Coding Auditor

Medical Coding Auditor

Hybrid (1 - 2 days in office per week)

Baltimore, MD 21201

Compensation $66k-$92k

Direct Placement

Responsible for conducting independent physician coding and auditing reviews to ensure the accuracy, completeness, and compliance of medical record documentation supporting codes selected by providers and/or coders. This role ensures compliance with CMS guidelines, CPT, HCPCS, and ICD-10 code sets, while supporting providers through ongoing physician coding education, auditing feedback, compliance guidance, and training initiatives.

This position plays a key role in physician documentation improvement, coding compliance, audit readiness, and provider education across the organization.

• Conduct independent physician coding and auditing reviews to assess the adequacy of medical record documentation supporting codes selected by providers and/or coders.
• Perform detailed physician coding compliance audits to ensure adherence to CMS guidelines, CPT, HCPCS, ICD-10 code sets, and internal billing policies.
• Utilize MDaudit software to complete audit documentation, tracking, and reporting activities.
• Analyze provider, division, and departmental documentation and coding trends to identify compliance risks and recommend corrective actions.
• Support reporting of audit results, including trending, regulatory tracking, and responses to compliance inquiries.
• Develop and deliver physician coding education and training materials to improve documentation accuracy and coding compliance.
• Present physician coding audit findings and compliance risks to providers, leadership, and practice administrators.
• Create and administer targeted provider education and training programs to address documentation and coding gaps identified through auditing activities.
• Contribute to system-wide compliance education initiatives, including New Provider Education and Annual Compliance Training programs.

• Prepare reports for compliance leadership and executive stakeholders, highlighting key findings from physician coding and auditing activities.
• Conduct regulatory research and draft responses to coding and compliance inquiries.
• Monitor and communicate regulatory updates impacting physician coding, documentation, and billing compliance.
• Document and track compliance cases, investigations, and inquiries within the case management system.
• Support compliance investigations related to documentation, billing, and coding concerns.
• Assist in developing policies, standard operating procedures, audit tools, and education toolkits to strengthen physician coding and auditing practices.

• Meet departmental KPIs, including:
• Audit productivity
• Audit quality/accuracy
• Turnaround time
• Provider education and training effectiveness
• Maintain strong knowledge of CMS, CPT, HCPCS, ICD-10, and payer documentation requirements.
• Perform other duties as assigned.

profee, coding, auditing, Ccs, Cpc, Education, Physician

• High school diploma.
• Five (5) years' experience in coding including two (2) years of auditing/billing compliance experience.
• Certified Professional Coder (CPC) certification
• Experience in and working knowledge of Corporate Compliance.
• Certified Coding Specialist (CCS), Certified Coding Specialist-Physician-based (CCS-P), or Certified Medical Auditor (CPMA) certification

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This is a Permanent position based out of Baltimore, MD.

The pay range for this position is $66102.00 - $92560.00/yr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic…