QA Medical Coder / Coding Auditor

Job Summary:

We are looking for a detail-oriented QA Medical Coder with expertise in neurology coding and coding
audits. This role will focus on reviewing coded encounters, identifying coding opportunities, and optimizing
reimbursement while ensuring compliance. The ideal candidate will work closely with the Accounts
Receivable (AR) team to validate diagnosis and procedure coding, identify undercoded services, and
recommend the most appropriate code selection based on clinical documentation.

Key Responsibilities
Review and analyze patient charts, consultation notes, operative reports, and clinical
Conduct quality assurance reviews of coded neurology encounters and claims.
Review physician-selected diagnosis and procedure codes for accuracy and completeness.
Identify coding discrepancies, missed coding opportunities, and potential undercoding
situations.
Recommend the most appropriate ICD-10, CPT, and HCPCS codes supported by documentation.
Collaborate with AR, billing, and provider teams to maximize reimbursement while maintaining
compliance.
Review denials related to coding issues and provide corrective recommendations.
Ensure coding practices comply with payer guidelines, CMS regulations, and industry standards.
Educate providers and staff on coding best practices and documentation improvement
opportunities.
Participate in coding audits and quality improvement initiatives.
Qualifications:
CPC, CCS, CRC, or equivalent coding certification required.
Minimum 3-5 years of medical coding experience.
Required experience with neurology coding, including evaluation and management (E/M)
services, EEGs, EMGs, nerve conduction studies, and other neurology-related procedures.
Strong understanding of coding audits, revenue cycle management, and accounts receivable
processes.
Experience identifying undercoding opportunities and reviewing documentation for coding
optimization.
Extensive knowledge of ICD-10-CM, CPT, HCPCS, and payer-specific coding guidelines.
Excellent attention to detail, analytical skills, and problem-solving abilities.
Experience working with denials management and claim appeals is highly preferred.

Preferred Experience:
Neurology practice or specialty coding background.
Prior experience in coding quality assurance, auditing, or compliance roles.
Familiarity with physician education and clinical documentation improvement (CDI) initiatives.