Medical Coding/Compliance Auditor

VMG Health; United States; On-site; USD 85,000 - 140,000; Full time

Job summary

VMG Health is seeking a Coding/Compliance Auditor to perform comprehensive coding reviews and project management for the CAC team. Responsibilities include chart abstraction, assigning ICD-10-CM and CPT codes, and developing corrective action plans.

The role also involves educating internal teams and clients on coding and compliance matters. The ideal candidate has 3+ years of CPT/ICD-10 experience, CCS-P or CPC with CPMA, and strong attention to detail.

Qualifications

• Minimum education: High School Diploma.
• Bachelor’s degree preferred for broader opportunities.
• 3+ years CPT/ICD-10 coding and auditing experience.
• Experience with EMR/chart abstraction and multispecialty coding.
• Credentials: CCS-P or CPC; CPMA certification required.

Responsibilities

• Collaborate in audit teams to complete client projects on time and to QA standards.
• Access medical records from EMR systems and perform chart reviews.
• Analyze medical records for coding and documentation requirements.
• Assign ICD-10-CM, CPT, HCPCS codes per guidelines.
• Create audit reports and action plans; support QA and client submissions.
• Educate internal teams and clients on coding/compliance matters.

Skills

CPT & ICD-10 coding

Medical coding auditing

Education & training

Regulatory knowledge

Project management

Client relations

Attention to detail

Communication

AI coding tools

Microsoft Office proficiency

Education

High School Diploma

Bachelor’s degree preferred

Tools

Microsoft Office Suite

AI-powered coding tools

Job description

Description

At VMG Health, we’re more than just a team of experts; we’re trusted partners in the business of healthcare. Backed by a team of over 300 professionals and a history of more than 70,000 engagements since 1995, we bring experience, deep and wide, to every project. Our national client base ranges from large health systems to small practices and everything in between, including investors and private equity firms. Our solutions‑oriented approach to client needs is bolstered by our strong market position, extensive contacts, unparalleled tools and solutions, and expert insights. We are proud to serve as the single source for all our clients’ valuation, strategic, and compliance needs.

Requirements

VMG Health is seeking a Coding/Compliance Auditor to perform all levels of documentation and coding reviews related to professional services as well as project management and report writing for VMG’s Coding Audit and Compliance (CAC) team. The Coding/Compliance Auditor will also provide education and training internally to the audit team in unique practice specialties and externally to clients which will include clinical providers and/or ancillary and coding/billing staff. The current team consists of a Managing Director, Director, Manager, Auditors, Coders, and Administrative Coordinators who work as consultants for healthcare organizations, providers, law firms, and private equity groups. Services provided include medical coding, auditing, due diligence coding reviews, education and training, general compliance and research. This is an excellent opportunity for the right professional who is interested in building a career in medical coding and compliance with the support of an industry expert recognized team.

Key Tasks & Responsibilities

• Work as a part of an audit team to professionally and successfully complete client projects meeting productivity and quality standards within timely deadlines.
• Access necessary medical record documentation from client’s EMR systems.
• Complete detailed analysis of medical records for chart content and documentation requirements.
• Assign diagnostic codes based on abstract from patient medical record information according to the ICD‑10‑CM and CPT‑4 Manuals and coding conventions and guidelines, as established by state and federal regulatory requirements.
• Utilize audit reporting tools to record audit results and create reports of results to submit for quality assurance (QA) and feedback prior to submission to client.
• Develop reports of audit results and corrective action plans based on audit findings.
• Conduct education and training sessions for internal team and clients as directed/requested.
• Educate and serve as a resource for providers regarding coding, documentation, and compliance matters.
• Coordinate, research, and access resources for execution of key client projects.
• Assist Managing Director, Director and Manager as requested/assigned to ensure key client projects are delivered on time, within scope, and within budget.
• Support the development and clarification of project scope and objectives, engaging all relevant stakeholders, and confirming that the project is technically feasible.
• Develop and maintain relationships with clients and all key stakeholders.
• Review QA audit reports and make corrections and/or adjustments identified.
• Keep current with changes in government regulatory coding and compliance guidance and other third‑party payers as needed.
• Maintain awareness of changes in coding auditing principles and practices and related areas to maintain professional competence.
• Utilize Microsoft Office Suite (Outlook, Word, Excel, PowerPoint) for completion of assigned tasks.

Qualifications

Required minimum education:

• High School Diploma.
• Bachelor’s degree preferred.

Experience

• Minimum of 3 years of CPT and ICD‑10 medical coding and auditing experience, including abstracting information from patient charts.
• Extensive experience in E/M coding and auditing, including detailed analysis and assignment of CPT, HCPCS and ICD‑10 codes for multispecialty practices.
• CRC (Certified Risk Coder) coding certification and/or significant HCC coding experience required.
• Demonstrated experience with regulatory guidelines, including teaching physician settings, incident‑to billing, and split/shared services, is required.

License/Certifications

• Coding Credentials: AHIMA – Certified Coding Specialist‑Physician (CCS‑P) or AAPC – CPC required. CPMA certification required.
• AAPC – CPC‑I Certified Professional Coding Instructor or CHCA Certification from AHCAE (Association of Health Care Auditors and Educators), preferred but not required.

Knowledge & Skills

• Delivered one‑on‑one and group education and training to providers, enhancing coding accuracy and compliance.
• Consistently achieved high productivity and quality outcomes while working independently with minimal supervision.
• Expertly manage multiple priorities and projects in fast‑paced, dynamic environments, consistently meeting deadlines.
• Demonstrate meticulous attention to detail in all aspects of coding, auditing, and documentation review.
• Communicate complex information clearly and confidently in both individual and group settings.
• Excel in organization, planning, problem‑solving, and decision‑making, with a strong focus on quality management and results.
• Provide exceptional client service, building and maintaining strong professional relationships.
• Foster teamwork and collaboration, always maintaining a professional and positive attitude.
• Proficiency in utilizing AI‑powered coding, auditing, and compliance tools to enhance accuracy, efficiency, and reporting.
• Advanced skills in Microsoft Office Suite (Outlook, Word, Excel, PowerPoint) and other relevant technologies.