RCS Medical Coding Auditor (CPC, CPMA)

Position SummaryThe RCS Medical Coding Auditor is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback.The ideal candidate brings strong hands-on experience with professional fee coding , deep knowledge of E/M, surgical, and modifier use , and the ability to translate audit findings into actionable insights.Key ResponsibilitiesPerform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedbackValidate ICD‑10‑CM, CPT, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelinesConduct medical chart audits of professional services across multiple specialtiesIdentify coding discrepancies, compliance risks, trends, root causes, and documentation gapsSupport coding education through feedback, targeted training, and reference materialsPrepare clear, defensible audit documentation including rationale and referencesProvide actionable recommendations to address audit findings and reduce future riskTrack audit outcomes and trends to support leadership reporting and risk mitigation strategiesSupport denial prevention, resolution and appeal strategiesCollaborate across teams to assist with coding supportMaintain confidentiality and comply with HIPAA and organizational policiesRequired QualificationsCPC (Required) and CPMA (Required/In Process)2+ years of ProFee auditing experienceKnowledge of:E/M documentation guidelinesModifier rules and NCCI editsCPT, ICD‑10‑CM, HCPCS Level IIHigh attention to detail with strong analytical and critical‑thinking skillsExcellent written and verbal communication skills for audit reporting and educationProficiency with EHRs, coding and auditing toolsProficiency with Microsoft Office SuitePreferred QualificationsMulti-specialty coding and auditing experience with preferred background in E/M Coding, Orthopedics, Pain Management, UrologyBackground in coding quality programs or compliance teamsAdvanced reporting skills for audit tracking and trend analysisPrior consulting or client‑facing audit experienceCompensation Range:$57,728-$80,243Compensation for this job is subject to market conditions, geographic considerations, the candidate’s unique skills and experience, state and local laws, and budget. Our commitment to pay transparency is a testament to our dedication to creating a fair, equitable, and inclusive workplace. By continuously analyzing market trends, staying abreast of changes in state laws, and making budgetary adjustments accordingly, we strive to ensure that our compensation practices reflect the value we place on our associates’ unique contributions and support their professional growth.Enhancing Lives and Building CareersVeradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work and to further their professional development. Together, we are In the Network. Interested in learning more?Take a look at our Culture , Benefits , Early Talent Program , and Additional Openings .We strongly advocate that our associates receive all CDC recommended vaccinations in prevention of COVID-19.Visa Sponsorship is not offered for this position.At Veradigm, our greatest strength comes from bringing together talented people with diverse perspectives to support the needs of healthcare providers, life science companies, health plans, and the patients they serve. The Veradigm Network is a dynamic, open community of solutions, external partners, and cutting-edge artificial intelligence technologies that provide advanced insights, technology, and data-driven solutions. Veradigm offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.Veradigm’s policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Veradigm must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire. Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.From a "VEVRAA Federal Contractor" We request Priority Referral of Protected VeteransThis is an official Veradigm Job posting. To avoid identity theft, please only consider applying to jobs posted on our official corporate site.Thank you for reviewing this Veradigm opportunity. Does this look like a great match for your skill set? If so, scroll on down and tell us more about yourself! #J-18808-Ljbffr Veradigm