Medical Coding Auditor

🔥 0 minutes ago

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

ModMed

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

ModMed is a healthcare technology company that provides specialty-specific electronic health record (EHR) software, practice management, revenue cycle management, analytics, and patient communication tools for medical practices. Their platform integrates AI-powered features—like ModMed Scribe—for clinical documentation, workflow automation, billing assistance, and patient engagement to help specialty physicians streamline operations and improve efficiency. ModMed focuses on serving specialty practices (dermatology, ophthalmology, gastroenterology, orthopedics, OBGYN, etc. ) with onboarding, support, and integrations (FHIR API, telehealth, payment processing).

📋 Description

• Conduct coding reviews and quality assurance audits for ICD-10-CM, HCPCS, CPT procedural coding, and modifier usage • Perform denial management coding by reviewing, analyzing, and correcting coding denials and claims when applicable • Perform quality assurance on global denial coding team processes • Maintain ongoing contact with internal and global coding teams to provide statistical and qualitative feedback • Ensure federal, state, coding, and payer guidelines and regulations are met • Provide feedback and training support to global coding teams • Maintain communication logs documenting training related to coding trends and issues • Report coding trends and issues to department leads • Review target cases monthly according to the ModMed Quality Assurance SOP • Document daily audit results and communicate coding resolutions • Collaborate on inquiries, clarifications, QA rebuttals, and training requests • Attend remote coding sessions with global coding teams • Support communications between internal BOOST RCM teams and the Auditing team • Perform special Quality Assurance, BOOST, and Compliance audits • Support review, appeal, and follow-up of third-party audits • Assist with maintaining coding guidelines, scrub edits, practice coding instructions, and coding protocols • Collaborate with coding and auditing team members to maintain department compliance and effectiveness • Obtain continuing education units for coding certification maintenance

🎯 Requirements

• Minimum 1 year of experience as a Certified Professional Coder required, with physician-based and/or ASC-based multi-specialty coding experience preferred • Minimum 1 year of experience as a Certified Professional Medical Auditor preferred, not required • Must agree to obtain CPMA auditing certification within 6 months of employment if not already a CPMA • Required knowledge of CPT, ICD-10-CM, HCPCS, CPT coding, modifiers, E/M, and coding guidelines • Required knowledge of medical terminology and anatomy • Required understanding of federal, state, and local coding compliance regulations and guidelines • Required understanding of NCCI and CCI bundling edits • Required understanding of LCDs, NCDs, and other payer coverage policies • Understanding of EOBs, ERAs, denial remarks, and claims review preferred • Detailed knowledge of medical billing preferred • Required detailed knowledge of medical coding systems, procedures, and documentation requirements • Ability to interpret and apply federal, state, and local coding guidelines • Proficiency with Microsoft Excel, Microsoft Word, and general computer functions preferred • Experience with gMed/gGastro or EMA/PM preferred but not required • Highly detail-oriented with a high degree of accuracy in data entry • Exceptional written, verbal, and interpersonal communication skills • Ability to isolate and define trends and problems and provide solutions • Strong analytical skills for identifying, researching, and resolving issues • Excellent time management and ability to manage changing work priorities

🏖️ Benefits

• Comprehensive medical, dental, and vision benefits • Company Health Savings Account contribution • 401(k) matching contribution of 50% of the employee’s contribution deferred on up to 6% of compensation • 100% vesting of matching contributions after one year of employment • Generous Paid Time Off • Paid Parental Leave programs • Company-paid Life and Disability benefits • Flexible Spending Account • Employee Assistance Programs • Company-sponsored Business Resource & Special Interest Groups • Professional development opportunities • Tuition reimbursement programs • Unlimited access to LinkedIn Learning