Medical Auditor - Remote

Sprinter Health
Menlo Park
Workplace: RemoteTemporaryUSD 33+Function: Healthcare (Clinical, Medical, Wellness)Experience: 3+ yearsSkills: ["Attention to detail","Independent work","Communication","Problem-solving","Data analysis"]

Conduct routine and focused audits of medical coding to ensure compliance and coding accuracy across CMS, payer, and organizational standards. Review records, claims, and documentation to validate ICD-10-CM, CPT, HCPCS, and modifier assignment, identify trends and errors, and produce actionable audit reports. Prepare for internal/external audits, maintain tracking logs and accuracy metrics, and continuously support coders and providers through education and feedback—while adhering to HIPAA and privacy requirements.

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FursaFursa
Sprinter Health
Sprinter Health
2 hours ago

Medical Auditor - Remote

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Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI
Last checked: 1 hour agoStatus: Live
Reposted: similar role first listed 1 month ago

Job Summary

Conduct routine and focused audits of medical coding to ensure compliance and coding accuracy across CMS, payer, and organizational standards. Review records, claims, and documentation to validate ICD-10-CM, CPT, HCPCS, and modifier assignment, identify trends and errors, and produce actionable audit reports. Prepare for internal/external audits, maintain tracking logs and accuracy metrics, and continuously support coders and providers through education and feedback—while adhering to HIPAA and privacy requirements.
Location: Menlo Park
Workplace: Remote
Employment Type: Temporary
Job Function: Healthcare (Clinical, Medical, Wellness)
Seniority: Mid level

Key Responsibilities

  • •Conduct routine and focused audits of medical coding to ensure compliance with CMS, payer, and organizational standards.
  • •Review medical records, claims data, and provider documentation to validate ICD-10-CM, CPT, HCPCS, and modifier assignment.
  • •Identify coding errors, trends, and improvement opportunities; prepare detailed audit reports with actionable findings.
  • •Provide education and feedback to coders and providers to improve documentation quality and coding accuracy.
  • •Assist with internal and external audit preparation and response, including documentation requests and validation reviews.

Pay and Benefits

Salary: USD 33
Perks:Health InsuranceDentalVision401kParental LeavePaid Leave

Key Requirements

  • •Active AAPC (CPC) or AHIMA (CCS-P, CCS) certification.
  • •Minimum 3 years of medical coding experience, including 1-2 years in coding audit, QA, or compliance.
  • •Strong understanding of HCC/risk adjustment coding principles, clinical documentation improvement, and coding validation practices.
  • •Deep familiarity with CPT, ICD-10-CM, HCPCS, and modifier assignment.
  • •Excellent medical terminology and anatomy/physiology/pathophysiology/disease progression/pharmacology knowledge.
Experience:3+ yearsHealthcareMedical codingComplianceAuditingHCCRisk adjustment
Skills:Attention to detailIndependent workCommunicationProblem-solvingData analysis
Certifications:AAPC CPCAHIMA CCS-PAHIMA CCS
Tech Stack:ElationGoogle SuiteEHRCoding softwareEncoders

Company Brief

Sprinter Health
Operates mobile and home-based primary care services focused on delivering in-home medical visits, chronic care management, and coordinated care for patients who face barriers accessing clinic-based care.
Industry: Healthcare Providers
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