Remote Medical Coding Auditor - QA & Denials

ModMed; Boca Raton (FL); Hybrid; USD 60,000 - 90,000; Full time

Benefits offered by this job

Medical benefits

401(k) matching

Paid time off

Tuition reimbursement

Hybrid/Remote options

Job summary

ModMed is seeking a Medical Coding Auditor to join our remote US team. You will perform coding reviews for ICD-10 CM, HCPCS, CPT, and modifiers, conduct denial management coding analysis, and provide quality assurance across BOOST and global coding teams.

The role involves collaboration with internal and global teams, documenting results, and participating in ongoing training and audits to ensure coding compliance and education across specialties.

Qualifications

• Responsible for analyzing, reviewing and providing feedback when performing quality assurance activities and completing QA audits.
• Ensure 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.
• Maintain a communication log to show successful training of the global coding team when coding trends or issues are found.
• Collaborate with the global coding teams on inquiries, clarifications, QA rebuttals and training requests.
• Support in review, appeal and follow up of third party audits (RAC, CERT, etc.).

Responsibilities

• Analyze, review and provide feedback during QA audits and QA activities.
• Ensure compliance with federal/state and payer guidelines.
• Provide feedback to BOOST and global coding teams to improve accuracy.
• Maintain audit logs and training communications.
• Coordinate with global teams on inquiries and training needs.
• Assist in review and follow-up of external audits.

Job description

ModMed is seeking a Medical Coding Auditor to join our remote US team. You will perform coding reviews for ICD-10 CM, HCPCS, CPT, and modifiers, conduct denial management coding analysis, and provide quality assurance across BOOST and global coding teams.

The role involves collaboration with internal and global teams, documenting results, and participating in ongoing training and audits to ensure coding compliance and education across specialties.