Provider Coding Auditor – Educator

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

📋 Description

• Conduct audits on clinician coding and documentation for physicians and advanced practice providers.

• Assess the assignment of CPT, HCPCS, and ICD-10-CM codes, evaluate E/M level selection, and review supporting medical decision-making documentation.

• Compile written audit results and recommendations highlighting errors, trends, risks, and opportunities for improvement.

• Provide individualized education to providers following audits.

• Create and deliver specialized training for clinicians and coding personnel.

• Identify gaps in Clinical Documentation Improvement (CDI) that impact accuracy, medical necessity, and defensibility.

• Assist in supporting clinician documentation guidelines, best practices, and reference materials.

• Track coding and documentation trends, audit results, and denial causes.

• Communicate findings to leadership and relevant stakeholders.

• Collaborate with coding, CDI, compliance, revenue integrity, and clinical leadership teams.

• Help educate new clinicians and support ongoing improvements in coding and documentation.

• Engage in compliance activities, revenue integrity initiatives, internal reviews, payer inquiries, and audit efforts.

• Maintain tools for audit tracking and quality metrics.

• Offer refresher training on coding, documentation, and regulatory updates.

• Travel to physician offices and clinical sites as necessary for on-site audits and in-person training.

⛳️ Requirements

• High School Diploma/GED with 7 years of overall professional coding experience, including E/M and procedural coding across various specialties, with at least 2 years in professional coding audits, provider education, compliance reviews, and/or CDI; OR an Associate’s Degree in Health Information Management or a related healthcare field with 5 years of overall professional coding experience, including E/M and procedural coding across various specialties, with at least 2 years in professional coding audits, provider education, compliance reviews, and/or CDI.

• CPC or CCS-P certification is required.

• CDEO certification must be obtained within 18 months of hire.

• Advanced understanding of CPT, ICD-10-CM, HCPCS, and E/M coding guidelines, along with payer-specific and regulatory requirements.

• Familiarity with outpatient/physician CDI principles, documentation specificity, medical necessity, clinical decision-making, and patient complexity.

• Capability to evaluate clinician documentation and coding accuracy while identifying patterns, trends, and areas of risk.

• Proficiency in delivering educational sessions to physicians and advanced practice providers.

• Ability to work collaboratively with clinicians, compliance, revenue cycle, CDI, and leadership teams.

• High accuracy level in reviewing medical records, audit findings, and educational content.

• Skill in managing priorities independently in a hybrid work environment and adapting to regulatory changes.

• Employees are required to be vaccinated or have lab-confirmed immunity for Measles, Mumps, Rubella, and Varicella, or meet applicable requirements.

• Employees must receive a flu vaccine during the flu season in the year of hire and annually thereafter, or receive an approved medical or religious exemption.

🏝️ Benefits

• Tuition reimbursement.

• Development opportunities through in-person and online training.

• Access to a career hub.

• Comprehensive benefits package.

• Paid holidays.

• Generous paid time off (PTO).

• Employee discounts.

• Complimentary individual retirement counseling.

• Free wellness platform available for you and your family.

• Personalized support for personal or family challenges.

• Opportunities for employee surveys and participation in town hall meetings.