{"id":577148,"url":"https://alion.io/job/sutherland-lead-healthcare-coding-quality-auditor","title":"Lead - Healthcare - Coding Quality Auditor","company":{"id":6648,"name":"Sutherland","domain":"sutherlandglobal.com","url":"https://alion.io/company/sutherland","size_band":"201-500","is_staffing_agency":false,"employer_type":"services","is_intermediary":false,"listed_via":null,"ats_vendor":"SmartRecruiters","truth_index":{"grade":"B","score":81,"open_postings":51,"ghost_share":0,"stale_share":0.961,"repost_share":0,"time_to_fill_p50_days":21,"computed_at":"2026-11-10T06:52:35Z"}},"role":"Finance","role_family":"Finance","seniority":"lead","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":null,"salary_estimate":{"min_usd":55000,"max_usd":117000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":110},"experience_years_min":3,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Microsoft Office","optional":false}],"status":"live","first_seen_at":"2026-09-09T16:48:01Z","employer_posted_date":"2026-09-09","last_verified_at":"2026-11-10T23:46:19Z","board_verified":true,"closed_at":null,"days_open":62,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":62},"description":"Artificial Intelligence. Automation. Cloud Engineering. Advanced Analytics.\nFor Enterprises, these are key factors of success. For us, they're our core expertise.\nWe work with global iconic brands. We bring them a unique value proposition through market-leading technologies and business process excellence. At the heart of it all is Digital Engineering - the foundation that powers rapid innovation and scalable business transformation.\nWe've created 363 unique and independent inventions, 250 of which are AI-based and rolled up under several patent grants in critical technologies. Leveraging our advanced products and platforms, we drive digital transformation at scale, optimize critical business operations, reinvent experiences, and pioneer new solutions, all provided through a seamless \"as-a-service\" model.\nFor each company, we provide new keys for their businesses, the people they work with, and the customers they serve. With proven strategies and agile execution, we don't just enable change - we engineer digital outcomes.\nSutherland\nDigital Outcomes.\nThe Medical Coding Auditor is responsible for keeping Sutherland coders in compliance by reviewing medical records and coding practices to ensure accurate assignment of ICD-10-CM, CPT, and HCPCS Level II codes in compliance with federal, state, payer, and organizational guidelines. This role evaluates coding accuracy, identifies documentation deficiencies, conducts audits, provides education to coding staff and providers, and supports revenue cycle integrity while minimizing compliance risk.\nEssential Duties and Responsibilities\nPerform retrospective, concurrent, and prospective coding audits for inpatient, outpatient, physician, and/or specialty services.\nReview medical documentation to validate the accuracy and completeness of assigned diagnosis and procedure codes.\nEnsure compliance with ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, Medicare, Medicaid, commercial payer, and regulatory guidelines.\nIdentify coding errors, documentation gaps, and reimbursement opportunities.\nPrepare detailed audit reports outlining findings, trends, recommendations, and corrective actions.\nProvide one-on-one and group education to coders, providers, and clinical staff regarding coding updates, documentation improvement, and compliance requirements.\nMonitor coding quality metrics and develop action plans to improve coding accuracy and consistency.\nStay current on coding regulations, Official Coding Guidelines, CMS regulations, payer policies, and industry best practices.\nAssist with internal and external audits, payer reviews, and regulatory investigations.\nMaintain confidentiality of protected health information (PHI) in accordance with HIPAA regulations.\nParticipate in policy development, process improvement initiatives, and coding education programs.\nTrack audit results and identify recurring trends to support continuous quality improvement.\n Qualifications\nMinimum of 3-5 years of medical coding experience in a healthcare setting.\nMinimum of 2 years of coding audit or quality review experience preferred.\nCurrent coding certification such as:\nCertified Professional Coder (CPC)\nCertified Professional Medical Auditor (CPMA)\nCertified Coding Specialist (CCS)\nCertified Inpatient Coder (CIC)\nRegistered Health Information Technician (RHIT) or\nRegistered Health Information Administrator (RHIA) preferred\nExtensive knowledge of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding systems.\nStrong understanding of CMS regulations, National Correct Coding Initiative (NCCI), Official Coding Guidelines, and payer-specific policies.\nExperience with electronic health records (EHR) and encoder software.\nKnowledge, Skills, and Abilities\nExceptional analytical and critical thinking skills.\nStrong knowledge of healthcare reimbursement methodologies.\nAbility to interpret complex clinical documentation.\nExcellent written and verbal communication skills.\nStrong attention to detail and organizational abilities.\nAbility to maintain objectivity while providing constructive feedback.\nProficiency with Microsoft Office Suite and coding/audit software.\nAbility to work independently and collaboratively in a fast-paced environment.\n All your information will be kept confidential according to EEO guidelines.\nEEOC and Veteran Documentation\nDuring employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.\nAt times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all\nAdministrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.\nPlease note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.","description_format":"text","description_chars":5298,"description_truncated":false,"requirements":{"experience_years_min":3,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[{"language":"English","level":"All levels","optional":false}]},"benefits":[],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Business Process Outsourcing (BPO)","Call Center Services"],"lifecycle":[{"event":"open","at":"2026-09-09T18:34:19Z"}],"visa":[{"country":"US","licensed_sponsor":true,"adverts_offering_sponsorship_24m":0,"sanctioned_now":false,"evidence":"H-1B filings in 12 months: 16","filings_12m":16,"filings_prev_12m":25,"green_card_filings_12m":0,"median_offered_wage_usd":106250,"route":null,"cap_exempt":false,"checked_at":"2026-11-10T11:34:35+00:00","sources":["US Department of Labor: LCA disclosure data (H-1B, H-1B1, E-3)","US Department of Labor: PERM disclosure data (green cards)"],"filings_for_role_12m":0}],"liveness":{"score":13,"band":"cold","label":"Long shot","p_open":1,"p_active":0.469,"p_room":0.28,"age_days":61,"expected_fill_days":21,"reasons":["conf:4","stale_co","velocity","win:tail","crowd:brand"],"computed_at":"2026-11-10T06:52:35Z"},"pay":null,"html_url":"https://alion.io/job/sutherland-lead-healthcare-coding-quality-auditor","json_url":"https://alion.io/job/sutherland-lead-healthcare-coding-quality-auditor.json","meta":{"generated_at":"2026-11-11T01:21:53Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":644,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-11-12T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.1,"usd":0.01,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":6648},"rest":"https://alion.io/mcp/rest/get_company?id=6648"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fsutherland-lead-healthcare-coding-quality-auditor"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":2,"usd":0.2},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fsutherland-lead-healthcare-coding-quality-auditor"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.1,"usd":0.01},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fsutherland-lead-healthcare-coding-quality-auditor"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/sutherland-lead-healthcare-coding-quality-auditor\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fsutherland-lead-healthcare-coding-quality-auditor"}],"agent":{"mcp":"https://alion.io/mcp/jobs","mcp_open":"https://alion.io/mcp/open","next":[{"tool":"get_job","arguments":{"id":577148}},{"tool":"search_jobs","arguments":{"company":"sutherlandglobal.com","detail":"compact"}},{"tool":"match_people","arguments":{"job_id":577148},"note":"people open to offers who fit this vacancy"}],"note":"The same data through MCP tools: https://alion.io/mcp/open needs no sign-in (compact searches, postings, people); https://alion.io/mcp with an Alion account has everything. Docs: https://alion.io/developers"}}