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Medical Coding Auditor Jobs in Raleigh, NC (NOW HIRING)

Elevance Health

Clinical Provider Auditor I

Durham, NC · On-site

Requires a AA/AS and minimum of 1 year related medical coding/auditing experience; or any combination of education and experience, which would provide an equivalent background. * Must achieve coding ...

Elevance Health

Clinical Provider Auditor I

Durham, NC · On-site

Requires a AA/AS and minimum of 1 year related medical coding/auditing experience; or any combination of education and experience, which would provide an equivalent background. * Must achieve coding ...

Elevance Health

Clinical Provider Auditor I

Durham, NC · On-site

Requires a AA/AS and minimum of 1 year related medical coding/auditing experience; or any combination of education and experience, which would provide an equivalent background. * Must achieve coding ...

Humana

Medical Coder

Morrisville, NC · On-site +1

$17.50 - $23.50/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

Humana

Medical Coder

Holly Springs, NC · On-site +1

$16.25 - $21.75/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

Humana

Medical Coder

Oxford, NC · On-site +1

$17.25 - $23/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

Humana

Medical Coder

Wake Forest, NC · On-site +1

$16 - $21.50/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

Humana

Medical Coder

Morrisville, NC · On-site +1

$17.50 - $23.50/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

Humana

Medical Coder

Durham, NC · On-site +1

$18 - $24.25/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

Humana

Medical Coder

Oxford, NC · On-site +1

$17.25 - $23/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

Humana

Medical Coder

Fuquay Varina, NC · On-site +1

$15.50 - $20.75/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

Humana

Medical Coder

Raleigh, NC · On-site +1

$18.25 - $24.25/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

Humana

Medical Coder

Holly Springs, NC · On-site +1

$16.25 - $21.75/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

Humana

Medical Coder

Fuquay Varina, NC · On-site +1

$15.50 - $20.75/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

Humana

Medical Coder

Youngsville, NC · On-site +1

$14.25 - $19/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

Humana

Medical Coder

Knightdale, NC · On-site +1

$17 - $22.50/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

Humana

Medical Coder

Apex, NC · On-site +1

$14.25 - $19/hr

... coding education and / or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets

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All JobsMedical Coding Auditor JobsMedical Coding Auditor Jobs in Raleigh, NC

Medical Coding Auditor information

See Raleigh, NC salary details

$33K

$66.5K

$89.9K

How much do medical coding auditor jobs pay per year?

As of Jun 20, 2026, the average yearly pay for medical coding auditor in Raleigh, NC is $66,497.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,400.00 and $72,900.00 per year, depending on experience, location, and employer.

What Do Medical Coding Auditors Do?

A medical coding auditor is an administrative professional in the healthcare industry. As a medical coding auditor, you check medical coding and billing information for accuracy, suspicious activity, and compliance with healthcare regulations. Your responsibilities require you to review medical data and document any areas where the medical coding could improve in terms of accuracy and efficiency. Your duties also include reviewing records of patients to make sure that there is documentation for each item on a billing inventory. Though you work in the medical coding and billing department, your focus is on regulations, compliance, and efficiency rather than on coding for billing and records purposes.

What is the difference between Medical Coding Auditor vs Medical Billing Specialist?

AspectMedical Coding AuditorMedical Billing Specialist
CertificationsCPMA, CPC, CCSCPB, CPC, CMA
Work EnvironmentHospitals, clinics, insurance companiesMedical offices, billing companies
Primary FocusReviewing coding accuracy and complianceProcessing patient bills and payments
Industry UsageHealthcare providers, insuranceHealthcare providers, billing services

Medical Coding Auditors focus on reviewing and ensuring the accuracy of medical codes used for billing and reimbursement, often working in compliance and quality assurance roles. Medical Billing Specialists handle the submission of claims, patient billing, and payment processing. While both roles require coding knowledge and certifications, their primary responsibilities and work environments differ, making them distinct but related careers in healthcare revenue cycle management.

What are the key skills and qualifications needed to thrive as a Medical Coding Auditor, and why are they important?

To thrive as a Medical Coding Auditor, you need in-depth knowledge of medical coding systems (ICD-10, CPT, HCPCS), healthcare regulations, and a credential such as CPC, CCS, or RHIA. Proficiency with electronic health record (EHR) systems, coding audit software, and compliance databases is typically required. Attention to detail, analytical thinking, and strong communication skills help auditors accurately review records and provide clear feedback. These skills are essential for ensuring coding accuracy, regulatory compliance, and minimizing risk for healthcare organizations.

What does a Medical Coding Auditor do?

A Medical Coding Auditor reviews medical records and coding to ensure accuracy, compliance with regulations, and proper reimbursement. They evaluate the work of medical coders, identify errors or inconsistencies, and provide feedback or training to improve coding practices. Medical Coding Auditors help healthcare organizations minimize risk, avoid overbilling or underbilling, and maintain high standards in documentation and billing processes.

What are some common challenges faced by Medical Coding Auditors and how can they be addressed?

Medical Coding Auditors often encounter challenges such as staying current with frequently changing coding guidelines, managing high volumes of records, and ensuring accuracy under tight deadlines. To address these, many auditors participate in ongoing training, leverage coding software tools, and collaborate closely with coding and billing teams to clarify discrepancies. Establishing consistent communication with healthcare providers and maintaining meticulous documentation also helps minimize errors and improve audit efficiency.

