RCS Medical Coding Auditor

Veradigm • Raleigh, NC

8d • $57,728 - $80,243

About The Position

The RCS Medical Coding Auditor is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback. The ideal candidate brings strong hands-on experience with professional fee coding, deep knowledge of E/M, surgical, and modifier use, and the ability to translate audit findings into actionable insights.

Requirements

• CPC (Required) and CPMA (Required/In Process)
• 2+ years of ProFee auditing experience
• Knowledge of: E/M documentation guidelines Modifier rules and NCCI edits CPT, ICD‑10‑CM, HCPCS Level II
• High attention to detail with strong analytical and critical‑thinking skills
• Excellent written and verbal communication skills for audit reporting and education
• Proficiency with EHRs, coding and auditing tools
• Proficiency with Microsoft Office Suite

Nice To Haves

• Multi-specialty coding and auditing experience with preferred background in E/M Coding, Orthopedics, Pain Management, Urology
• Background in coding quality programs or compliance teams
• Advanced reporting skills for audit tracking and trend analysis
• Prior consulting or client‑facing audit experience

Responsibilities

• Perform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedback
• Validate ICD‑10‑CM, CPT®, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelines
• Conduct medical chart audits of professional services across multiple specialties
• Identify coding discrepancies, compliance risks, trends, root causes, and documentation gaps
• Support coding education through feedback, targeted training, and reference materials
• Prepare clear, defensible audit documentation including rationale and references
• Provide actionable recommendations to address audit findings and reduce future risk
• Track audit outcomes and trends to support leadership reporting and risk mitigation strategies
• Support denial prevention, resolution and appeal strategies
• Collaborate across teams to assist with coding support
• Maintain confidentiality and comply with HIPAA and organizational policies

Benefits

• Veradigm offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 501-1,000 employees