California Licensed Medical Coding Auditor

To support a leading healthcare company, the part-time California Licensed Medical Coding Auditor will conduct risk-based audits on professional coding and billing workflows, validating code assignments and compliance remotely. Key responsibilities Validate code assignment, documentation, medical necessity, and modifier usage through prospective and retrospective audits Analyze error trends and financial impacts while developing appropriate audit samples and maintaining consistent documentation Communicate findings and recommend improvements to physicians and APCs, managing multiple concurrent audits and reporting deadlines Required qualifications 5+ years of professional coding, billing, or healthcare audit experience, including risk-based auditing Advanced knowledge of CPT, HCPCS, ICD-10-CM, modifiers, and current E/M guidelines Experience with Medicare, Medi-Cal, and commercial payer policies, including CMS manuals and NCDs/LCDs Proficiency in Epic charge review and coding documentation Ability to analyze audit results and develop defensible audit samples