Medical Coding Auditor

🕒 September 18

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

👻 Ghost score 13%

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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

• Analyze, review, and provide feedback during quality assurance activities and QA audits • Ensure federal, state, and payer coding guidelines and regulations are met • Provide feedback to global coding teams to support successful coding of BOOST clients • Maintain communication logs documenting global coding team training • Report coding trends and issues to the department lead • Review target cases each month according to the ModMed Quality Assurance SOP • Document daily audit results in the Daily Audit Log • Communicate coding resolutions to BOOST and global coding teams • Assist with monthly QA audit log summary pages detailing global coding accuracy levels • Collaborate on inquiries, clarifications, QA rebuttals, and training requests • Work with coding leadership on training covering coding processes, documentation, coding guidelines, and QA findings • Participate in remote coding sessions and sync or committee calls • Support communications between internal BOOST RCM teams and the Auditing team • Perform special BOOST quality assurance audits, including assignment accuracy and coding appeals accuracy • Perform BOOST or Compliance audits when requested • Support review, appeal, and follow-up of third-party audits such as RAC and CERT • Assist with maintaining coding guidelines, coding scrub edits, and practice coding instructions • Support continuous quality improvement and implementation of coding protocols and procedures • Collaborate with coding and auditing team members to maintain department compliance and effectiveness

🎯 Requirements

• Maintain coding certification(s) through continuing education units (CEU) • Knowledge of ICD-10-CM, HCPCS, CPT procedural coding, modifier usage, and federal, state, and payer-specific coding guidelines • Ability to conduct coding reviews, quality assurance audits, denial management coding, and compliance audits • Ability to analyze coding denials and provide claim corrections when applicable • Ability to provide statistical and qualitative feedback to coding teams • Ability to collaborate with internal and global coding teams on inquiries, clarifications, QA rebuttals, and training requests • Ability to review and maintain coding guidelines, coding scrub edits, and practice coding instructions • Ability to support third-party audits, including RAC and CERT audits

🏖️ Benefits

• Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution • 401(k) matching contribution of 50% of employee contributions deferred on up to 6% of compensation; matching contributions vest fully after one year • 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 • Global presence and in-person collaboration opportunities • Dog-friendly headquarters • Weekly catered breakfast and lunch • Treadmill workstations • Zen and wellness rooms • Remote availability for some roles

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