{"id":4226350,"url":"https://alion.io/job/tegria-certified-professional-medical-coding-auditor","title":"Certified Professional Medical Coding Auditor","company":{"id":4478931,"name":"Tegria","domain":"tegria.com","url":"https://alion.io/company/tegria","size_band":null,"is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"B","score":75,"open_postings":3,"ghost_share":0,"stale_share":1,"repost_share":0,"time_to_fill_p50_days":null,"computed_at":"2026-11-12T10:38:37Z"}},"role":"Finance","role_family":"Finance","seniority":"middle","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":{"min":75000,"max":95000,"currency":"USD","period":"year","gross":null,"usd_annual":95000},"salary_estimate":null,"experience_years_min":3,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[],"status":"live","first_seen_at":"2026-11-12T00:00:00Z","employer_posted_date":"2026-11-12","last_verified_at":"2026-11-13T08:02:43Z","board_verified":true,"closed_at":null,"days_open":1,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":1},"description":"As aCertified Professional Medical Coding Auditor, your work atTegriawill focus onevaluating the accuracy, consistency, and quality of coded medical records completed by internal and external coding staff, conducting routine monthly and targeted audits to ensure adherence to official coding guidelines, payer requirements, regulatory standards, and organizational policies.\nThis role completes audits, applying established coding guidelines and audit procedures to resolve most coding questions independently. The role may recommend improvements to coding procedures as guidelines and requirements evolve, escalates findings that may signal a compliance or revenue concern to coding leadership for evaluation, and provides supporting documentation that leadership relies on when determiningnext steps.\nThe auditor identifiescoding trends and improvement opportunities from completed audits and shares them with coding leadership. Partnering with the Coding Manager and Coding Leads, this role delivers clear, constructive feedback and helps support coder development, while championing accuracy, compliance, and revenue integrity throughout the organization.\nThe role you play\nAn effectiveCertified Professional Medical Coding Auditorwill help the organization on a whole achieve success through:\nLiving ourTegriavalues: Respect Every Person, Act with Integrity, Strive for Better, Embrace Change, Deliver as a Team\n\nCoding Audits and Quality Reviews\nConduct audits according to the audit plan and methodologyestablishedby coding leadership, applying sound judgment within defined parameters.\n\nConduct retrospective and concurrent audits of coder-assigned ICD-10-CM, CPT, HCPCS Level II, ICD-10-PCS, and modifier codes.\n\nEvaluate coding accuracy, completeness, consistency, and compliance with official coding guidelines and organizational standards.\n\nPerform routine monthly quality assurance audits as well as focused reviews assigned by coding leadership.\n\nValidate appropriate codeassignment and sequencing based on provider documentation.\n\nApply sound coding judgment to resolve routine coding questions, escalating more complex or ambiguous coding requirements to a senior auditor or coding leadership for guidance.\n\nIdentifycoding errors, trends, and opportunities for process improvement; flag potential compliance or revenue concerns to coding leadership for evaluation.\n\nMonitor coding quality metrics and assistleadership with accuracy ofscorecard development and reporting.\n\nParticipate in quality improvement initiatives designed to enhance coding performance and consistency across teams.\n\nCoder Feedback and Education\nProvide timely, constructive, and individualized feedback to coders regardingaudit findings.\n\nTranslate audit findings and coding trends into topics for education sessions and identifydevelopmental needs, in partnership with coding leadership.\n\nContribute to and help deliver coding education sessions based on audit results, identifiedtrends, and regulatory updates.\n\nCreate educational resources including tip sheets, coding guidance documents, case studies, and training materials.\n\nAssistwith onboarding and mentoring newly hired coders.\n\nPartner with coding leadership to support corrective action plans and individualized education plans when needed.\n\nServe as a coding resource for staff and assistcoders with complex coding questions.\n\nCompliance and Regulatory Support\nEnsure coding practices comply withICD-10-CM, CPT, HCPCS, CMS, Official Coding Guidelines, and payer requirements.\n\nRecommend updates to coding procedures and guidance documents as guidelines, payer requirements, or organizational needs evolve.\n\nMonitor regulatory and coding guideline changes and communicate their impact oncoding staff and leadership.\n\nEscalate audit findings and potential compliance risks to coding leadership andprovide supporting documentation and input on possible remediationactions.