Medical Coding Auditor: Compliance & Revenue Expert

PACT MSO

Branford (CT)

On-site

USD 80,000 - 100,000

Full time

10 days ago

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Job summary

PACT MSO, LLC in Branford, CT, is seeking an experienced Medical Coding Auditor to join our on-site team. The role involves auditing medical records, coding, billing, and documentation to ensure compliance with federal, state, and payer requirements, and to support revenue integrity.

You will work with clinicians and billing staff, develop corrective actions, provide education, and maintain audit trackers. Requirements include CPC certification, 3–5 years of healthcare auditing, and EPIC

Qualifications

Bachelor's degree in healthcare-related field required.
3–5 years of healthcare auditing, compliance or related ops experience.
Experience auditing E/M services and professional claims.
Certified Professional Coder (CPC) required.
CPMA strongly preferred.
EPIC EHR experience is highly desired.

Responsibilities

Conduct routine and focused audits of medical records, provider documentation, coding, billing, and reimbursement practices in accordance with the Compliance Work Plan and departmental priorities.
Review professional, outpatient, inpatient, home health, SNF, and other healthcare service documentation for regulatory and payer compliance.
Evaluate provider documentation for ICD-10, CPT, HCPCS, and E/M coding accuracy and compliance with guidelines.
Validate charges and billing activity against supporting medical record documentation.
Review encounter forms, charge documents, and billing workflows to identify compliance risks and opportunities.
Participate in audits requested by government agencies, payers, or third parties.