Remote Medical Coding Compliance Auditor

Riverside Health; United States; Remote; USD 57,000 - 79,000; Full time

Job summary

Riverside Health is seeking a senior Coding Auditor to independently review medical records, perform risk adjustment audits, and educate provider personnel on coding methodologies to improve payor accuracy. You will coordinate denial analysis, root cause investigation, and educational materials for clinical and administrative staff.

Requires CPC/COC/CPMA credentials and 3–4 years of billing/coding experience; HS diploma, remote work eligible in several states.

Qualifications

• High School Diploma or GED required.
• 3-4 years Commercial and Government Billing/Coding/Collections required.
• 1 year Medical Record Reviews required.
• Certified Professional Coder (CPC) and CO C credentials recommended (as per ad).

Responsibilities

• Independently conducts Medical Record audits following official coding guidelines and applies payor rules.
• Pre-reviews files and provides summaries of findings to leadership.
• Analyzes coding and documentation to identify trends and corrective actions.
• Audits aggregate and encounter data to identify education opportunities.
• Educates staff on payor regulations and coding standards.

Skills

Medical Coding Audits

Charge Reimbursement Analysis

Education on Coding Methodologies

Payor Audits

Root Cause Analysis

Education

High School Diploma or GED

Job description

Riverside Health is seeking a senior Coding Auditor to independently review medical records, perform risk adjustment audits, and educate provider personnel on coding methodologies to improve payor accuracy. You will coordinate denial analysis, root cause investigation, and educational materials for clinical and administrative staff.

Requires CPC/COC/CPMA credentials and 3–4 years of billing/coding experience; HS diploma, remote work eligible in several states.