Medical Coding Auditor
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Job Description
RCS Medical Coding Auditor responsible for auditing professional fee medical coding for compliance. Ensuring accuracy and providing education and feedback for continuous quality improvement.
Responsibilities:
- Perform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedback
- Validate ICD‑10‑CM, CPT®, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelines
- Conduct medical chart audits of professional services across multiple specialties
- Identify coding discrepancies, compliance risks, trends, root causes, and documentation gaps
- Support coding education through feedback, targeted training, and reference materials
- Prepare clear, defensible audit documentation including rationale and references
- Provide actionable recommendations to address audit findings and reduce future risk
- Track audit outcomes and trends to support leadership reporting and risk mitigation strategies
- Support denial prevention, resolution and appeal strategies
- Collaborate across teams to assist with coding support
- Maintain confidentiality and comply with HIPAA and organizational policies
Requirements:
- CPC (Required)
- CPMA (Required/In Process)
- 2+ years of ProFee auditing experience
- Knowledge of E/M documentation guidelines
- Modifier rules and NCCI edits
- CPT, ICD‑10‑CM, HCPCS Level II
- High attention to detail with strong analytical and critical‑thinking skills
- Excellent written and verbal communication skills for audit reporting and education
- Proficiency with EHRs, coding and auditing tools
- Proficiency with Microsoft Office Suite
Benefits:
- holidays
- vacation
- medical insurance
- dental insurance
- vision insurance
- company paid life insurance
- retirement savings
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