documentation audits to ensure accurate code assignment, appropriate billing, integrity of the medical record, and compliance with federal and state healthcare program requirements.
Audit facility coding and professional fees for partners, and audit other coders and physicians.

Desired Qualifications

A Bachelor's Degree in Business, Information Systems, Nursing, Health Care, or a related field is preferred.
Epic experience is preferred.
Experience with 3M or Optum is preferred.
Experience completing a formal validation report after audits is preferred.
Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) certification is preferred.
Two or more certifications are preferred.

Overview

Opportunities for you!

Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek

Free Continuing Education and certification

Tuition reimbursement, educationprogramsand scholarships

Vacation time starts building on Day 1, and builds with your seniority

Free money toward retirement with a 403(b) and matching contributions

Great food options with on-demand ordering

Free parking and electric charging

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page.

Responsibilities

The Coding Compliance Auditor is a member of the Compliance Office and contributes to the Community Health System’s mission to better the lives of all those we serve. As a Coding Compliance Auditor, you will be responsible for conducting coding and documentation audits to ensure accurate code assignment, appropriate billing, integrity of the medical record, and compliance with federal and state healthcare program requirements.

The role requires a highly confident coder who can audit both facility coding and professional fees for partners, as well as audit other coders and physicians.

Qualifications

Education

Associate's Degree in Business, Information Systems, Nursing, Health Care, or a related field required
Bachelor's Degree in Business, Information Systems, Nursing, Health Care, or a related field preferred

Experience

Experience performing medical record and billing audits/reviews, including clinical documentation, medical terminology, codes (CPT, HCPCS, ICD-10-CM, and revenue), and reviews for charge and reimbursement accuracy required
Knowledge of federal, state, and private payer guidelines required

One of the following is required:

5 years of healthcare coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCS, if qualifying with an Associate’s Degree
3 years of healthcare coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCS, if qualifying with a Bachelor’s Degree
Epic experience preferred
Experience with 3M or Optum is preferred
Experience completing a formal validation report after completing audits preferred.

Licenses and Certifications:

One of the following is required:
- CCS - Certified Coding Specialist
- CCS-P - Certified Coding Specialist- Physician-based
- CMAS - Certified Medical Audit Specialist
- CPMA - Certified Professional Medical Auditor
- CPC - Certified Professional Coder
Additional certifications preferred:
- RHIA - Registered Health Information Administrator
- RHIT - Registered Health Information Technician
Two or more certifications preferred

Disclaimers

• Pay ranges listed are an estimate and subject to change.
• If any bonuses are noted, they are only applicable to external hires meeting criteria.

About the Company

Community Health System

Regional hospital network delivering medical care

Community Health System operates a regional health network across Central California, running hospitals and care facilities such as Community Regional Medical Center, Clovis Community Medical Center, and Fresno Heart Surgical Hospital. It provides inpatient and outpatient services across specialties including cancer care, neuroscience, orthopedics, obstetrics, pediatrics, cardiology, imaging, and mental health, supported by tools like MyChart for patient access and pre-registration. It differentiates itself by running regional centers of excellence and integrated campuses—such as a cancer center, trauma center, NICU, and specialized heart and brain services—across the San Joaquin Valley. Its goal is to extend advanced medical care, improve patient outcomes, and ensure comprehensive, accessible health services for the Central Valley community.

Company size: 1,001-5,000
Company stage: Grant
Total funding: $10.7M
Headquarters: Clovis, CA
Founded: 1897

Recently Posted Jobs

Explore more opportunities at Community Health System

See more jobs