Auditor, Educator – Professional Services

This is a fully remote position, open to applicants in California.

📋 Description

• Leverage specialized expertise to support critical areas within the organization related to a specific field of knowledge.

• Utilize data, research analysis, critical thinking, and problem-solving abilities to assist colleagues and leadership in meeting the organization's strategic goals.

• Act as a peer influencer and may lead a project or project team by applying industry experience and specialized skills.

• Provide high-level technical proficiency and subject matter expertise in analyzing coding and documentation reviews for professional services, including the selection of evaluation and management codes and procedural services.

• Conduct thorough audits of professional coders and providers to ensure accuracy, compliance, and alignment with CPT, ICD-10, HCPCS, HCC, and payer-specific guidelines.

• Analyze documentation and coding trends to identify risks associated with compliance, revenue integrity, and regulatory requirements.

• Offer clear, actionable feedback to providers, coders, and leadership to enhance documentation quality and coding precision.

• Maintain up-to-date knowledge and credentials through continuous education and the interpretation of regulatory and industry changes.

• Design and deliver targeted education and training programs based on audit findings, regulatory updates, and identified knowledge deficiencies.

• Provide training and onboarding for new providers.

• Comply with coding quality and productivity standards as set by Revenue Excellence.

⛳️ Requirements

• An associate degree in Health Information Management or a related area, or an equivalent combination of education and experience.

• Must have extensive knowledge of ICD-10, HCPCS, CPT, and HCC guidelines, as well as medical terminology, regulatory guidelines including Medicare and Medicaid, and payer policies.

• Three (3) to five (5) years of experience in professional coding or auditing.

• Certification as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), or Coding Profession Certification (CPC) is mandatory.

• A bachelor's degree in health information management (HIM) or a related healthcare field is preferred.

• Prior experience in auditing and provider education is preferred.

• Preferred certifications include Certified Professional Medical Auditor (CPMA), Certified Risk Coder (CRC), and Clinical Documentation Expert – Outpatient (CDEO).

🏝️ Benefits

• Comprehensive benefit packages, including medical, dental, vision, mental health, paid time off, 403B, education assistance, and voluntary benefits (pet insurance, accident insurance, hospital indemnity, and others) available from the first day of employment.

• Work/life balance with flexible scheduling.

• Free onsite parking.