Coding Auditor – Educator

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

📋 Description

• Provide education and training to the coding staff at WVU Healthcare as instructed by Coding Managers.

• Supervise and execute auditing and educational initiatives for coding personnel.

• Conduct coding quality audits and deliver ongoing feedback and educational support.

• Utilize ICD-10-CM, ICD-10-PCS, CPT, and other resources and software to guarantee precise coding and proper MS-DRG, HCC, and APR-DRG assignments.

• Oversee training activities for assigned coding staff and track and report on employee development.

• Manage quality improvement audits and training for designated coding personnel.

• Act as a coding expert resource for coders, clinical documentation improvement teams, providers, revenue cycle staff, specialty groups, and meetings.

• Serve as a super user for coding-related electronic medical record systems and support EMR data governance.

• Revise policies, procedures, work queues, and educational materials.

• Interact with coding staff, medical staff, Physician Advisors, Department Chairpersons, and Department Administrators.

• Organize, facilitate, execute, track, trend, and report on internal quality reviews.

• Create and implement audit tools to assess coding accuracy, identify documentation gaps, and manage billing processes.

• Coordinate external agency audits, data collection, exit meetings, and final reporting.

• Manage coding and documentation denial reviews and assist in the creation of appeal letters.

• Communicate issues related to coding, documentation, audits, and activities to Coding Leadership.

• Ensure the completion of audit recommendations, including coding education, changes, and rebills.

• Extract and analyze data to develop action plans as required.

• Assist in the onboarding process for new Coding Specialists.

• Keep Coding Specialists informed about compliance and regulatory updates.

• Stay updated on coding modifications, state and federal regulations, and coding resources.

• Develop curriculum for the WVU Healthcare Coding Certificate Program and assist with special EMR data governance projects as necessary.

• Utilize systems for curriculum and educational courses, administer examinations, and support the testing and installation of system upgrades.

⛳️ Requirements

• Graduate from a Health Information Technology (HIT) program or an equivalent program with five (5) years of coding experience; OR a graduate from a Medical Coding Certification Program with five (5) years of coding experience; OR a high school diploma or equivalent with eight (8) years of coding experience.

• Certification in one of the following: RHIA, RHIT, COC, CCS, or CPC.

• Significant experience with ICD-10-CM, ICD-10-PCS, CPT, MS-DRG, HCC, and APR-DRG assignments, as well as multi-specialty coding, E&M coding, procedural/surgical coding, and governmental billing and coding regulations is preferred.

• Previous supervisory or project management experience is preferred.

• Exceptional written, verbal, and interpersonal communication skills.

• Understanding of healthcare compliance, revenue cycle operations, and auditing methodologies.

• Capability to mentor, educate, and train others.

• Ability to uphold quality and productivity benchmarks.

• Capacity to manage high-stress and critical scenarios with composure and professionalism.

• Skill in maintaining accuracy amidst frequent interruptions.

• Independent decision-making capabilities.

• Proficiency in prioritizing job responsibilities and adjusting to workplace changes.

• Strong organizational and time management skills.

• Knowledge of anatomy, physiology, and medical terminology.

• Proficient analytical and problem-solving skills.

• Competency in office software, medical record systems, and billing software.

• Ability to analyze complex data and reporting.

• Ability to remain seated for prolonged periods, operate computer and office equipment, and lift, push, or pull weights of 10–20 pounds.

• Travel may be required.

🏝️ Benefits

• Competitive salary and performance bonuses.

• Comprehensive health, dental, and vision insurance plans.

• Retirement savings plan with employer matching.

• Opportunities for professional development and continuing education.

• Paid time off and flexible scheduling.