Medical Coding Auditor (no remote option)

PACT MSO LLC; Branford (CT); On-site; USD 85,000 - 110,000; Full time

Job summary

PACT MSO LLC in Branford, CT seeks a Medical Auditor to coordinate medical billing, coding, and documentation audits across clinical settings to ensure compliance with regulations and billing accuracy.

You will educate clinicians and staff on audit findings, partner with revenue cycle leadership to strengthen documentation integrity, and drive compliant reimbursement practices.

This role requires CPC certification and 3–5 years of healthcare auditing experience.

Qualifications

• Minimum 3–5 years of experience in healthcare auditing, compliance, or related operations.
• Experience auditing E/M services and professional claims is required.
• CPC certification is required; CPMA preferred and other relevant certifications may be considered.

Responsibilities

• Coordinate and conduct medical billing, coding, and documentation audits to ensure compliance.
• Educate clinicians and staff on findings and provide recommendations to improve documentation integrity and revenue optimization.
• Collaborate with revenue cycle leadership and clinicians to promote compliant practices across settings.

Skills

Healthcare auditing

E/M auditing

Regulatory compliance

Coding accuracy

Education

Bachelor’s degree in healthcare administration, Health Information Management, Nursing, Business, Finance, or related field

CPC certification

CPMA certification preferred

Job description

Responsibilities

The Medical Auditor is responsible for coordinating and conducting medical billing, coding, and documentation audits to ensure compliance with federal, state, and commercial payer regulations, organizational policies, and industry standards. This role evaluates provider documentation, coding accuracy, billing practices, and revenue cycle processes across multiple clinical specialties and care settings. The Medical Auditor provides education, consultation, and recommendations to clinicians, clinical staff, and operational leaders to improve documentation integrity, coding accuracy, regulatory compliance, and revenue optimization. This position works closely with physicians, advanced practice providers, coding and billing personnel, revenue cycle leadership, compliance officers, operational leaders, and other healthcare stakeholders to promote compliant documentation, coding, billing, and reimbursement practices.

Qualifications

Education and Experience

• Bachelor’s degree in healthcare administration, Health Information Management, Nursing, Business, Finance, or a related healthcare field required.
• Minimum of three to five (3-5) years of experience in healthcare auditing, compliance, physician billing, coding, revenue integrity or related healthcare operations.
• Experience performing documentation, coding, and billing audits in a healthcare system, academic medical center, physician practice, consulting organization, or related setting preferred.
• Experience auditing Evaluation and Management (E/M) services and professional claims required.
• Certified Professional Coder (CPC) required
• Certified Professional Medical Auditor (CPMA) strongly preferred
• Other relevant coding or auditing certifications may be considered