Senior Medical Coding & Audit Lead

Sutherland Global; Clifton (NJ); On-site; USD 65,000 - 90,000; Full time

Job summary

Sutherland Global is seeking a Medical Coding Auditor to ensure accuracy and compliance across ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II coding. The role includes conducting audits, identifying documentation gaps, and guiding coders and providers with training to optimize revenue cycle integrity.

Ideal candidates have 3–5 years of coding experience, relevant certs (CPC, CPMA, CCS, CIC, RHIT or RHIA), and strong knowledge of CMS regulations and payer policies.

Qualifications

• 3–5 years of medical coding experience in a healthcare setting.

Responsibilities

• Perform retrospective, concurrent, and prospective coding audits for inpatient, outpatient, physician, and/or specialty services.
• Review medical documentation to validate the accuracy and completeness of assigned diagnosis and procedure codes.
• Ensure compliance with ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, Medicare, Medicaid, commercial payer, and regulatory guidelines.
• Identify coding errors, documentation gaps, and reimbursement opportunities.
• Prepare detailed audit reports outlining findings, trends, recommendations, and corrective actions.
• Provide one-on-one and group education to coders, providers, and clinical staff regarding coding updates, documentation improvement, and compliance requirements.
• Monitor coding quality metrics and develop action plans to improve coding accuracy and consistency.
• Stay current on coding regulations, Official Coding Guidelines, CMS regulations, payer policies, and industry best practices.
• Assist with internal and external audits, payer reviews, and regulatory investigations.
• Maintain confidentiality of PHI in accordance with HIPAA regulations.
• Participate in policy development, process improvement initiatives, and coding education programs.
• Track audit results and identify recurring trends to support continuous quality improvement.

Skills

Medical coding

Auditing

Documentation review

Communication skills

Detail oriented

Education

CPC

CPMA

CCS

CIC

RHIT

RHIA

Tools

EHR systems

Encoder software

Microsoft Office

Coding/audit software

Job description

Sutherland Global is seeking a Medical Coding Auditor to ensure accuracy and compliance across ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II coding. The role includes conducting audits, identifying documentation gaps, and guiding coders and providers with training to optimize revenue cycle integrity.

Ideal candidates have 3–5 years of coding experience, relevant certs (CPC, CPMA, CCS, CIC, RHIT or RHIA), and strong knowledge of CMS regulations and payer policies.