Modernizing Medicine
Medical Coding Auditor
Remote - USA · Staff+
Sponsorship not specifiedDetected 30 days ago
Cloud PlatformsExcelAuditingEHR/EMRICD-10ResearchLeadershipCommunicationCollaborationTime Management
About the role
- Responsible for analyzing, reviewing and providing feedback when performing quality assurance activities and completing QA audits, including but not limited to:
- Ensuring all federal and state coding guidelines and regulations are met as well as payer guidelines
- Provide effective feedback to the global coding teams to aid in their successful coding of BOOST clients
Responsibilities
- Report all coding trends and issues to the department lead as they are identified
- Accurately document their daily audit results in the Daily Audit Log and communicate coding resolutions to the BOOST or global coding teams
- Collaborate with the global coding teams on inquiries, clarifications, QA rebuttals and training requests
- Perform BOOST special Quality Assurance audits on the global coding teams
- Perform BOOST or Compliance audits when requested by BOOST or other ModMed staff which help to determine coding compliance or client documentation issues
- Support in the review, appeal and follow-up of third-party (RAC, CERT, etc.) audits
- Collaborate with fellow coding/auditing team members to maintain department compliance and effectiveness
Requirements
- Knowledge of CPT, ICD-10 CM, HCPCS, CPT coding, modifiers, E/M and all coding guidelines, required
- Understanding of federal, state and local coding compliance regulations and guidelines, required
- Understanding of NCCI and CCI bundling edits, required
- The ability to interpret and apply coding guidelines for federal, state, and local standards is required
Nice to have
- Minimum 1-year experience as a Certified Professional Coder required - physician-based and/or ASC-based - multi-specialty coding experience preferred
- Understanding of EOBs and ERA's, denial remarks and claims review, preferred
- Proficient with Microsoft programs (Excel, Word) as well as the use of overall computer functions, preferred
- Experience in gMed/gGastro or EMA/PM is preferred but not required
Skills
- Consistently ranked as a Top Place to Work
- 2025
Compensation
- 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation.
Benefits
- At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce.
- Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution,
- Generous Paid Time Off and Paid Parental Leave programs,
- Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs,
- Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning,
- Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.
Company info
- Venture-Backed Company of the Year
- We are growing fast, thinking big, and we are just getting started.
- Ready to modernize medicine with us?
- Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process.
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This listing is sourced directly from Modernizing Medicine's careers page and normalized into a canonical job model.