Description
The Medical Coding Auditor reviews medical records and coding practices to ensure accurate assignment of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II codes. The role performs retrospective, concurrent, and prospective audits; identifies coding errors and documentation gaps; prepares audit reports; educates coding staff and providers; monitors quality metrics; supports payer reviews and regulatory investigations; and maintains PHI confidentiality. It requires 3–5 years of medical coding experience, with 2 years of coding audit or quality review experience preferred, along with relevant coding certifications, knowledge of CMS and payer policies, and experience with EHR and encoder software.
