Medical Coding Auditor
We are seeking a detail-oriented and experienced Medical Coding Auditor to review and evaluate medical coding accuracy across patient records. The ideal candidate will ensure compliance with federal regulations, payer guidelines, and internal policies while supporting high standards of billing integrity and documentation quality.
Responsibilities
- Audit medical records to ensure accurate assignment of ICD-10, CPT, and HCPCS codes
- Identify coding errors, inconsistencies, overcoding, and undercoding
- Ensure compliance with healthcare regulations, including HIPAA and payer-specific rules
- Review documentation for completeness and support of billed services
- Provide clear feedback and corrective guidance to coding staff
- Prepare detailed audit reports and maintain accurate audit records
- Collaborate with compliance, billing, and clinical teams to improve coding quality
Requirements
- Certification such as CPC, CCS, or CCA required (advanced certifications preferred)
- Previous experience in medical coding (typically 2–5 years)
- Strong knowledge of medical terminology, anatomy, and coding guidelines
- Familiarity with electronic health records (EHR) systems
- Excellent attention to detail and analytical skills
- Strong written and verbal communication abilities
Preferred Qualifications
- Prior experience in medical auditing or compliance roles
- Knowledge of payer guidelines and reimbursement systems
- Experience working in a remote healthcare environment