Coding Audit Manager

Core Health LLC

. Review and analyze denied claims related to CPT, ICD-10-CM, and HCPCS coding and documentation issues .

Posted 10/9/2026full-timeRemote • Louisiana • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in medical coding and billing, particularly in denial management, with a strong focus on compliance with CPT, ICD-10-CM, and HCPCS coding guidelines. Proven ability to analyze denial trends, implement corrective actions, and collaborate effectively with clinical and operational teams.

Highest-signal resume keywords

Medical Coding And BillingDenial ManagementCertified Professional Coder (CPC)Regulatory ComplianceTeam Leadership

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CPT CodingICD-10-CM CodingHCPCS CodingDenial Trend AnalysisMedical-Record AuditsCoding Accuracy ImprovementPayer-Specific Coding GuidelinesAppeal Letter PreparationCoding Systems KnowledgeFinancial Impact Reporting

Soft Skills

Strong Organizational SkillsExcellent Communication SkillsAnalytical SkillsAbility To Multi-TaskInterpersonal Skills

Tools & Technologies

Proprietary Software Applications

Certifications & Qualifications

Certified Professional Coder (CPC)Certified Coding Specialist (CCS)Registered Health Information Administrator (RHIA)Certified Documentation Improvement Practitioner (CDI)

Industry Keywords

Payer PoliciesMedicareMedicaidHIPAA ComplianceRegulatory Requirements

About the role

Key responsibilities & impact

Review and analyze denied claims related to CPT, ICD-10-CM, and HCPCS coding and documentation issues
Oversee Core’s clinician auditors
Identify denial trends, root causes, and recurring denial patterns
Implement corrective actions to improve coding accuracy and reduce future denials
Collaborate with billing, revenue cycle, coding, and clinical teams to resolve discrepancies and appeal denials
Conduct medical-record audits for coding accuracy, documentation support, and regulatory and payer compliance
Develop and maintain reporting on denial volumes, reasons, financial impact, trends, and outcomes
Communicate findings and improvement opportunities to leadership and operational teams
Track coding errors and identify coder/provider education and workflow improvement opportunities
Monitor corrective-action effectiveness and provide follow-up reporting
Develop and maintain a payer-specific coding denial crosswalk
Monitor coding productivity and quality metrics, individual and team performance, workflow barriers, and workload optimization
Prepare and submit appeal letters with supporting documentation within payer-specific timeframes
Track appeals through resolution
Maintain current knowledge of coding guidelines, payer policies, and regulatory requirements
Ensure coding and billing activities comply with HIPAA and other relevant regulations
Document denial and appeal activities accurately
Generate denial-trend and appeal-outcome reports
Provide feedback, training, and coding best practices
Perform other related duties as assigned

Requirements

What you’ll need

Bachelor’s degree or equivalent is required
Minimum of 6 years of experience in medical coding and billing, with a focus on denial management
Prior experience supervising or leading a team
Familiarity with various payer guidelines, including Medicare and Medicaid
Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required
Preferred: RHIA, CDI, CPC, CCS, CCS-P
Knowledge and understanding of medical coding and billing systems and regulatory requirements
Knowledge of legal, regulatory and policy compliance issues related to medical coding and billing procedures and documentation
Strong organizational skills and ability to multi-task in a fast-paced environment
Ability to adapt, modify and prioritize while adhering to strict deadlines
Excellent communication and interpersonal skills
Strong analytical skills and ability to work independently
Ability to learn proprietary software applications
Ability to collaborate across geographic locations
Ability to navigate competing priorities and work effectively in a fast-paced environment

Benefits

Comp & perks

Equal opportunity employer
Compliance with ADA regulations as applicable