Medical Auditor - Remote

About the role

As a Medical Coding Auditor, you will be responsible for conducting routine and focused audits of medical coding to ensure compliance, accuracy, and quality. You'll play a critical role in providing education and feedback to coders and providers to improve documentation and coding accuracy.

Location: Remote
Level: Associate, Medical Coding Auditor
Team: Coding Department

What You Will Do

• Carry out routine and focused audits of medical coding to ensure compliance with CMS, payer, and organizational standards.
• Develop and deliver education and feedback to coders and providers to improve documentation quality and coding accuracy.
• Aid with internal and external audit preparation and response, including documentation requests and validation reviews.
• Maintain audit tracking logs, productivity reports, and accuracy metrics in accordance with company policies.
• Review medical records, claims data, and provider documentation to assess the accuracy of ICD-10-CM, CPT, HCPCS, and modifier assignment.
• Identify coding errors, trends, and opportunities for improvement; prepare detailed audit reports with actionable findings.
• Stay current with AAPC, AHIMA, CMS, and OIG guidelines, as well as payer policy changes and HCC model updates.
• Uphold all HIPAA, privacy, and compliance standards in handling patient data and audit documentation.

What We're Looking For

• Certification: Active AAPC (CPC) or AHIMA (CCS-P, CCS) certification.
• Experience: Minimum 3 years of medical coding experience, with at least 1-2 years in a coding audit, QA, or compliance capacity.
• Strong understanding of HCC / risk adjustment coding principles, clinical documentation improvement, and coding validation practices.
• Excellent command of medical terminology, anatomy, physiology, pathophysiology, disease progression, and pharmacology.
• Deep familiarity with CPT, ICD-10-CM, HCPCS, and modifier assignment.
• Ability to work independently and maintain productivity in a remote setting.
• Strong communication and problem-solving skills.
• Proficiency in EHR systems, encoder/coding software, and Google tools.
• Reliable internet connection and dedicated, secure workspace.

Technologies We Use

• EMR: Elation
• Google Suite (docs, slides, sheets)

Benefits

• $36 base salary
• 100% paid health, dental, vision premiums (for families too)
• Generous parental leave (4 months for birthing parent, 2 months for partners)
• 401(k) with company match
• Unlimited PTO + flexible schedule

Company Information

• Sprinter Health is an equal opportunity employer.
• We value diversity and do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, disability status, or other protected characteristics.