\n\nAssistwith preparation for internal and external coding quality reviews.\n\nSupport organizational compliance initiatives related to coding quality and documentation integrity.\n\nData Analysis and Reporting\nAnalyze audit data to identifypatterns, trends, and educational opportunities.\n\nPrepare audit reports and coding quality metrics for coding leadership, including findings and supporting documentation.\n\nTrack coder performance improvement over time and measure the effectiveness of educational interventions.\n\nProvide recommendations for workflow improvements and process standardization.\n\nCollaboration\n\nPartner closely with the Coding Manager and Coding Leads to align audit findings, education, and coder development efforts with organizational goals.\n\nContribute to coding policy and procedure development.\n\nSupport organizational goals related to coding quality, compliance, and productivity.\n\nLeverage approved AI tools to enhance productivity, accuracy,and decision making.\n\nPerforms othergenerally relatedduties as assigned.\n\nWhatwe’relooking for\nWe expect:\nHigh school diploma or equivalent required;\n\nAssociatesor Bachelor's degree in Health Information Managementor related healthcare field preferred.\n\nCurrent Certified Professional Medical Auditor (CPMA) certification, in addition to one of the following AAPC or AHIMA certifications:\n\nCertified Professional Coder (CPC)\n\nCertified Coding Specialist (CCS)\n\nCertified Outpatient Coder (COC)\n\nRHIT or RHIA\n\nMinimum 3 years of medical coding experience in professional and/or facility coding.\n\nMinimum 1 year of coding quality review, auditing, or coding education experience, with demonstratedability to work with general direction and exercise sound judgment on coding issues.\n\nStrong working knowledge of ICD-10-CM, CPT, HCPCS Level II, ICD-10-PCS, and official coding guidelines.\n\nSolid understanding of coding quality methodologies and audit principles.\n\nW2 project-based consultants will be expected to provide a computing device that adheres to industry standards and security best practices to use in satisfying the Project Services on behalf ofTegria\n\nSuccess Criteria\nPeople who are successful in this role…\nAre productive, responsive, and reliable in a remote working environment.\n\nExercise sound, independent judgment on ambiguous or complex coding issues.\n\nDemonstrate objectivity and consistency in evaluating others' work.\n\nCommunicate clearly and constructively, even when delivering critical feedback.\n\nStay current and adaptable as coding guidelines and regulations evolve.\n\nBalance strong attention to detail with big-picture, trend-level thinking.\n\nBuild trust and credibility through sound, well-supported judgment.\n\nManage competing priorities and deadlines effectively.\n\nApproach coaching and development with patience and a constructive mindset.\n\nTake ownership and follow through on outcomes.\n\nSalary Range\n$75,000 - $95,000Now, a little about us …\nAt Tegria, we bring bold ideas and breakthroughs to improve care, technology, revenue, and operations in ways that move healthcare organizations from patient-centered to human-centered. We are helping healthcare put people first-both patients and those who dedicate their lives to delivering care.\nAnd at the very core of this vital work is our incredibly talented people.\nPeople with different backgrounds who welcome challenge and change. People who listen first, ask hard questions, and make decisions to cultivate a culture of equity and inclusion. People who chase after goals, growth, and generosity. We’re real. We’re nimble, and we believe in our mission to humanize healthcare.\nPerks and benefits\nTop talent deserves top rewards. We’ve carefully curated a best-in-class benefits package, meant to meet you wherever you are in your life and career.\nYour health, holistically. We offer a choice of multiple health and dental plans with nationally recognized networks, as well as vision benefits, a total wellness program, and an employee assistance program for you and your family.\n\nYour financial well-being. We offer competitive wages, retirement savings plans, company-paid disability and life insurance, pre-tax savings opportunities (HSA and/or FSA), and more.\n\nAnd everything in between. Our lifestyle benefits are unrivaled, including professional development offerings, opportunities for remote work, and our favorite: a generous paid-time-off program, giving you the flexibility to plan a vacation, take time away for illness (or life’s important events), and shift your schedule to accommodate those unexpected curve balls thrown your way.\n\nTegria is an equal employment opportunity employer and provides equal employment opportunities (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. 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