Are medical coders going to be replaced by AI?

Medical coding auditors, as part of the medical coding field, are unlikely to be fully replaced by AI in the near future because they require critical thinking, review skills, and understanding of complex medical documentation. AI tools can assist with coding accuracy and efficiency, but human oversight remains essential for compliance and handling complex cases. Continuous learning and certification help coders stay relevant as technology evolves.

How do I become a medical coding auditor?

To become a medical coding auditor, you typically need a medical coding certification such as the Certified Professional Coder (CPC) or Certified Coding Specialist (CCS), along with experience in medical coding. Strong attention to detail, knowledge of coding guidelines, and familiarity with coding and auditing software are essential for the role.

What is the highest paying job in medical coding?

The highest paying roles in medical coding are often senior-level positions such as Coding Manager, Coding Director, or Compliance Officer, which require extensive experience, certifications like CPC or CCS, and strong leadership skills. These roles typically offer higher salaries due to increased responsibilities and expertise in auditing, compliance, and coding accuracy.

What do medical coding auditors do?

Medical coding auditors review healthcare claims and medical records to ensure accurate and compliant coding of diagnoses and procedures. They identify errors, verify coding accuracy, and ensure adherence to billing regulations, often using coding software and industry guidelines. Their work helps prevent fraud and optimize reimbursement for healthcare providers.
More about Medical Coding Auditor jobs
What are the most commonly searched types of Medical Coding Auditor jobs in Raleigh, NC? The most popular types of Medical Coding Auditor jobs in Raleigh, NC are:
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What cities near Raleigh, NC are hiring for Medical Coding Auditor jobs? Cities near Raleigh, NC with the most Medical Coding Auditor job openings:
Medical Coding Auditor jobs near you
Infographic showing various Medical Coding Auditor job openings in Raleigh, NC as of June 2026, with employment types broken down into 86% Full Time, 7% Part Time, and 7% Contract. Highlights an 50% In-person, 3% Hybrid, and 47% Remote job distribution, with an average salary of $66,497 per year, or $32 per hour.
RCS Medical Coding Auditor (CPC, CPMA)

RCS Medical Coding Auditor (CPC, CPMA)

Veradigm

Raleigh, NC • On-site, Remote

$57K - $80K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago

Job description

Position Summary
The RCS Medical Coding Auditor is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback.
The ideal candidate brings strong hands-on experience with professional fee coding, deep knowledge of E/M, surgical, and modifier use, and the ability to translate audit findings into actionable insights.
Key Responsibilities
  • Perform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedback
  • Validate ICD-10-CM, CPT®, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelines
  • Conduct medical chart audits of professional services across multiple specialties
  • Identify coding discrepancies, compliance risks, trends, root causes, and documentation gaps
  • Support coding education through feedback, targeted training, and reference materials
  • Prepare clear, defensible audit documentation including rationale and references
  • Provide actionable recommendations to address audit findings and reduce future risk
  • Track audit outcomes and trends to support leadership reporting and risk mitigation strategies
  • Support denial prevention, resolution and appeal strategies
  • Collaborate across teams to assist with coding support
  • Maintain confidentiality and comply with HIPAA and organizational policies

Required Qualifications
  • CPC (Required) and CPMA (Required/In Process)
  • 2+ years of ProFee auditing experience
  • Knowledge of:
    • E/M documentation guidelines
    • Modifier rules and NCCI edits
    • CPT, ICD-10-CM, HCPCS Level II
  • High attention to detail with strong analytical and critical-thinking skills
  • Excellent written and verbal communication skills for audit reporting and education
  • Proficiency with EHRs, coding and auditing tools
  • Proficiency with Microsoft Office Suite

Preferred Qualifications
  • Multi-specialty coding and auditing experience with preferred background in E/M Coding, Orthopedics, Pain Management, Urology
  • Background in coding quality programs or compliance teams
  • Advanced reporting skills for audit tracking and trend analysis
  • Prior consulting or client-facing audit experience

Compensation Range:
$57,728-$80,243
Compensation for this job is subject to market conditions, geographic considerations, the candidate's unique skills and experience, state and local laws, and budget. Our commitment to pay transparency is a testament to our dedication to creating a fair, equitable, and inclusive workplace. By continuously analyzing market trends, staying abreast of changes in state laws, and making budgetary adjustments accordingly, we strive to ensure that our compensation practices reflect the value we place on our associates' unique contributions and support their professional growth.
Enhancing Lives and Building Careers
Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work and to further their professional development. Together, we are In the Network. Interested in learning more?
Take a look at our Culture, Benefits, Early Talent Program, and Additional Openings.
Visa Sponsorship is not offered for this position.
At Veradigm, our greatest strength comes from bringing together talented people with diverse perspectives to support the needs of healthcare providers, life science companies, health plans, and the patients they serve. The Veradigm Network is a dynamic, open community of solutions, external partners, and cutting-edge artificial intelligence technologies that provide advanced insights, technology, and data-driven solutions. Veradigm offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.
Veradigm's policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Veradigm must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire. Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.
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This is an official Veradigm Job posting. To avoid identity theft, please only consider applying to jobs posted on our official corporate site.
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