Job Description

Required Skills & Competencies

Strong knowledge of medical coding standards and guidelines Expertise in ICD-10-CM, CPT, HCPCS, and/or ICD-10-PCS (as applicable) High attention to detail and strong analytical skills Ability to interpret clinical documentation accurately Strong written and verbal communication skills for feedback and reporting Proficiency with encoder tools, EHR systems, and auditing software Ability to meet deadlines and manage multiple audits
Key Responsibilities

Review and audit medical records coded by coders for accuracy, completeness, and compliance Validate assignment of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes based on clinical documentation Ensure adherence to official coding guidelines, payer-specific rules, and regulatory requirements (CMS, Medicare, Medicaid, etc.) Identify coding errors, trends, and root causes; provide corrective action recommendations Provide detailed feedback, coaching, and training to coders to improve quality and productivity Maintain QA reports, audit logs, and performance metrics Monitor coder accuracy scores and ensure quality benchmarks are met Support internal and external audits and assist with audit responses Collaborate with coding, compliance, and operations teams to improve documentation and coding processes Stay current with coding updates, guideline changes, and regulatory requirements Participate in quality improvement initiatives and process optimization
Qualifications

Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification (required/preferred) Minimum 2-5 years of hands-on medical coding experience Prior experience in coding audits or QA role preferred Experience with inpatient, outpatient, or specialty coding .
Job Type: Full-time

Work Location: In person