Medical Coding Auditor

DaMar Staffing; United States; Hybrid; USD 85,000 - 110,000; Full time

Benefits offered by this job

Health benefits

401(k) matching

Paid time off

Job summary

ModMed is hiring a driven Medical Coding Auditor to join our BOOST Services team, focusing on coding compliance and accuracy for clients in a fast-paced Healthcare IT environment.

The role conducts coding reviews, QA audits, and denial management, collaborating with global teams and providing feedback for continuous improvement. Remote-friendly with flexible hybrid options in the US.

Qualifications

• Certified Professional Coder (CPC) with at least 1 year of experience is required.
• Experience in medical auditing (CPMA) is preferred but not required.
• Knowledge of CPT, ICD-10-CM, HCPCS, modifiers and E/M guidelines is essential.
• Strong analytical skills and attention to detail are required.

Responsibilities

• Perform coding reviews and QA audits for ICD-10-CM, HCPCS, CPT and modifiers.
• Conduct denial management reviews and propose corrections for claims.
• Provide feedback to global coding teams and maintain training logs.
• Collaborate with BOOST and global coding teams on inquiries and training requests.

Skills

CPMA

CPT coding

ICD-10-CM

Auditing

Denial management

MS Excel

Tools

gMed/gGastro or EMA/PM

Job description

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 terminology and anatomy, required
• Understanding of federal, state and local coding compliance regulations and guidelines, required
• Understanding of NCCI and CCI bundling edits, required
• Understanding of LCD's, NCDs and other payer coverage policies, required
• Understanding of EOBs and ERA's, denial remarks and claims review, preferred
• Detailed knowledge of medical billing, preferred
• Detailed knowledge of medical coding systems, procedures, and documentation requirements is required
• The ability to interpret and apply coding guidelines for federal, state, and local standards is required
• Proficient with Microsoft programs (Excel, Word) as well as the use of overall computer functions, preferred
• Experience in gMed/gGastro or EMA/PM is preferred but not required
• Highly detail-oriented with a critical degree of accuracy regarding data entry
• Exceptional written, verbal, and interpersonal communication skills
• Ability to clearly isolate and define trends/problems and provide alternatives or solutions
• Strong analytical skills, such as the ability to identify, research, and resolve issues
• Excellent time management skills with an emphasis on managing changing work priorities

ModMed Benefits Highlight:

At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. 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.