RCS Medical Coding Auditor

The RCS Medical Coding Auditor is responsible for auditing professional fee medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI, and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback.

The ideal candidate has strong hands-on experience with professional fee coding, deep knowledge of E/M, surgical, and modifier use, and the ability to translate audit findings into actionable insights.

Key responsibilities include:

• Perform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedback
• Validate ICD-10-CM, CPT, HCPCS, and modifier assignment against clinical documentation
• Conduct medical chart audits of professional services across multiple specialties
• Identify coding discrepancies, compliance risks, trends, root causes, and documentation gaps
• Support coding education through feedback, targeted training, and reference materials
• Prepare clear, defensible audit documentation with rationale and references
• Provide actionable recommendations to reduce future risk
• Track audit outcomes and trends to support leadership reporting and risk mitigation strategies
• Support denial prevention, resolution, and appeal strategies
• Collaborate across teams to assist with coding support
• Maintain confidentiality and comply with HIPAA and organizational policies