Medical Coding Auditor

About the Role

As a Medical Coding Auditor, you will be responsible for conducting routine and focused audits of medical coding to ensure compliance, accuracy, and quality. You'll play a critical role in providing education and feedback to coders and providers to improve documentation and coding accuracy.

• 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.

• 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.

• 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,

You’ll Love this Job If…

• 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.

• You love the idea of transforming complex audit findings into meaningful insights that drive better outcomes and operational excellence.

• You’re energized by the chance to make a real difference — ensuring that accurate, ethical coding supports Sprinter Health’s mission to deliver care where patients need it most.

What We’re Looking For

• Certification: Active AAPC (CPC) or AHIMA (CCS-P, CCS) certification.

• Experience: 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