Join the Team Modernizing Medicine
At ModMed, we’re not just building software—we’re reimagining the healthcare experience. Founded in 2010 by a practicing physician and a successful tech entrepreneur, they took a radically different approach: hiring doctors and teaching them how to code. This "for doctors, by doctors" philosophy has allowed the creation of an AI-enabled, specialty-specific cloud platform that places patients at the center of care.
The Medical Coding Auditor will join the high-performing BOOST Services team focused on delivering top-tier coding compliance and accuracy. Responsibilities include conducting coding reviews and quality assurance audits to ensure guidelines for ICD-10-CM, HCPCS, CPT procedural coding, and modifier usage are followed. Role also involves denial management tasks including analyzing coding denials and providing corrections and performing quality assurance on global denial coding teams' processes.
The Auditor provides feedback and education to coding teams consistent with established guidelines, reports trends and issues, and collaborates with teams for training and compliance.
Key duties:
- Perform QA audits adhering to all federal, state, and payer coding guidelines
- Provide feedback and training to global coding teams
- Document daily audit results and coding resolutions
- Collaborate on inquiries, clarifications, and training requests
- Support appeals and follow-ups on third-party audits
- Assist with coding guidelines, scrub edits, and quality improvements
- Maintain continuing education units (CEU) for certifications
Skills & Requirements:
- Minimum 1 year experience as Certified Professional Coder (CPC), physician-based and/or ASC-based preferred
- CPMA certification preferred or must obtain within 6 months
- Knowledge of CPT, ICD-10 CM, HCPCS, modifiers, E/M and coding guidelines
- Knowledge of medical terminology and anatomy
- Understanding of coding compliance regulations, bundling edits, payer policies
- Preferred knowledge of EOBs, ERAs, denial remarks, medical billing
- Proficiency in Microsoft Office
- Detail oriented with strong communication and analytical skills
Benefits:
- Comprehensive medical, dental, vision insurance with HSA
- 401(k) with company matching
- Paid Time Off and Parental Leave
- Life and Disability insurance
- Flexible Spending Account and Employee Assistance Program
- Professional development and tuition reimbursement
- Hybrid office-based roles with remote availability
- Wellness programs and catered meals at HQ
Note: The company is aware of phishing scams and cautions applicants to verify official communication channels.
- Minimum 1 year experience as Certified Professional Coder (CPC), physician-based and/or ASC-based preferred
- CPMA certification preferred or must be obtained within 6 months if not already certified
- Knowledge of CPT, ICD-10 CM, HCPCS, CPT coding, modifiers, E/M and all coding guidelines
- Knowledge of medical terminology and anatomy
- Understanding of federal, state, and local coding compliance regulations and guidelines
- Understanding of NCCI and CCI bundling edits
- Understanding of LCDs, NCDs, and other payer coverage policies
- Preferred understanding of EOBs, ERAs, denial remarks, and claims review
- Detailed knowledge of medical billing and coding systems
- Ability to interpret and apply coding guidelines for federal, state, and local standards
- Proficient with Microsoft Excel, Word, and computer functions
- Preferred experience with gMed/gGastro or EMA/PM
- Highly detail-oriented with strong accuracy for data entry
- Exceptional written, verbal, and interpersonal communication skills
- Strong analytical skills and problem-solving capabilities
- Excellent time management and ability to manage changing priorities
- Comprehensive medical, dental, and vision benefits including company HSA contribution
- 401(k) with 50% match up to 6% of compensation
- Generous Paid Time Off and Paid Parental Leave
- Company paid Life and Disability benefits
- Flexible Spending Account and Employee Assistance Programs
- Company-sponsored Business Resource & Special Interest Groups
- Professional development opportunities including tuition reimbursement and LinkedIn Learning access
- Hybrid office-based roles with remote availability for some roles
- Wellness programs including treadmill workstations and catered meals at headquarters
Location
N/A
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
3 weeks ago