Radiology Coder/Auditor

Accountabilities
The Radiology Coder/Auditor is responsible for maintaining high standards of coding accuracy, compliance, and reimbursement performance across radiology-related services. This role requires strong auditing capabilities, attention to detail, and the ability to identify improvement opportunities across internal processes, vendor partnerships, and emerging coding technologies. Perform advanced coding reviews for radiology, PET, and Nuclear Medicine procedures to ensure accuracy and compliance with applicable guidelines. Conduct quality assurance audits of internal coding activities, external coding partners, and AI-assisted coding platforms. Evaluate coding accuracy, identify trends, and recommend process improvements that enhance revenue integrity and operational efficiency. Review and resolve coding-related issues, including claim denials, reimbursement challenges, and documentation discrepancies. Ensure compliance with ICD-10-CM, CPT, HCPCS, modifier usage, payer requirements, and regulatory standards. Analyze radiopharmaceutical and tracer coding, including HCPCS A-codes and Q-codes, along with dosage-based unit calculations and payer-specific requirements. Support continuous improvement initiatives by providing education, feedback, and coaching to coding teams and stakeholders. Collaborate with revenue cycle, clinical, compliance, and operational teams to strengthen coding quality and reimbursement outcomes. Assess the effectiveness of AI-assisted coding solutions and identify opportunities to improve automation accuracy and workflow performance. Requirements: The ideal candidate brings extensive radiology coding experience, strong auditing knowledge, and a deep understanding of healthcare reimbursement processes. This professional should be analytical, detail-oriented, and comfortable working with evolving technologies while supporting compliance and operational excellence. Bachelor’s degree preferred or equivalent combination of education and relevant experience. 5+ years of recent radiology coding experience with direct exposure to PET and/or Nuclear Medicine studies. CPC or RCC certification required. CPMA and/or RCC-IR certification preferred. Proven experience performing coding audits, quality assurance reviews, and compliance assessments. Strong knowledge of ICD-10-CM, CPT, HCPCS, modifiers, and radiology reimbursement methodologies. Expertise in radiopharmaceutical and tracer coding, including HCPCS A-codes and Q-codes. Knowledge of Medicare NCD/LCD guidelines, medical necessity requirements, and payer-specific regulations. Experience reviewing and resolving coding denials, claim rejections, and revenue cycle issues. Familiarity with outsourced coding partners, vendor review programs, or third-party coding operations. Experience with AI-assisted coding platforms such as Aideo and/or Gemini is preferred. Strong analytical, problem-solving, organizational, and communication skills. Ability to coach teams, communicate recommendations effectively, and drive process improvements. Proficiency with coding, auditing, and revenue cycle technology platforms. Benefits: Competitive compensation package. Medical, dental, and vision insurance coverage. 401(k) eligibility. Free whole-body scans for team members. Pet insurance options. Paid holidays. Paid time off (PTO). Sick time benefits. Opportunities for professional growth and development. Exposure to innovative AI-assisted healthcare technologies. Opportunity to make a direct impact on coding quality, compliance, and patient care outcomes.

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