Provider Coding Compliance Consultant
The Provider Coding Compliance Consultant at Confidential Client is responsible for conducting audits of provider services to ensure compliance with healthcare regulations and organizational policies. This role involves identifying audit projects, reporting findings, recommending corrective actions, and providing coding education to providers to mitigate risks and enhance compliance effectiveness. The consultant serves as a resource on coding compliance and supports continuous improvement through training and adherence to federal, state, and local laws.
About Careertakes
👉 Important disclosure: Careertakes is a third-party recruiting platform supporting this hiring process. If selected, you will be employed directly by our client, IT.
Applicants for this role may also receive access to additional matched opportunities through the Careertakes platform.
Position overview
Confidential Client is seeking a Provider Coding Compliance Consultant to support coding audit, compliance, and provider-education activities. This role focuses on auditing provider services, identifying coding and documentation risk, recommending corrective action, and delivering targeted education to clinical teams and providers.
What You’ll Do
- Identify and prioritize audit projects; schedule audits with appropriate stakeholders.
- Conduct provider and chart audits to evaluate compliance with policies, payer rules, and federal/state regulations.
- Prepare clear, actionable written audit and investigation reports that identify risks and recommend remediation.
- Obtain, document, and follow up on corrective action plans to ensure implementation and effectiveness.
- Track audit findings and measure audit satisfaction and outcomes through stakeholder feedback.
- Deliver provider-facing coding education on audit trends and documentation best practices.
- Act as a coding compliance resource for departments across the organization for routine questions and guidance.
Minimum qualifications
- Bachelor’s degree OR 4 years of professional coding experience.
- At least 1 year of relevant experience in a healthcare coding, auditing, or compliance role.
- Advanced knowledge of CPT, ICD-10-CM, HCPCS, CMS regulations, and payer-specific billing/documentation rules.
- Experience auditing E/M services, surgical procedures, office-based and diagnostic services across multiple specialties; advanced orthopedics experience preferred.
- Proficient with Microsoft Word and Excel.
- Strong written and verbal communication skills, including ability to present audit findings and provide provider education.
- Demonstrated judgment, attention to detail, critical thinking, integrity, and dependability.
Preferred qualifications & certifications
- Bachelor’s in Health Information Management (HIM) or 4+ years of physician/professional fee coding experience.
- Medical coding credentials such as CPC, CCS, or CCS-P.
- HCCA certification preferred.
- Demonstrated commitment to continuing education and professional development in auditing and coding.
Compensation & location
- Hourly equivalent: $30.52/hour to $45.79/hour (est.).
- Annual equivalent: $63,481/year to $95,243/year (est.). Actual pay will depend on experience and qualifications.
- Location: Tarrytown, TX (onsite or as specified by the hiring manager).
Why this role is a good fit
- Impact: Directly reduce revenue risk and improve coding/documentation quality across providers.
- Professional growth: Opportunities for continuing education and to pursue advanced certifications.
- Cross-functional exposure: Work with compliance leadership, clinical teams, and revenue cycle stakeholders.
Equal Opportunity & Hiring Transparency
Careertakes and our client are Equal Opportunity Employers committed to building a diverse and inclusive workforce. We prohibit discrimination or harassment of any kind. To support a fair and efficient hiring process, AI tools may be used to assist with application review or resume screening. These tools do not replace human decision-making. Final hiring decisions are made by people.
If you have questions about how your data is used, please contact us directly.
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