What does the Coding Audit Supervisor do?
Under manager’s direction, the Coding Audit Supervisor oversees the daily operations, quality, productivity, and workflow of the coding audit team. This role provides direct supervision, coaching, audit assignment management, quality review, reporting, and escalation support to ensure audits are completed accurately, consistently, and timely. The Coding Audit Supervisor partners with coding leadership to identify coding risk, monitor trends, support corrective action, and promote compliant documentation and billing practices. This role supports and follows the US Oncology Compliance Program, including the Code of Ethics and Business Standards.
Responsibilities
Essential Duties and Responsibilities
Supervises assigned coding auditors and supports daily audit operations, including workload assignments, prioritization, follow-up, and timely completion of audit deliverables.
Monitors audit productivity, timeliness, quality, and documentation standards to ensure consistent performance across prospective, retrospective, focused, risk-based, new provider, and follow-up audits.
Reviews audit deliverables, findings, summaries, and trend reports for accuracy, completeness, clarity, and alignment with approved audit methodology and compliance expectations.
Provides coaching, mentoring, and technical guidance to coding auditors regarding coding rules, documentation standards, payer requirements, audit approach, and communication of findings.
Supports development, maintenance, and standardization of audit tools, templates, workflows, tracking methods, outcome labels, and reporting processes.
Identifies coding trends, documentation gaps, repeat errors, payer concerns, workflow barriers, and potential compliance risks based on audit results and team feedback.
Escalates significant findings, unresolved issues, repeated noncompliance, provider or coder concerns, and operational barriers to leadership as appropriate.
Prepares and presents audit status updates, productivity summaries, and recommendations for process improvement.
Assists with audit planning, sample selection guidance, project timelines, prioritization of risk-based work, and coordination of special audit requests.
Conducts or supports secondary reviews, validation reviews, focused reviews, and complex audit research when needed.
Participates in meetings with providers, coders, auditors, educators, business office teams, reimbursement teams, compliance partners, and leadership to communicate audit findings and next steps.
Supports onboarding, training, and competency development for new and existing coding audit team members.
Promotes consistent application of CPT, HCPCS, ICD-10-CM, CMS, OIG, NCCI edits, LCD/NCD guidance, commercial payer policies, AMA guidance, and specialty-specific requirements.
Maintains confidentiality of patient, provider, employee, and business information.
Qualifications
The ideal candidate for the Coding Supervisor will have the following background and experience:
High school diploma or equivalent required.
Current CPC, CCS-P, or CPMA certification required.
Minimum of five years of certified coding and/or coding audit experience required, including a minimum of three years of professional fee coding audit experience.
Prior experience leading projects, mentoring staff, supporting audit workflows, or coordinating team deliverables required.
Strong knowledge of ICD-10-CM, CPT, HCPCS, modifier rules, payer billing requirements, medical necessity, and medical record documentation standards required.
Prior experience auditing evaluation and management, infusion, medical oncology, surgery, radiation oncology, and/or other specialty documentation required.
Proficiency with Microsoft Outlook, Word, PowerPoint, and Excel required.
Strong written and verbal communication skills required.
Strong organizational, analytical, follow-up, and problem-solving skills required.
Strong attention to detail.
Ability to manage competing priorities, meet deadlines, coach others, and escalate issues appropriately required.
Preferred Qualifications
Four-year degree in a related field preferred; an associate degree with four years of related work experience, or eight years of related work experience, may be considered as equivalent experience.
Minimum two years of supervisory, team lead, or people-management experience preferred, including assigning work, managing priorities, and following up on team deliverables.
Experience supporting employee coaching, performance feedback, corrective action processes, and employee development preferred.
Experience working effectively in a remote environment and leading or supporting remote teams preferred.
Experience developing audit plans, audit templates, productivity trackers, trend reporting, and leadership summaries preferred.
Experience supporting government and regulatory audits, including OIG-related reviews, payer audits, and compliance audits, as well as documentation review, validation of findings, corrective action plans, and focused reviews preferred.
Experience with Microsoft Lists, Power BI, Access, or other reporting and workflow tracking tools preferred.
Specialized Knowledge and Skills
Strong knowledge of professional coding audit standards, provider documentation requirements, payer billing rules, medical necessity, modifier use, and specialty-specific coding guidance.
Ability to supervise audit workflows, assess workload status, monitor productivity, evaluate audit quality, and support consistent team performance.
Ability to coach auditors, resolve audit questions, provide constructive feedback, and promote consistent application of coding and compliance standards.
