Medical Coding Auditor

SGS Consulting; United States; On-site; USD 80,000 - 100,000; Full time

Job summary

SGS Consulting is looking for a Coding Quality Auditor who will ensure accurate coding standards in medical documentation. With a focus on HCC risk adjustments, the auditor will review and validate charts, ensuring compliance and accuracy. Ideal candidates will have over three years of medical coding experience and hold relevant certifications like CPC or CRC.

Qualifications

• Minimum of 3 years in Medical Coding, preferably HCC coding experience.
• Proficiency in ICD-10-CM Coding with understanding of HCC Risk Adjustment.

Responsibilities

• Validate and review HCC risk adjustable Charts through Retrospective Chart Reviews.
• Ensure Accurate, Complete, and compliant ICD-10 Coding for Risk Adjustment submissions.

Skills

Attention to Detail

Accuracy

Compliance with Coding Standards

Education

Completion of AAPC or AHIMA Coding Program (e.g., CPC, CCS-P, CRC)

Job description

4 days ago Be among the first 25 applicants

Shift time: Monday – Friday from 9:00 AM - 5:00 PM EST

Pay Rate: $24 - $26/hour on W2

If Interested Kindly share your most recent resume at [e-mail]

Position Summary:

• The Coding Quality Auditor will be responsible for validating and reviewing Hierarchical Condition Category (HCC) risk adjustable Charts through Retrospective Chart Reviews.
• The role focuses on ensuring Accurate, Complete, and compliant ICD-10 Coding for Risk Adjustment submission to CMS.
• Candidates must apply Clinical Documentation Standards and industry guidelines to support coding decisions.
• This role contributes to Audit Accuracy, Process Improvements, and helps maintain compliance with State/Federal Regulations and internal policies.

Experience:

• Minimum Experience: 3 years in Medical Coding (some Experience in HCC coding is required).
• Experience with retrospective Risk Adjustment Audits and Chart Validation is preferred.
• Must have worked with both CMS HCCs and RX HCCs.
• Familiarity with HIPAA-compliant Data Handling and CMS Coding guidelines.
• Completion of an AAPC or AHIMA Coding Program (e.g., CPC, CCS-P, CRC) with a minimum of 3 years of relevant Coding/Audit experience.
• Proficiency in ICD-10-CM Coding with strong understanding of HCC Risk Adjustment
• Attention to Detail and Accuracy in Retrospective Chart Reviews
• Familiarity with CMS CodingGuidelines and HIPAA-Compliant Datahandling.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Staffing and Recruiting

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