Professional Billing Quality Coding Auditor

Prisma Health

Professional billing coding auditor improving coding accuracy for Prisma Health, a healthcare provider. Reviewing medical coding, preventing denials, and training coders on compliance and process improvement.

Posted 8/11/2026full-timeRemote • South Carolina • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in multi-specialty coding, including CPT, ICD-10, and HCPCS codes, while ensuring compliance with official coding and CMS guidelines. Proficient in training and mentoring coders, analyzing coding processes, and improving operational efficiencies.

Highest-signal resume keywords

CPC Certified Professional CoderCPMA Certified Professional Medical AuditorMulti-Specialty Coding ExperienceKnowledge of Medical TerminologyWorking Knowledge of Epic

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

CPT CodingICD-10 CodingHCPCS CodingProfessional Billing CodingCoding Review AnalysisData Entry SkillsAnalytical SkillsCorrect Coding Application

Soft Skills

MentoringIndependent WorkProject Management

Tools & Technologies

EpicEncoder Pro3MWord Processing SoftwareSpreadsheetsDatabases

Certifications & Qualifications

CPC Certified Professional CoderCPMA Certified Professional Medical Auditor

Industry Keywords

Medical CodingCoding GuidelinesCoding DenialsClinical DocumentationMulti-Specialty Reviews

About the role

Key responsibilities & impact

Perform multi-specialty reviews for the Medical Group, validating CPT, ICD-10, modifiers, and HCPCS codes using official coding and CMS guidelines
Prepare summaries of coding review findings and present reports to leadership monthly
Review all coders within the department
Train and mentor coders on identified issues and correct coding guidelines
Code professional billing charges based on clinical documentation
Identify and help resolve coding issues and improve processes
Assist in creating edits to prevent coding denials
Assist in creating standardized front-end coding processes and training materials
Interact with other departments to resolve coding issues
Perform other duties as assigned

Requirements

What you’ll need

Bachelor's degree in Business or related field of study
Three years of multi-specialty coding experience in professional billing
CPC Certified Professional Coder certification from AAPC
CPMA Certified Professional Medical Auditor certification from AAPC
Knowledge of medical terminology and basic anatomy and physiology
Ability to apply coding concepts to ensure correct coding
Analytical skills
Working knowledge of Epic, Encoder Pro, and 3M
Ability to work independently and manage multiple projects consistently
Proficient computer skills in word processing, spreadsheets, and databases
Data entry skills

Benefits

Comp & perks

🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account Prisma Health Website LinkedIn All Job Openings 10,000+ employees Founded 2017 🏥 Healthcare 💰 Grant on 2024-08 Healthcare Prisma Health is a large integrated health system that operates hospitals, clinics, and related patient services in South Carolina and Tennessee. The organization employs nearly 32,000 people and focuses on providing clinical care, nursing and allied health services, and workforce training (e. g. , nurse residency programs), with an emphasis on patient-centered care and community health. The company posts career opportunities across administrative, clinical, technical, and support roles and highlights benefits, hiring events, and candidate resources on its careers site. Professional Billing Quality Coding Auditor 🔥 3 minutes ago 🌴 South Carolina – Remote ⏰ Full Time 🟡 Mid-level 🟠 Senior 🔎 Auditor Apply Now Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
Perform multi-specialty reviews for the Medical Group, validating CPT, ICD-10, modifiers, and HCPCS codes using official coding and CMS guidelines
Prepare summaries of coding review findings and present reports to leadership monthly
Review all coders within the department
Train and mentor coders on identified issues and correct coding guidelines
Code professional billing charges based on clinical documentation
Identify and help resolve coding issues and improve processes
Assist in creating edits to prevent coding denials
Assist in creating standardized front-end coding processes and training materials
Interact with other departments to resolve coding issues
Perform other duties as assigned 🎯 Requirements
Bachelor's degree in Business or related field of study
Three years of multi-specialty coding experience in professional billing
CPC Certified Professional Coder certification from AAPC
CPMA Certified Professional Medical Auditor certification from AAPC
Knowledge of medical terminology and basic anatomy and physiology
Ability to apply coding concepts to ensure correct coding
Analytical skills
Working knowledge of Epic, Encoder Pro, and 3M
Ability to work independently and manage multiple projects consistently
Proficient computer skills in word processing, spreadsheets, and databases
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