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About Wilmington Health
Since 1971, Wilmington Health has been committed to the care and health of our community in Wilmington as well as all of Southeastern North Carolina. Wilmington Health is structured as a multi-specialty medical practice with primary care providers integrated into the system. In this way, Wilmington Health is able to provide a comprehensive and coordinated approach to the care of all our patients. Wilmington Health is committed to using collaborative, evidence-based medicine in providing the highest quality of care to the patients we serve.
Purpose:
The Internal Auditor is responsible for conducting regular medical record and coding compliance audits across a multispecialty medical practice to evaluate coding accuracy, and compliance with CPT, ICD-CM, and CMS guidelines.
This position partners with providers, managers, and directors to identify educational opportunities for documentation and coding improvement.
Essential Duties/Responsibilities:
- Perform coding audits for E/M services and procedures across multiple specialties by ensuring services billed are supported.
- Apply current CPT, ICD-10-CM, CMS and payer coding guidelines to audit findings.
- Identify coding discrepancies, documentation gaps, compliance risks, and opportunities for improvement.
- Provide one-on-one and group education to providers regarding coding and documentation best practices.
QUALIFICATIONS
- Strong knowledge of CPT and ICD-10-CM guidelines.
- Experience working within a multispecialty medical practiceÂ
- The ability to understand documentation and coding requirements across specialties.
- Excellent verbal and written communication skills
- The ability to work independently and manage multiple audits
Required:
- CPC or CCS-P Coding Certification
- Experience with physician professional-fee auditing
Preferred:
- Additional certifications CPMA, CRC, or other relevant coding/auditing certification
ADA Physical Demands:
Rarely (Less than .5 hrs/day) Occasionally (0.6 – 2.5 hrs/day) Frequently (2.6 – 5.5 hrs/day) Continuously (5.6 – 8.0 hrs/day)
Physical Demand | Required? | Frequency |
Standing | Occasionally | |
Sitting | Continuously | |
Walking | Occasionally | |
Kneeling/Crouching | Rarely | |
Lifting | Rarely |
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