Medical Coder Auditor

• Revenue Cycle Management is looking for a Medical Coder Auditor to join our team! **Remote opportunity after 30-90 day in-person training*
• SUMMARY The Medical Coder Auditor is responsible for reviewing coded encounters to ensure accuracy, compliance, and alignment with coding guidelines, payer rules, and organizational policies. This role provides feedback to coders, identifies trends in errors, and supports coding education and process improvement initiatives. ESSENTIAL FUNCTIONS:
• Conduct retrospective and prospective coding audits to ensure coding accuracy and compliance with regulations.
• Review coded documentation for completeness, accuracy, and adherence to ICD-10-CM, CPT, HCPCS, and/or ICD-10-PCS guidelines.
• Identify coding trends, error patterns, and compliance risks, and develop corrective action plans.
• Provide feedback and education to coders to improve accuracy and consistency.
• Collaborate with providers and clinical staff to clarify documentation as needed.
• Prepare audit reports, track coding quality metrics, and communicate results to leadership.
• Assist in resolving complex coding questions, claim edits, and denials.
• Support the development of coding policies and procedures to align with best practices.
• Maintain up-to-date knowledge of coding regulations and payer requirements.
• Develop audit tools and standard operating procedures to ensure consistency in audits.
• Track trends and generate reports on coding accuracy, compliance, and productivity.
• Collaborate with leadership to implement corrective actions and staff training

Knowledge, skills, and abilities

• Strong knowledge of ICD-10-CM, CPT, HCPCS, and ICD-10-PCS coding guidelines.
• Ability to analyze complex coding issues and communicate findings clearly.
• Excellent auditing, critical thinking, and documentation skills.
• Strong interpersonal skills with the ability to coach and mentor coders.
• Proficiency with coding software, EHRs, and auditing tools.
• Critical thinking and decision-making in evaluating coding accuracy.