RCS Medical Coding Auditor

📋 Description

• • 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.
• • Day to day, the auditor performs daily QA on completed coding, validates ICD‑10‑CM, CPT®, HCPCS, and modifier assignment against clinical documentation, conducts medical chart audits across multiple specialties, identifies coding discrepancies and compliance risks, provides targeted coding education and feedback, prepares defensible audit documentation with rationale and references, tracks audit outcomes for leadership reporting, and collaborates across teams to support coding initiatives while maintaining HIPAA compliance.
• • Veradigm LLC is a dynamic, open community of solutions, external partners, and cutting-edge AI technologies that provide advanced insights, technology, and data-driven solutions to healthcare providers, life science companies, health plans, and patients. The company empowers associates with tools and flexibility to bring their best selves to work and grow professionally, emphasizing equal opportunity, diversity, and inclusion in all employment practices.
• • In this role, the auditor can deepen expertise in professional fee coding, E/M guidelines, modifier use, and compliance auditing; develop advanced reporting and trend analysis skills; contribute to denial prevention strategies; and gain experience influencing coding quality and compliance programs across specialties such as Orthopedics, Pain Management, and Urology.