ModMed is hiring a driven Medical Coding Auditor to join its BOOST Services team focused on coding compliance and accuracy for clients. This role supports coding quality standards and denial management processes within a fast-paced healthcare IT environment.
The Medical Coding Auditor conducts coding reviews and quality assurance audits to verify adherence to ICD-10-CM, HCPCS, CPT procedural coding, and modifier usage guidelines across internal and global coding teams. The role also functions as a denial management coder, reviewing coding denials, making applicable corrections, and supporting quality assurance for denial coding processes.
The position requires regular communication with coding teams to provide statistical and qualitative feedback, support education, and help maintain coding compliance. The role is performed under the supervision of the Medical Coding and Auditing Manager.
Qualifications
- Minimum 1 year of experience as a Certified Professional Coder (CPC) required; physician-based and/or ASC-based experience preferred
- Minimum 1 year of experience as a Certified Professional Medical Auditor (CPMA) preferred, but not required
- Must agree to obtain CPMA certification within 6 months of employment if not already certified
- Knowledge of CPT, ICD-10-CM, HCPCS, modifiers, E/M coding, and coding guidelines required
- Knowledge of medical terminology and anatomy required
- Understanding of federal, state, and local coding compliance regulations required
- Understanding of NCCI and CCI bundling edits required
- Understanding of LCDs, NCDs, and payer coverage policies preferred
- Understanding of EOBs, ERAs, denial remarks, and claims review preferred
- Detailed knowledge of medical billing and medical coding systems required
- Ability to interpret and apply coding guidelines across federal, state, and local standards required
- Proficiency with Microsoft Excel and Word preferred
- Experience with gMed/gGastro or EMA/PM preferred but not required
- Highly detail-oriented with strong data entry accuracy
- Strong written, verbal, and interpersonal communication skills
- Strong analytical skills with the ability to identify, research, and resolve issues
- Excellent time management skills and ability to manage changing priorities
Benefits
- Comprehensive medical, dental, and vision coverage
- Company Health Savings Account contribution
- 401(k) with company matching contribution
- Generous paid time off and paid parental leave
- Company-paid life and disability benefits
- Flexible spending account
- Employee assistance programs
- Company-sponsored business resource and special interest groups
- Professional development opportunities, including tuition reimbursement and LinkedIn Learning access
- Global collaboration opportunities
- Dog-friendly headquarters, catered meals, treadmill workstations, Zen rooms, and wellness rooms at HQ
Location
N/A
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 week ago