Xtensys is a rapidly growing managed service provider delivering innovative technology solutions to health systems nationwide. With more than 500 professionals, we are building a people-centered culture rooted in collaboration, innovation, and continuous improvement. We are seeking an experienced Professional Lead Medical Coding Auditor to support our continued growth and commitment to exceptional client outcomes.
Mission-Driven Work: Help improve coding quality, compliance, reimbursement integrity, and provider education.
Leadership Opportunity: Serve as the senior auditing resource and functional lead for the coding audit team.
Culture of Innovation: Contribute to process improvements, education initiatives, and compliance excellence.
Professional Growth: Mentor coding professionals while expanding your own technical and leadership expertise.
The Role
As our next Professional Lead Medical Coding Auditor, you will serve as the senior subject matter expert for auditing, documentation integrity, compliance, and provider education activities across multiple specialties. You will perform complex audits, develop educational programs, mentor coding staff, monitor audit outcomes, and support quality and compliance initiatives throughout the revenue cycle.
What You'll Do Day-to-Day
-
Perform comprehensive audits of medical records, provider documentation, and coding assignments.
-
Review CPT, ICD10CM, HCPCS Level II, modifiers, and E/M code selection for accuracy and compliance.
-
Identify coding, billing, documentation, and compliance risks and recommend corrective actions.
-
Support internal, payer, and regulatory audits.
-
Monitor adherence to CMS, Medicare, Medicaid, commercial payer, OIG, HIPAA, and organizational requirements.
-
Serve as the primary resource and escalation point for coding auditors and coding staff.
-
Assist with workflow coordination, workload balancing, onboarding, and mentoring.
-
Promote consistency in audit methodologies, coding interpretations, and educational practices
-
Support operational priorities and departmental performance goals.
-
Develop and deliver provider education programs and training materials.
-
Conduct oneonone and group education sessions with physicians and advanced practice providers.
-
Educate providers on documentation requirements, coding guidelines, reimbursement implications, and regulatory updates.
-
Monitor performance improvement following educational interventions.
-
Prepare detailed audit reports and recommendations.
-
Analyze documentation and coding trends across providers and specialties.
-
Develop performance reports, dashboards, and compliance tracking tools.
-
Present findings and recommendations to providers and Revenue Cycle leadership.
-
Identify recurring documentation deficiencies and coding trends.
-
Support denial prevention and revenue integrity initiatives.
-
Recommend workflow improvements that enhance coding quality, efficiency, and compliance.
Who You Are & What You'll Bring
-
Five (5) or more years of professional coding and auditing experience.
-
Expert knowledge of ICD10CM, CPT, HCPCS coding, modifier usage, and current E/M guidelines.
-
Experience with physician documentation requirements and reimbursement methodologies.
-
Experience presenting audit findings and providing provider education.
-
Experience with Medicare Part B, Medicaid, and commercial payer requirements preferred.
-
Previous lead, mentoring, trainer, or senior auditor experience preferred.
Education & Certifications
-
High School Diploma or GED.
-
Completion of approved coding education and training programs.
-
Active coding certification through AAPC, AHIMA, or an equivalent organization, including: CPC, CCS, RHIT, RHIA, Other approved coding credentials
-
Associate's or Bachelor's degree in Health Information Management, Healthcare Administration, or related field.
-
Certified Professional Medical Auditor (CPMA).
-
Advanced specialty coding certifications.
-
Expert knowledge of professional coding and auditing workflows.
-
Strong understanding of revenue cycle operations and reimbursement processes.
-
Advanced analytical and criticalthinking skills.
-
Proficiency with Microsoft Office applications and reporting tools.
-
Experience with Epic Professional Coding and Revenue Cycle systems preferred.
-
Strong reporting, dashboard development, and audit analytics capabilities.
-
Exceptional mentoring, coaching, and facilitation abilities.
-
Excellent provider education and presentation skills.
-
Strong written communication and audit reportwriting skills.
-
Ability to effectively communicate complex coding and compliance concepts.
-
Minimal travel required.
-
Occasional travel for provider meetings, educational programs, conferences, or organizational initiatives.
-
Fulltime, exempt position (40 hours per week).
-
Standard business hours, Monday through Friday.
-
Fully remote work environment.
-
Must maintain a secure, HIPAAcompliant home workspace and reliable internet connection.
-
Primarily sedentary work involving prolonged periods of sitting and computer use.
-
Frequent keyboarding and data entry.
-
Ability to communicate effectively via telephone and video conferencing.
We are new but mighty. Xtensys, a recently established managed service provider, delivers cutting-edge technology to health systems, starting in NY and expanding beyond. Owned by two industry leaders focused on innovation in rural and community health, we are rapidly growing with several major initiatives underway. We seek talented professionals to join our team of 500 and support our exciting journey. We value people and are building a culture to match. If you're a collaborative, innovative, and strategic leader, we’d love to talk.
