Medical Auditor

Responsibilities

• Conduct routine and focused audits of medical coding to ensure compliance with CMS, payer, and organizational standards.
• Develop and deliver education and feedback to coders and providers to improve documentation quality and coding accuracy.
• Assist with internal and external audit preparation and response, including documentation requests and validation reviews.
• Maintain audit tracking logs, productivity reports, and accuracy metrics in accordance with company policies.
• Review medical records, claims data, and provider documentation to assess the accuracy of ICD-10-CM, CPT, HCPCS, and modifier assignment.
• Identify coding errors, trends, and opportunities for improvement; prepare detailed audit reports with actionable findings.
• Stay current with AAPC, AHIMA, CMS, and OIG guidelines, as well as payer policy changes and HCC model updates.
• Uphold all HIPAA, privacy, and compliance standards in handling patient data and audit documentation.

Requirements

• Active AAPC (CPC) or AHIMA (CCS-P, CCS) certification.
• Minimum 3 years of medical coding experience, with at least 1-2 years in a coding audit, QA, or compliance capacity.
• Strong understanding of HCC / risk adjustment coding principles, clinical documentation improvement, and coding validation practices.
• Excellent command of medical terminology, anatomy, physiology, pathophysiology, disease progression, and pharmacology.
• Deep familiarity with CPT, ICD-10-CM, HCPCS, and modifier assignment.
• Ability to work independently and maintain productivity in a remote setting.
• Strong communication and problem-solving skills.
• Proficient in EHR systems, encoder/coding software, and Google tools.
• Reliable internet connection and dedicated, secure workspace.

Nice-to-Haves

• You have an eye for detail and take pride in upholding the highest standards of coding accuracy and compliance.
• You’re motivated by the impact your work has on data integrity, provider education, and overall care quality.
• You enjoy analyzing trends, identifying opportunities for improvement, and helping others strengthen their documentation and coding practices.
• You thrive in a tech-forward, mission-driven environment where innovation and accountability go hand in hand.
• You’re comfortable working independently in a remote setting, yet you value being part of a collaborative, growth-oriented team.

Compensation and Benefits

• $36 base salary (hourly, equivalent to the provided ATS salary range).
• 100% paid health, dental, vision premiums (for families too).
• Generous parental leave (4 months for birthing parent, 2 months for partners).
• 401(k) with company match.
• Unlimited PTO + flexible schedule.