Medical Coding Auditor

Job Listing ID:

4486052

Job Title:

Medical Coding Auditor Application Deadline:

Open Until Filled

Job Location:

Salem

Date Posted:

05/05/2026

Hours Worked Per Week:

Not Provided Shift:

Not Provided Duration of Job:

Either Full or Part Time, more than 6 months You may contact this employer directly. (Obtain the contact information to print or add to your jobs.)

Job Summary:

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines You will prepare written summaries of audit findings You will present verbal audit feedback and provide education upon completion of the medical record audit You will pespond to or clarify internal requests for information You will support and participate in process and quality improvement projects You will partner with business associates from other departments to understand their needs and concerns, and help develop system solutions You will understand department, segment, and organizational strategy and operating goals, including their linkages to related areas You will makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receive guidance where needed. You will follow established guidelines/procedures You will help code capacities Use your skills to make an impact Required Qualifications This position requires both a

CPMA AND

CRC and it also requires at least ONE of the certifications from AAPC or AHIMA from the list below: CPC

• Certified Professional Coder (AAPC) CCS
• Certified Coding Specialist (AHIMA) CCS-P
• Certified Coding Specialist-Physician Based (AHIMA) 2 or more years of outpatient coding experience (Preferably in a risk adjustment setting) Knowledge of several reimbursement methodologies, including risk adjustment and fee for service Must maintain annual continuing education requirements and remain in good standing with the certification governing body Will work in a goal-oriented environment that is production and quality driven Passionate about contributing to an organization focused on continuous improvement Proficient in all Microsoft Office applications, including Word and Excel Public speaking / group presentation skills Ability to travel locally and overnight within Conviva and CenterWell markets per business need Preferred Qualifications CDEO Bachelor's Degree Experience with Athena and eCW (Electronic Medical Records) Outpatient auditing experience, preferably in a risk adjustment setting

Travel:

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay...

Job Classification:

Medical Records Specialists Access our statewide or regional occupation report for more information about wages, employment outlooks, skills, training programs, related occupations, and more. Compensation

Salary:

Not Provided Job Requirements

Experience Required:

 See Job Summary

Education Required:

None

Minimum Age:

N/A Gender:

N/A