Medical Coding Auditor

CenterWell Senior Primary Care

Medical Coding Auditor responsible for processing clinical information and auditing medical records for compliance. Join Conviva Senior Primary Care and contribute to quality improvement initiatives.

Posted 5/1/2026full-timeRemote • 🇺🇸 United StatesJuniorMid-Level💰 $59,300 - $80,900 per yearWebsite

About the role

Key responsibilities & impact

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.
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.
verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions
confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines
use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines
prepare written summaries of audit findings
present verbal audit feedback and provide education upon completion of the medical record audit
respond to or clarify internal requests for information
support and participate in process and quality improvement projects
partner with business associates from other departments to understand their needs and concerns, and help develop system solutions
make decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receive guidance where needed.
follow established guidelines/procedures
help code capacities

Requirements

What you’ll need

This position requires both a CPMA AND CRC
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

Benefits

Comp & perks

medical, dental and vision benefits
401(k) retirement savings plan
time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
short-term and long-term disability
life insurance and many other opportunities

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

medical codingICD-10-CMCPTauditingcompliancemedical billingdocumentation accuracycoding guidelinesreimbursement methodologiesoutpatient coding

Soft Skills

communicationpublic speakingpresentation skillsdecision makingcollaborationproblem solvingattention to detailadaptabilitycontinuous improvementgoal-oriented

Certifications

CPMACRCCPCCCSCCS-P