As a Medical Coding Auditor, you will be responsible for conducting routine and focused audits of medical coding to ensure compliance, accuracy, and quality. You'll play a critical role in providing education and feedback to coders and providers to improve documentation and coding accuracy.
Conduct routine and focused audits of medical coding to ensure compliance with CMS, payer, and organizational standards.
Develop and deliver education and feedback to coders and providers to improve documentation quality and coding accuracy.
Assist with internal and external audit preparation and response, including documentation requests and validation reviews.
Maintain audit tracking logs, productivity reports, and accuracy metrics in accordance with company policies.
Review medical records, claims data, and provider documentation to assess the accuracy of ICD-10-CM, CPT, HCPCS, and modifier assignment.
Identify coding errors, trends, and opportunities for improvement; prepare detailed audit reports with actionable findings.
Develop and deliver education and feedback to coders and providers to improve documentation quality and coding accuracy.
Assist with internal and external audit preparation and response, including documentation requests and validation reviews.
Maintain audit tracking logs, productivity reports, and accuracy metrics in accordance with company policies.
Stay current with AAPC, AHIMA, CMS, and OIG guidelines, as well as payer policy changes and HCC model updates.
Uphold all HIPAA, privacy, and compliance standards in handling patient data and audit documentation,
You have an eye for detail and take pride in upholding the highest standards of coding accuracy and compliance.
You’re motivated by the impact your work has on data integrity, provider education, and overall care quality.
You enjoy analyzing trends, identifying opportunities for improvement, and helping others strengthen their documentation and coding practices.
You thrive in a tech-forward, mission-driven environment where innovation and accountability go hand in hand.
You’re comfortable working independently in a remote setting, yet you value being part of a collaborative, growth-oriented team.
You love the idea of transforming complex audit findings into meaningful insights that drive better outcomes and operational excellence.
You’re energized by the chance to make a real difference — ensuring that accurate, ethical coding supports Sprinter Health’s mission to deliver care where patients need it most.
Certification: Active AAPC (CPC) or AHIMA (CCS-P, CCS) certification.
Experience: Minimum 3 years of medical coding experience, with at least 1-2 years in a coding audit, QA, or compliance capacity.
Strong understanding of HCC / risk adjustment coding principles, clinical documentation improvement, and coding validation practices.
Excellent command of medical terminology, anatomy, physiology, pathophysiology, disease progression, and pharmacology.
Deep familiarity with CPT, ICD-10-CM, HCPCS, and modifier assignment.
Ability to work independently and maintain productivity in a remote setting
Strong communication and problem-solving skills
Proficient in EHR systems, encoder/coding software, and Google tools.
Reliable internet connection and dedicated, secure workspace
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