Medical Coding Auditor

Benefits

Additional Information

Join the Team Modernizing Medicine At 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 Excellence When 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 Work 2025 Globee Business Awards: Gold Globee for "Technology Team of the Year" 2025 Black Book Awards: Ranked #1 EHR in 11 Specialties Florida Venture Forum: Venture-Backed Company of the Year We are growing fast, thinking big, and we are just getting started. Ready to modernize medicine with us? Job Description Summary: ModMed is hiring a driven Medical Coding Auditor to join our positive, passionate, and high-performing BOOST Services team focused on delivering top-tier coding compliance and accuracy for our clients. This is an exciting opportunity to play a key role in upholding coding quality standards and supporting audit and denial management processes within a fast-paced Healthcare IT company that is truly Modernizing Medicine! 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 the 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. Your Role: Responsible 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 guidelines Provide effective feedback to the global coding teams to aid in their successful coding of BOOST clients Maintaining a communication log to show successful training of the global coding team when coding trends or issues are found Report all coding trends and issues to the department lead as they are identified Review target cases per month based on the ModMed Quality Assurance SOP Accurately document their daily audit results in the Daily Audit Log and communicate coding resolutions to the BOOST or global coding teams Collaborate with the global coding teams on inquiries, clarifications, QA rebuttals and training requests Work alongside coding leadership in regards to global coding teams training of coding processes as well as attending remote coding sessions with the global coding teams Help with other daily communications between the internal BOOST RCM teams and the Auditing team in regards to other coding inquiries or issues Perform BOOST special Quality Assurance audits on the global coding teams Perform BOOST or Compliance audits when requested by BOOST or other ModMed staff which help to determine coding compliance or client documentation issues Support in the review, appeal and follow-up of third-party (RAC, CERT, etc.) audits Assist 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 procedures Collaborate with fellow coding/auditing team members to maintain department compliance and effectiveness Responsible for obtaining continuing education units (CEU) for maintaining coding certification(s) Skills & Requirements: Minimum 1-year experience as a Certified Professional Coder required - physician-based and/or ASC-based - multi-specialty coding experience preferred Minimum 1-year experience as a Certified Professional Medical Auditor (CPMA), preferred not required Must agree to obtain CPMA auditing certification within 6 months of employment (if not a CPMA already) Knowledge of CPT, ICD-10 CM, HCPCS, CPT coding, modifiers, E/M and all coding guidelines, required Knowledge of medical term