Professional Coding Auditor & Educator

Responsibilities

• Reviews and analyzes all aspects of the department clinical documentation and care to ensure timely, accurate, and compliant charge capture and submission
• Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges
• Collaborates with Coding Supervisor to ensure clinical documentation in high-risk areas is consistent and complete
• Identifies inconsistencies in medical reports and works with healthcare staff to improve charge capture and error correction
• Mets daily production standards
• Audits providers on documentation and assigning accurate CPT and ICD-10 codes

Minimum Qualifications

• High School diploma or equivalent
• Active CPC or CCS Certification from AAPC or AHIMA required
• 3+ years of hands-on auditing experience (not just coding) required
• Professional billing experience in an urgent care or multi-specialty environment required
• Direct experience educating physicians/providers on documentation and coding requirements required
• Experience using coding resources/tools (e.g., AMA guidelines, payer policies, online resources) to support audit decisions required
• Energy, enthusiasm, and the ability to work under pressure in a high volume, fast paced environment with high growth

Key Attributes That Will Promote Success In This Role

• Knowledge of insurance payers, the AR/revenue billing lifecycle and appealing denied claims
• Strong Critical thinking
• Experience in billing software and EMR systems, Epic experience a plus
• Extremely organized with a strong attention to detail
• Motivated, dependable, and flexible with the ability to handle periods of stress and pressure
• Stay up to date on coding changes and updates
• Ability to work within a team environment and maintain a positive attitude