Medical Coding Auditor

Job Title: Medical Coder AuditorHourly/Salary Compensation Range: Contract Length: 6 monthsLocation: Long Beach, CA/Surrounding areas (Remote, must be withing 50 miles of Long Beach or Woodland Hills, CA incase of any onsite needs) Hours: 8-5 PSTStart Date: ASAP Client Overview: A leading nonprofit health plan serving millions of members across commercial, Medicare, Medicaid, and individual market programs. The organization is committed to improving healthcare quality, affordability, and access through innovative care delivery models, population health initiatives, and regulatory compliance excellence. This role supports enterprise-wide risk adjustment, medical record review, and government audit activities that help ensure accurate documentation, coding integrity, and compliance with federal and state requirements. Job Description: Seeking two experienced Senior Medical Review Coders to support high-priority government audit and medical record review initiatives. Responsibilities include retrospective and prospective medical record reviews, coding validation, abstraction, provider outreach, and audit support across Medicare Advantage (MA), ACA, and Medi-Cal programs.Key ResponsibilitiesReview and abstract medical records for coding and audit projectsSupport government audit initiatives including RADV and other regulatory reviewsPerform retrospective and prospective coding reviewsValidate diagnosis coding and documentation accuracyRequest and follow up on medical records from providersConduct provider outreach and resolve documentation issuesUtilize coding guidelines and regulatory requirements to ensure complianceCollaborate with internal audit, coding, and quality teams Skill Set Requirements: 10+ years of medical coding/review experienceActive coding certification (CPC, CCS, CRC, RHIT, RHIA, or equivalent)Extensive experience with:Medicare Advantage (MA)ACA risk adjustment programsMedi-Cal programsRisk adjustment codingMedical record abstraction and reviewGovernment audit support (RADV preferred)Strong knowledge of ICD-10-CM coding guidelinesAssociate degree or equivalent experienceMicrosoft Excel proficiencyMicrosoft Office SuiteSharePoint experienceMedical record retrieval and documentation systemsExperience with Facets preferred (training available)Experience using fax systems such as RightFax preferred Nice to Haves: Prospective and retrospective review experienceGovernment audit experienceProvider outreach and medical record retrievalHealth plan or managed care environmentRisk adjustment/HCC coding programs Education/Certification(s)/License(s):Active coding certification (CPC, CCS, CRC, RHIT, RHIA, or equivalent)