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Type: Contract To Hire
Pay: Apply For Details
Location: Remote
Seeking a detail-oriented and knowledgeable Provider/Coding Auditor Educator to support accurate and compliant coding practices across provider network. This role will be responsible for performing audits of medical documentation and coding, educating providers on best practices, and ensuring adherence to industry guidelines and payer regulations. The ideal candidate is a certified coding professional with strong communication skills and a passion for education and compliance. This role requires flexibility in working hours, which may vary based on organizational needs, and may include periodic onsite visits to various provider locations, typically on a quarterly basis, with additional collaboration conducted via Microsoft Teams or other virtual platforms as needed.
Key Responsibilities:
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Conduct prospective, concurrent, and retrospective coding audits for professional and/or facility services.
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Review medical documentation to ensure codes assigned (ICD-10-CM, CPT, HCPCS) are supported and meet regulatory and payer guidelines.
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Deliver coding and documentation education to providers through individual coaching, team sessions, and formal training presentations—both virtually and in person.
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Develop educational tools such as tip sheets, coding guides, and compliance reference materials.
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Identify trends in audit findings and provide feedback to leadership to guide quality improvement initiatives.
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Serve as a subject matter expert (SME) on coding policies, E/M documentation, and payer regulations.
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Support new provider onboarding and orientation with training on coding expectations and documentation standards.
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Collaborate with compliance, revenue cycle, and clinical operations teams to improve accuracy in coding and billing.
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Assist in the development and revision of policies, procedures, and training programs related to coding and documentation compliance.
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Maintain up-to-date knowledge of CMS guidelines, payer-specific rules, and industry coding updates.
Qualifications:
Education & Certification:
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Associate or bachelor’s degree in health information management, or related healthcare field preferred.
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Active coding certification required: CPC, CCS, or equivalent.
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CPMA (Certified Professional Medical Auditor) strongly preferred or required to be obtained within 6 months of hire.
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Additional certifications (e.g., CRC, CCS-P, CDEO) are a plus.
Experience:
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Minimum of 3–5 years of experience in medical coding with direct auditing and provider education responsibilities.
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Proficient in Evaluation & Management (E/M) coding, outpatient and/or inpatient coding, and modifier usage.
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Experience in developing and delivering provider education in both individual and group settings.
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Prior experience using EMR/EHR systems and audit tools such as Allscripts and eClinical Works or similar platforms.
Skills:
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In-depth knowledge of CPT, ICD-10-CM, and HCPCS coding and official coding guidelines.
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Strong understanding of managed care regulations and professional fee (profee) billing requirements.
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Strong communication and presentation skills with the ability to explain complex coding topics in an understandable way.
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High level of professionalism and discretion when delivering feedback.
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Ability to analyze trends and provide data-driven recommendations.
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Proficiency in Microsoft Office tools (Excel, PowerPoint, Word).
Other Requirements:
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Self-motivated and able to work independently and as part of a collaborative team.
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Flexible and adaptable to changing priorities and regulations.
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Willingness and ability to travel up to 10% quarterly, including overnight stays for onsite education or audit support
Job Id: a1sVb000004jtIzIAI