Ability to analyze audit results, identify trends, summarize risk, recommend practical next steps, and communicate findings clearly to different stakeholder groups.
Ability to maintain professionalism, confidentiality, and compliance awareness when handling patient, provider, employee, and business information.
Essential Duties and Responsibilities
Supervises assigned coding auditors and supports daily audit operations, including workload assignments, prioritization, follow-up, and timely completion of audit deliverables.
Monitors audit productivity, timeliness, quality, and documentation standards to ensure consistent performance across prospective, retrospective, focused, risk-based, new provider, and follow-up audits.
Reviews audit deliverables, findings, summaries, and trend reports for accuracy, completeness, clarity, and alignment with approved audit methodology and compliance expectations.
Provides coaching, mentoring, and technical guidance to coding auditors regarding coding rules, documentation standards, payer requirements, audit approach, and communication of findings.
Supports development, maintenance, and standardization of audit tools, templates, workflows, tracking methods, outcome labels, and reporting processes.
Identifies coding trends, documentation gaps, repeat errors, payer concerns, workflow barriers, and potential compliance risks based on audit results and team feedback.
Escalates significant findings, unresolved issues, repeated noncompliance, provider or coder concerns, and operational barriers to leadership as appropriate.
Prepares and presents audit status updates, productivity summaries, and recommendations for process improvement.
Assists with audit planning, sample selection guidance, project timelines, prioritization of risk-based work, and coordination of special audit requests.
Conducts or supports secondary reviews, validation reviews, focused reviews, and complex audit research when needed.
Participates in meetings with providers, coders, auditors, educators, business office teams, reimbursement teams, compliance partners, and leadership to communicate audit findings and next steps.
Supports onboarding, training, and competency development for new and existing coding audit team members.
Promotes consistent application of CPT, HCPCS, ICD-10-CM, CMS, OIG, NCCI edits, LCD/NCD guidance, commercial payer policies, AMA guidance, and specialty-specific requirements.
Maintains confidentiality of patient, provider, employee, and business information.
The ideal candidate for the Coding Supervisor will have the following background and experience:
High school diploma or equivalent required.
Current CPC, CCS-P, or CPMA certification required.
Minimum of five years of certified coding and/or coding audit experience required, including a minimum of three years of professional fee coding audit experience.
Prior experience leading projects, mentoring staff, supporting audit workflows, or coordinating team deliverables required.
Strong knowledge of ICD-10-CM, CPT, HCPCS, modifier rules, payer billing requirements, medical necessity, and medical record documentation standards required.
Prior experience auditing evaluation and management, infusion, medical oncology, surgery, radiation oncology, and/or other specialty documentation required.
Proficiency with Microsoft Outlook, Word, PowerPoint, and Excel required.
Strong written and verbal communication skills required.
Strong organizational, analytical, follow-up, and problem-solving skills required.
Strong attention to detail.
Ability to manage competing priorities, meet deadlines, coach others, and escalate issues appropriately required.
Preferred Qualifications
Four-year degree in a related field preferred; an associate degree with four years of related work experience, or eight years of related work experience, may be considered as equivalent experience.
Minimum two years of supervisory, team lead, or people-management experience preferred, including assigning work, managing priorities, and following up on team deliverables.
Experience supporting employee coaching, performance feedback, corrective action processes, and employee development preferred.
Experience working effectively in a remote environment and leading or supporting remote teams preferred.
Experience developing audit plans, audit templates, productivity trackers, trend reporting, and leadership summaries preferred.
Experience supporting government and regulatory audits, including OIG-related reviews, payer audits, and compliance audits, as well as documentation review, validation of findings, corrective action plans, and focused reviews preferred.
Experience with Microsoft Lists, Power BI, Access, or other reporting and workflow tracking tools preferred.
Specialized Knowledge and Skills
Strong knowledge of professional coding audit standards, provider documentation requirements, payer billing rules, medical necessity, modifier use, and specialty-specific coding guidance.
Ability to supervise audit workflows, assess workload status, monitor productivity, evaluate audit quality, and support consistent team performance.
Ability to coach auditors, resolve audit questions, provide constructive feedback, and promote consistent application of coding and compliance standards.
Ability to analyze audit results, identify trends, summarize risk, recommend practical next steps, and communicate findings clearly to different stakeholder groups.
Ability to maintain professionalism, confidentiality, and compliance awareness when handling patient, provider, employee, and business information.
