Medical Coding Auditor

ModMed•Boca Raton, FL

1d•Hybrid

About The Position

At ModMed, we’re not just building software—we’re reimagining the healthcare experience. Founded in 2010 by a practicing physician and a successful tech entrepreneur, we took a radically different approach: we hired doctors and taught them how to code. This "for doctors, by doctors" philosophy has allowed us to create an AI-enabled, specialty-specific cloud platform that places patients at the center of care. When you join ModMed, you’re joining an award-winning team recognized for innovation and employee satisfaction. From our global headquarters in Boca Raton Florida, and extensive employee base in Hyderabad India, we are a team of 4,500+ passionate problem-solvers on a mission to increase medical practice success and improve patient outcomes: Consistently ranked as a Top Place to Work 2025 Globee Business Awards: Gold Globee for “Technology Team of the Year” 2025 Black Book Awards: Ranked #1 EHR in 11 Specialties Florida Venture Forum: Venture-Backed Company of the Year We are growing fast, thinking big, and we are just getting started. Ready to modernize medicine with us? ModMed is hiring a driven Medical Coding Auditor to join our positive, passionate, and high-performing BOOST Services team focused on delivering top-tier coding compliance and accuracy for our clients. This is an exciting opportunity to play a key role in upholding coding quality standards and supporting audit and denial management processes within a fast-paced Healthcare IT company that is truly Modernizing Medicine! The Medical Coding Auditor conducts coding reviews and quality assurance audits to verify that all applicable guidelines associated with ICD-10-CM, HCPCS, CPT procedural coding, and modifier usage are followed by the BOOST coding team and the global coding teams. The Medical Coding Auditor also performs as a denial management coder, which reviews and analyzes coding denials and provides needed corrections of these claims when applicable, and performs quality assurance on the global denial coding teams' processes. Medical Coding Auditors must maintain continuous contact with the BOOST internal and global coding teams to provide statistical and qualitative feedback on the coding quality and aid in education and guidance consistent with established coding and compliance guidelines. They will perform duties under the supervision of the Medical Coding and Auditing Manager.

Requirements

Minimum 1-year experience as a Certified Professional Coder required - physician-based and/or ASC-based - multi-specialty coding experience preferred
Minimum 1-year experience as a Certified Professional Medical Auditor (CPMA), preferred not required
Must agree to obtain CPMA auditing certification within 6 months of employment (if not a CPMA already)
Knowledge of CPT, ICD-10 CM, HCPCS, CPT coding, modifiers, E/M and all coding guidelines, required
Knowledge of medical terminology and anatomy, required
Understanding of federal, state and local coding compliance regulations and guidelines, required
Understanding of NCCI and CCI bundling edits, required
Understanding of LCD’s, NCDs and other payer coverage policies, required
Understanding of EOBs and ERA’s, denial remarks and claims review, preferred
Detailed knowledge of medical billing, preferred
Detailed knowledge of medical coding systems, procedures and documentation requirements, required
Ability to interpret and apply coding guidelines for federal, state, and local standards, required
Proficient with Microsoft programs (Excel, Word) as well as use of overall computer functions, preferred
Highly detail-oriented with a critical degree of accuracy regarding data entry
Exceptional written, verbal and interpersonal communication skills
Ability to clearly isolate and define trends/problems and provide alternatives or solutions
Strong analytical skills such as the ability to identify, research, and resolve issues
Excellent time management skills with an emphasis on managing changing work priorities

Nice To Haves

Experience in gMed/gGastro or EMA/PM is preferred but not required

Responsibilities

Responsible for analyzing, reviewing and providing feedback when performing quality assurance activities and completing QA audits, including but not limited to: Ensuring all federal and state coding guidelines and regulations are met as well as payer guidelines
Provide effective feedback to the global coding teams to aid in their successful coding of BOOST clients
Maintaining a communication log to show successful training of the global coding team when coding trends or issues are found
Report all coding trends and issues to the department lead as they are identified
Review target cases per month based on the ModMed Quality Assurance SOP
Accurately document their daily audit results in the Daily Audit Log and communicate coding resolutions to the BOOST or global coding teams
Collaborate with the global coding teams on inquiries, clarifications, QA rebuttals and training requests
Work alongside coding leadership in regards to global coding teams training of coding processes as well as attending remote coding sessions with the global coding teams
Help with other daily communications between the internal BOOST RCM teams and the Auditing team in regards to other coding inquiries or issues
Perform BOOST special Quality Assurance audits on the global coding teams
Perform BOOST or Compliance audits when requested by BOOST or other ModMed staff which help to determine coding compliance or client documentation issues
Support in the review, appeal and follow-up of third-party (RAC, CERT, etc.) audits
Assist in review and maintenance of coding guidelines, coding scrub edits and/or practice coding instructions and assist with continuous quality improvement by helping with the process of implementation and carry through of coding protocols and procedures
Collaborate with fellow coding/auditing team members to maintain department compliance and effectiveness
Responsible for obtaining continuing education units (CEU) for maintaining coding certification(s)

Benefits

United States Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution
401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.
Generous Paid Time Off and Paid Parental Leave programs
Company paid Life and Disability benefits
Flexible Spending Account, and Employee Assistance Programs
Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed
Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning
Global presence and in-person collaboration opportunities; dog-friendly HQ (US)
Hybrid office-based roles and remote availability for some roles
Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.