Coding Auditor

Job Summary

Performing detailed reviews of medical records and billing data, the full-time remote Coding Auditor will ensure proper coding and documentation while generating audit reports that identify overpayments and potential fraud.

Key responsibilities

• Conduct thorough reviews of medical records, claims, and billing data to verify charges and ensure compliance with coding standards
• Document audit findings and generate preliminary and final reports, collaborating with internal teams and client stakeholders
• Support audit management processes and contribute to case building and legal support as needed, maintaining confidentiality and regulatory compliance

Required qualifications

• Strong knowledge of medical coding and billing practices, including ICD, CPT, and HCPCS
• Proficiency in audit methodologies and documentation review
• Experience with healthcare data analytics tools and familiarity with fraud detection approaches
• Relevant professional certifications (e.g., CPC, CPMA, CCS) and prior experience as a coding auditor or medical coder
• Associate or bachelor's degree in health information management, healthcare administration, or a related field preferred