Coding Auditor

Role Description The Coding Auditor role is a full-time, remote position. This role is responsible for performing detailed reviews of medical records, claims, and billing data to verify charges, and ensure proper coding and documentation. Day-to-day tasks include, applying citation and policy guidelines, documenting audit findings, and generating preliminary and final audit reports that identify overpayments and potential fraud, waste, or abuse. The Coding Auditor will collaborate closely with internal teams and client stakeholders, support audit management and quality assurance processes, and contribute to case building and legal support when needed. The role requires maintaining professional conduct, objectivity, and strict adherence to confidentiality and regulatory requirements, including HIPAA.QualificationsStrong knowledge of medical coding and billing practices, including ICD, CPT, and HCPCS, with experience in claims review and charge verification.Proficiency in audit methodologies, documentation review, and application of citation and policy guidelines.Experience working with healthcare data analytics tools and large data sets, including familiarity with fraud, waste, and abuse detection approaches.Ability to produce clear, concise audit reports, document findings thoroughly, and communicate results effectively to internal and external stakeholders.Commitment to ethical standards, confidentiality, HIPAA compliance, and maintaining objectivity in interactions with healthcare personnel and patients.Strong analytical, critical thinking, and problem-solving skills, with high attention to detail and accuracy.Effective interpersonal and collaboration skills, with the ability to work on-site in a professional healthcare audit environment.Relevant professional certifications (e.g., CPC, CPMA, CCS, or equivalent) and prior experience as a coding auditor or medical coder are highly beneficial.Associate or bachelor’s degree in health information management, healthcare administration, or a related field preferred.