Coding Auditor

Healthfirst

. Audit data, claim submissions, and member medical records for completeness, accuracy, and compliance with Healthfirst policy .

Posted 9/18/2026full-timeRemote • Connecticut • United StatesMid-LevelSenior💰 $61,300 - $89,440 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in auditing medical records for compliance and accuracy, with a strong focus on coding quality and adherence to clinical practice guidelines. Proficient in managing caseloads and collaborating across departments to drive continuous improvement initiatives.

Highest-signal resume keywords

Coding Certification (AAPC, CPC, AHIMA)ICD10 KnowledgeMedical Terminology (Anatomy, Pathophysiology)Professional Writing SkillsTime Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Audit DataClaim Submission ReviewMedical Record EvaluationQuality ImprovementCompliance Assessment

Soft Skills

Critical ThinkingCreative ThinkingCommunicationProblem-SolvingTime Management

Tools & Technologies

OutlookWordExcelPowerPointAdobe Acrobat

Certifications & Qualifications

Coding Certification (AAPC, CPC, AHIMA)

Industry Keywords

Health ComplianceMedical CodingClinical Practice GuidelinesAudit FindingsInternal Audits

About the role

Key responsibilities & impact

Audit data, claim submissions, and member medical records for completeness, accuracy, and compliance with Healthfirst policy
Document audit findings according to departmental procedure
Identify patterns of under-performance, noncompliance, and inconsistencies and recommend resolutions
Evaluate medical coding quality and notify management of discrepancies
Conduct internal audits of medical record reviews performed by colleagues
Collaborate with departments to improve compliance with coding conventions and clinical practice guidelines
Support continuous improvement and quality initiatives across departments
Perform additional duties as assigned

Requirements

What you’ll need

Coding certification from either American Academy of Professional Coders (AAPC), Certified Professional Coders (CPC), or American Health Information Management Association (AHIMA)
High school diploma or GED
Previous relevant experience
Time management, critical/creative thinking, communication, and problem-solving skills
Ability to manage large caseloads and effectively work in a fast-paced environment
Professional writing, electronic documentation, and assessment skills
Intermediate Outlook, Basic Word, Excel, PowerPoint, and Adobe Acrobat skills
Knowledge of ICD10 and anatomy and pathophysiology medical terminologies

Benefits

Comp & perks

Medical, dental and vision coverage
Incentive and recognition programs
Life insurance
401k contributions
Competitive compensation and benefits package