Audit Defense Auditor & Coding Specialist

CareCloud; Franklin Township (NJ); Hybrid; USD 90,000 - 130,000; Full time

Benefits offered by this job

Healthcare plans

401(k) with company match

Flexible spending accounts

Company-paid life insurance

Company-paid short and long-term/dis

Job summary

CareCloud is seeking an Audit Defense Auditor/Coder to lead detailed medical record reviews and coding audits, interfacing with clients and staff. The role emphasizes regulatory compliance, chart reviews, ICD-10/CPT coding, and producing precise findings for clients.

The ideal candidate has extensive experience in clinical documentation auditing, payer audits, and CMS guideline application, with strong communication and collaboration skills for cross-functional teams.

Qualifications

• 5+ years’ experience with clinical documentation auditing.
• Minimum 1 year in audit defense or
• 3+ years of payer-side audit experience including medical record review, coding validation, CMS guideline application.

Responsibilities

• Lead regulatory audits for coding teams.
• Ensure completion of projects to meet regulatory deadlines.
• Provide SME for regulatory audits and guidance to audit teams.
• Mentor audit coding teams to ensure deliverables meet standards.
• Ensure audit compliance with CMS Coding Guidelines and payer guidelines.
• Prepare final audit reports per specifications for Audit Defense or client audits.

Skills

Analytical skills

Communication skills

Medical terminology

Regulatory compliance

Education

Associate’s degree in healthcare, clinical or business related

Bachelor’s degree preferred

Job description

CareCloud is seeking an Audit Defense Auditor/Coder to lead detailed medical record reviews and coding audits, interfacing with clients and staff. The role emphasizes regulatory compliance, chart reviews, ICD-10/CPT coding, and producing precise findings for clients.

The ideal candidate has extensive experience in clinical documentation auditing, payer audits, and CMS guideline application, with strong communication and collaboration skills for cross-functional teams.