Auditor and Educator - Professional Services/Remote

Employment Type: Full-time
Shift: Day (Remote)
Location: St. Mary’s Medical Center

About the role

Use specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking, and problem-solving skills to support colleagues and leadership in achieving the organization’s strategic objectives. Serves as a peer influencer and may direct a project or project team by applying industry experience and specialized knowledge.

Responsibilities

• Provides high-level technical competency and subject matter expertise analyzing coding and documentation review for professional services, including code selection of evaluation and management codes and procedural services.
• Conducts comprehensive audits of professional coders and providers to ensure accuracy, compliance, and alignment with CPT, ICD-10, HCPCS, HCC, and payer-specific guidelines.
• Analyzes documentation and coding patterns to identify risks related to compliance, revenue integrity, and regulatory requirements.
• Provides clear, actionable feedback to providers, coders, and leadership to improve documentation quality and coding accuracy.
• Maintains current knowledge and credentials through ongoing education and interpretation of regulatory and industry changes.
• Develops and delivers targeted education and training programs based on audit findings, regulatory updates, and identified knowledge gaps.
• Provides training and onboarding to new providers.
• Adheres to coding quality and productivity standards as established by Revenue Excellence.
• Responsible for completion of audit and education workplan as defined by the Service Area Manager of Coding Audit and Education.

Requirements

• Associate degree in Health Information Management or a related field or an equivalent combination of years of education and experience.
• Must possess comprehensive knowledge of ICD-10, HCPCS, CPT, and HCC guidelines, medical terminology, regulatory guidelines including Medicare and Medicaid, and payer policies.
• Three (3) to five (5) years of professional coding or auditing experience.
• Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), or Coding Professional Certification (CPC) is required.

Qualifications

• Bachelor's degree in health information management (HIM) or related healthcare field is preferred.
• Preferred prior experience in auditing and provider education.
• Preferred credentials: Certified Professional Medical Auditor (CPMA), Certified Risk Coder (CRC), Clinical Documentation Expert – Outpatient (CDEO).

Schedule

0.5 FTE (20 hours weekly) up to 1.0 FTE (40 hours weekly)

Benefits

• Comprehensive benefit packages, including medical, dental, vision, mental health, paid time off, and 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 schedules.
• Free onsite parking.
• Referral Rewards Program.