Coding Auditor

Medical Coding Auditor Hybrid (1 - 2 days in office per week) Baltimore, MD 21201 Compensation: $66k-$92k Direct Placement Description Responsible for conducting independent physician coding and auditing reviews to ensure the accuracy, completeness, and compliance of medical record documentation supporting codes selected by providers and/or coders. This role ensures compliance with CMS guidelines, CPT, HCPCS, and ICD-10 code sets, while supporting providers through ongoing physician coding education, auditing feedback, compliance guidance, and training initiatives. This position plays a key role in physician documentation improvement, coding compliance, audit readiness, and provider education across the organization. Core Responsibilities Conduct independent physician coding and auditing reviews to assess the adequacy of medical record documentation supporting codes selected by providers and/or coders. Perform detailed physician coding compliance audits to ensure adherence to CMS guidelines, CPT, HCPCS, ICD-10 code sets, and internal billing policies. Utilize MDaudit software to complete audit documentation, tracking, and reporting activities. Analyze provider, division, and departmental documentation and coding trends to identify compliance risks and recommend corrective actions. Support reporting of audit results, including trending, regulatory tracking, and responses to compliance inquiries. Develop and deliver physician coding education and training materials to improve documentation accuracy and coding compliance. Present physician coding audit findings and compliance risks to providers, leadership, and practice administrators. Create and administer targeted provider education and training programs to address documentation and coding gaps identified through auditing activities. Contribute to system-wide compliance education initiatives, including New Provider Education and Annual Compliance Training programs. Compliance Auditing Operations & Process Support Prepare reports for compliance leadership and executive stakeholders, highlighting key findings from physician coding and auditing activities. Conduct regulatory research and draft responses to coding and compliance inquiries. Monitor and communicate regulatory updates impacting physician coding, documentation, and billing compliance. Document and track compliance cases, investigations, and inquiries within the case management system. Support compliance investigations related to documentation, billing, and coding concerns. Assist in developing policies, standard operating procedures, audit tools, and education toolkits to strengthen physician coding and auditing practices. Performance Expectations Meet departmental KPIs, including: Audit productivity Audit quality/accuracy Turnaround time Provider education and training effectiveness Maintain strong knowledge of CMS, CPT, HCPCS, ICD-10, and payer documentation requirements. Perform other duties as assigned. Skills profee, coding, auditing, Ccs, Cpc, Education, Physician Additional Skills & Qualifications High school diploma. Five (5) years' experience in coding including two (2) years of auditing/billing compliance experience. Certified Professional Coder (CPC) certification Experience in and working knowledge of Corporate Compliance. Certified Coding Specialist (CCS), Certified Coding Specialist-Physician-based (CCS-P), or Certified Medical Auditor (CPMA) certification Job Type & Location This is a Permanent position based out of Baltimore, MD. Pay and Benefits The pay range for this position is $66102.00 - $92560.00/yr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors. UMMS offers a comprehensive benefits package including health coverage, retirement plans, wellness programs, paid leave, tuition remission, and employee discounts to support both professional and personal well-being. Health and Insurance Benefits UMMS provides medical, dental, and vision coverage for eligible employees and their dependents, with enrollment effective from the first day of employment if completed within 31 days. Prescription drug benefits are managed through MedImpact, and employees can also access life insurance, long-term disability, and accidental death & dismemberment (AD&D) coverage. Flexible Spending Accounts (FSAs) allow pre-tax savings on qualified medical and dependent care expenses, potentially saving 22% to 38% on out-of-pocket costs. Retirement and Financial Planning Employees can participate in mandatory and supplemental retirement plans, helping them plan for long-term financial security. Leave and Work-Life Balance UMMS offers a generous leave package, including sick leave, personal leave, holidays, and Family Medical Leave. These policies are designed to help employees recharge and maintain a healthy work-life balance. Wellness and Support Programs The system emphasizes employee well-being through programs like Launch Your Life, which supports health, wellness, and personal growth. Employees can access emotional, financial, and personal support services, as well as participate in wellness activities tailored to their goals. Professional Development and Tuition Remission UMMS supports career growth and education through tuition remission programs, allowing employees to take classes at University System of Maryland institutions tuition-free. Employee Discounts and Perks Staff have access to exclusive discounts on products and services through the UMMS Beneplace platform, enhancing overall employee satisfaction and financial savings. beneplace.com Summary Overall, UMMS benefits are designed to support employees' health, financial security, professional growth, and personal well-being, making it a competitive and comprehensive package for staff, residents, and fellows. Workplace Type This is a hybrid position in Baltimore,MD. Application Deadline This position is anticipated to close on Aug 31, 2026. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. San Francisco Fair Chance Ordinance Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records. Massachusetts Lie Detector It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Use of Artificial Intelligence (AI) We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools. #J-18808-Ljbffr