Medical Coding Auditor

Join the Team Modernizing MedicineAt ModMed, we’re not just building software—we’re reimagining the healthcare experience. Founded in 2010 by a practicing physician and a successful tech entrepreneur, we took a radically different approach: we hired doctors and taught them how to code. This \"for doctors, by doctors\" philosophy has allowed us to create an AI-enabled, specialty-specific cloud platform that places patients at the center of care.A Culture of ExcellenceWhen you join ModMed, you’re joining an award-winning team recognized for innovation and employee satisfaction. From our global headquarters in Boca Raton Florida, and extensive employee base in Hyderabad India, we are a team of 4,500+ passionate problem-solvers on a mission to increase medical practice success and improve patient outcomes:Consistently ranked as a Top Place to Work2025 Globee Business Awards: Gold Globee for “Technology Team of the Year”2025 Black Book Awards: Ranked #1 EHR in 11 SpecialtiesFlorida Venture Forum: Venture-Backed Company of the YearWe are growing fast, thinking big, and we are just getting started.Ready to modernize medicine with us?Job Description Summary:Medical Coding Auditors are responsible for ensuring that coding performed on behalf of ModMed BOOST clients is in compliance with all published federal, state and payer-specific coding guidelines.The Medical Coding Auditor conducts coding reviews and quality assurance audits to verify that all applicable guidelines associated with ICD-10 CM, HCPCS, CPT procedural coding, and modifier usage are followed by the BOOST coding team and the global coding teams. The Medical Coding Auditor also performs as a denial management coder, which reviews and analyzes coding denials and provides needed corrections of these claims when applicable, and performs quality assurance on global denial coding teams processes.Medical Coding Auditors must maintain continuous contact with the BOOST internal and global coding teams to provide statistical and qualitative feedback on the coding quality and aid in education and guidance consistent with established coding and compliance guidelines. They will perform duties under the supervision of the Medical Coding and Auditing Manager.Essential Functions of Medical Coding AuditorResponsible 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 guidelinesProvide effective feedback to the global coding teams to aid in their successful coding of BOOST clientsMaintaining a communication log to show successful training of the global coding team when coding trends or issues are foundReport all coding trends and issues to department lead as they are identifiedReview target cases per month based on the ModMed Quality Assurance SOPAccurately document their daily audit results in the Daily Audit Log and communicate coding resolutions to the BOOST or global coding teamsThis would include monthly assistance in maintaining QA audit logs summary pages which details the global coding teams monthly coding accuracy levelsCollaborate with the global coding teams on inquires, clarifications, QA rebuttals and training requestsWork alongside coding leadership in regard to global coding teams training of coding processes as well as attending remote coding sessions with the global coding teamsThis would consist of coding, documentation, coding guideline training and overall QA findings resolutionsHelp with other daily communications between the internal BOOST RCM teams and the Auditing team in regards to other coding inquiries or issuesThis would include any sync calls pertaining to assigned clients or ModMed committee calls pertaining to assigned specialtiesPerform BOOST special Quality Assurance audits on the global coding teamsSuch as on their assignment accuracy, coding appeals accuracy and all other coding scopesPerform BOOST or Compliance audits when requested by BOOST or other ModMed staff which help to determine coding compliance or client documentation issuesSupport in the review, appeal and follow up of third party (RAC, CERT, etc.) auditsAssist in review and maintenance of coding guidelines, coding scrub edits and/or practice coding instructions and assist with continuous quality improvement by helping with the process of implementation and carry through of coding protocols and proceduresCollaborate with fellow coding/auditing team members to maintain department compliance and effectivenessResponsible for obtaining continuing education units (CEU) for maintaining coding certification(s)ModMed Benefits Highlight: At ModMed, we believe it’s important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits:United StatesComprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution,401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.Generous Paid Time Off and Paid Parental Leave programs,Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs,Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed,Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning,Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles,Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote \"interviews,\" and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address (View email address on click.appcast.io). Please check senders’ email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website. #J-18808-Ljbffr Modernizing-Medicine,-Inc.