Certified Medical Coder / Clinical Chart Auditor (AAPC certified)

Description

Position Summary

Elite DNA Behavioral Health is seeking a detail-oriented Certified Medical Coder / Clinical Chart Auditor (AAPC certified) to support our internal compliance and quality assurance program. This role focuses on chart auditing, documentation review, and provider education, with an emphasis on CMS, Florida Medicaid, and behavioral health documentation standards.

This position goes beyond CPT coding alone. The Auditor will review each element of the medical record—including assessments, treatment plans, progress notes, and billing documentation—to ensure services meet regulatory, payor, and internal compliance requirements. The Auditor will also provide constructive feedback and education to providers to improve documentation accuracy and reduce audit risk.

This is an excellent opportunity for early-career coders (0–3 years experience) looking to build expertise in healthcare compliance and auditing.

Essential Duties and Responsibilities

• Conduct routine and targeted chart audits for therapy, psychiatry, and behavioral health services
   
• Review CPT, HCPCS, and ICD-10 coding accuracy
   
• Evaluate documentation compliance with:
   
  • CMS requirements
     
  • Florida Medicaid policies and handbooks
     
  • Payor-specific standards (Optum, Sunshine, Molina, etc.)
     
  • Internal clinical documentation policies
     
• Validate medical necessity, time-based coding, and treatment plan requirements
   
• Assess completeness of:
   
  • Intakes/assessments
     
  • Treatment plans
     
  • Progress notes
     
  • Signatures and credentials
     
  • Billing support documentation
     
• Identify trends, risks, and recurring documentation issues
   
• Prepare clear, objective audit findings and reports
   
• Provide education and feedback to providers and staff on documentation improvements
   
• Participate in compliance initiatives, internal training, and corrective action plans
   
• Assist with preparation for external audits and payor requests
   
• Maintain strict confidentiality of PHI in accordance with HIPAA
   

Qualifications

Required

• Active AAPC certification (CPC, CPMA, COC, or similar)
   
• 0–3 years of coding, auditing, or healthcare documentation experience
   
• Strong attention to detail and analytical skills
   
• Working knowledge of CPT, ICD-10-CM, and medical necessity principles
   
• Ability to interpret regulatory and payor documentation standards
   
• Strong written and verbal communication skills
   
• Ability to provide constructive, professional feedback to clinicians
   

Preferred

• Experience with behavioral health or outpatient mental health services
   
• Experience with Athena or other EHR systems
   
• Knowledge of Medicaid and managed care documentation requirements
   
• CPMA (Certified Professional Medical Auditor) or interest in obtaining
   
• Experience in compliance, quality assurance, or internal audits
   

Skills & Competencies

• Detail-oriented and highly organized
   
• Strong critical thinking and problem-solving skills
   
• Comfortable reviewing large volumes of documentation
   
• Ability to balance accuracy with productivity
   
• Collaborative and educational mindset
   
• Professional discretion and confidentiality