Medical Coding Auditor; no remote option

Responsibilities

The Medical Auditor is responsible for coordinating and conducting medical billing, coding, and documentation audits to ensure compliance with federal, state, and commercial payer regulations, organizational policies, and industry standards. This role evaluates provider documentation, coding accuracy, billing practices, and revenue cycle processes across multiple clinical specialties and care settings. The Medical Auditor provides education, consultation, and recommendations to clinicians, clinical staff, and operational leaders to improve documentation integrity, coding accuracy, regulatory compliance, and revenue optimization.

This position works closely with physicians, advanced practice providers, coding and billing personnel, revenue cycle leadership, compliance officers, operational leaders, and other healthcare stakeholders to promote compliant documentation, coding, billing, and reimbursement practices.

• Bachelor’s degree in healthcare administration, Health Information Management, Nursing, Business, Finance, or a related healthcare field required.
• Minimum of three to five (3-5) years of experience in healthcare auditing, compliance, physician billing, coding, revenue integrity or related healthcare operations.
• Experience performing documentation, coding, and billing audits in a healthcare system, academic medical center, physician practice, consulting organization, or related setting preferred.
• Experience auditing Evaluation and Management (E/M) services and professional claims required.
• Certified Professional Coder (CPC) required
• Certified Professional Medical Auditor (CPMA) strongly preferred
• Other relevant coding or auditing certifications may be considered