South Shore Health·Weymouth, Massachusetts
The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy while identifying opportunities for improvement. They also design and deliver educational programs to ensure clinical staff and coders adhere to Federal, State, and local regulatory requirements.
If you are an existing employee of South Shore Health then please apply through the internal career site.
LOC0006 - 780 Main Street780 Main Street Weymouth, MA 02190
Status: Full time
Budgeted Hours: 40
Shift: Day (United States of America)
The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements.
2 days onsite; 3 days remote option.
$73,000.00 - $104,400.00
Pertaining to compliance training / education as requested from providers and/or staff related to coding, billing and documentation in the inpatient, outpatient, professional, surgical and Home Health divisions of the Health System to ensure accuracy and support program objectives.
Designs training programs around compliant coding and billing from a regulatory standpoint for any new initiatives or programs affecting the Health System.
Evaluates vendor-training materials for its application or recommendation for use in educational programs.
Knowledge of all State and Federal regulatory changes that impact the Health System
Revises/modifies any instructional tools as necessary based on any changes to State and Federal regulatory changes to ensure guidance and training are accurate.
Assists in the development of follow-up mechanisms to ensure that knowledge and/or skills learned in the training are being applied on the job and have an impact on staff performance in meeting organizational goals.
Reports on program effectiveness and documents necessary changes.
Minimum Education - Preferred
Associates or Bachelor’s degree in Health Information Management.
Minimum 5 years acute care coding with demonstrated expertise in ICD-9-CM, ICD-10-CM, PCS and CPT coding. Experience, preferred, in adult and continuing education, organizational development and training.
CCA - Certified Coding Associate (AHIMA-American Health Information Management Assoc) or
CCS - Certified Coding Specialist (AHIMA-American Health Information Management Assoc) or
CCS-P - Certified Coding Specialist-Physican Based (AHIMA-American Health Information Management Assoc) or
CPC - Certified Professional Coder (AAPC-American Academy of Professional Coders) or
RHIA - Registered Health Information Administrator (AHIMA-American Health Information Management Association)
Interact with constituents who have competing priorities and effectively communicate the importance of compliance in a respectful yet authoritative manner.
Monday thru Friday 8am - 5pm
Responsibilities: if Required:
Certified Coding Associate - American Health Information Management Association (AHIMA), Certified Coding Specialist - American Health Information Management Association (AHIMA), Certified Coding Specialist - Physician Based - American Health Information Management Association (AHIMA), Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Certified Professional Medical Auditor (CPMA) - American Academy of Professional Coders (AAPC), Registered Health Information Administrator - American Health Information Management Association (AHIMA)
Market context
In Massachusetts, Coding and Compliance Auditor roles are typically driven by ongoing hospital compliance, documentation review, and revenue integrity needs in acute care settings. These positions are competitive because employers usually want at least 5 years of acute care coding experience plus a recognized credential such as CCA, CCS, CCS-P, CPC, CPMA, or RHIA, along with strong ICD-9-CM, ICD-10-CM, PCS, and CPT knowledge. Review the AI-summarized requirements and benefits on this page to save research time, and tailor your application to show audit findings, compliance work, and acute care coding depth.