Medical Coding Auditor

Modernizing Medicine, Inc.; United States; Hybrid; USD 70,000 - 95,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) matching

PTO

Parental leave

Life & disability

LinkedIn Learning

Job summary

Modernizing Medicine, Inc. is seeking a Medical Coding Auditor to ensure coding on BOOST client projects complies with all federal, state, and payer guidelines.

You will perform reviews, QA audits, and denial management in collaboration with BOOST and global coding teams to improve accuracy and compliance. The role emphasizes continual education, documentation of audit results, and participation in training activities with other coding teams across the global organization.

Qualifications

• Able to analyze and provide feedback from QA audits.
• Ensure adherence to federal, state, and payer guidelines.
• Coordinate with global coding teams on training and QA findings.

Responsibilities

• Analyze, review, and provide feedback on QA audits and coding reviews.
• Ensure compliance with ICD-10 CM, HCPCS, CPT guidelines and modifier usage.
• Provide corrections to denials and assist in denial management activities.
• Maintain communication logs for training and guideline adherence.
• Document audit results daily and report coding resolutions to BOOST/global teams.
• Collaborate with global coding teams on inquiries and training requests.
• Assist in remote coding sessions and ongoing QA process improvements.
• Support review of third-party audits (RAC, CERT) and coding guidelines updates.

Skills

QA audits

Coding guidelines

Denial management

Training & education

Communication log

Tools

ICD-10 CM

Job description

Join the Team Modernizing Medicine At ModMed, we're not just building software—it is 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.

Job Description Summary:

Medical Coding Auditors are responsible for ensuring that coding performed on behalf of ModMed BOOST clients is in compliance with all published federal, state and payer-specific coding guidelines.

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 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.

Essential Functions of Medical Coding Auditor

• 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 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
• This would include monthly assistance in maintaining QA audit logs summary pages which details the global coding teams monthly coding accuracy levels
• Collaborate with the global coding teams on inquires, clarifications, QA rebuttals and training requests
• Work alongside coding leadership in regard to global coding teams training of coding processes as well as attending remote coding sessions with the global coding teams
• This would consist of coding, documentation, coding guideline training and overall QA findings resolutions
• Help with other daily communications between the internal BOOST RCM teams and the Auditing team in regards to other coding inquiries or issues
• This would include any sync calls pertaining to assigned clients or ModMed committee calls pertaining to assigned specialties
• Perform BOOST special Quality Assurance audits on the global coding teams Such as on their assignment accuracy, coding appeals accuracy and all other coding scopes
• 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)

ModMed Benefits Highlight:

• Eligible Modernizers can enroll in a wide range of benefits:
• United States Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution
• 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation.
• After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.
• Generous Paid Time Off and Paid Parental Leave programs
• Company paid Life and Disability benefits
• Flexible Spending Account, and Employee Assistance Programs
• Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed
• Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning
• Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles
• Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.

Our web and mobile applications are transforming healthcare information technology to increase practice efficiency and improve patient outcomes. Our innovative and collaborative culture fuels our growth and creates rewarding and empowering experiences for our team.

It takes more than just a great product to modernize medicine. It takes a great team.