[Hiring] Certified Medical Coder & Provider Documentation Trainer @Lifeline Medical Center, LLC

Role Description

We are seeking a highly experienced, confident, and detail-oriented Certified Medical Coder & Provider Documentation Trainer to join our growing healthcare organization. This is not an entry-level coding position.

• Review clinical documentation for coding accuracy, completeness, medical necessity, and appropriate code selection.
• Conduct ongoing internal coding and documentation audits.
• Identify documentation deficiencies, coding errors, missed coding opportunities, and areas requiring provider education.
• Provide direct education and training to physicians, nurse practitioners, therapists, counselors, and other clinical staff regarding proper documentation and coding.
• Explain why documentation does or does not support a particular CPT, HCPCS, ICD-10-CM, modifier, or service.
• Develop practical documentation guidance, training materials, coding resources, and corrective education for providers.
• Monitor coding and documentation patterns and proactively identify areas of concern.
• Remain current on coding guidelines, payer requirements, Medicare/Medicaid requirements, and relevant regulatory changes.
• Evaluate existing and potential services to identify compliant opportunities to appropriately capture services being provided and expand organizational service offerings.
• Research coding requirements for new programs and services before implementation.
• Work with leadership and clinical teams to establish compliant documentation and coding workflows.
• Review payer policies, medical policies, billing requirements, and reimbursement guidelines.
• Assist with corrective action plans when documentation or coding concerns are identified.
• Receive and coordinate payer audit requests.
• Review requested medical records before submission.
• Evaluate documentation and coding associated with audited claims.
• Identify potential concerns and communicate them promptly to leadership.
• Prepare organized and timely audit responses.
• Work with providers to obtain necessary documentation or clarification when appropriate.
• Track audit deadlines and ensure responses are completed on time.
• Review payer findings and determine whether findings are supported by the documentation and applicable coding or payer guidelines.
• Assist with reconsiderations or appeals when appropriate.
• Develop corrective education based on audit findings.
• Help the organization identify patterns that could create future audit or recoupment risk.

Qualifications

• Current recognized professional coding certification, such as CPC, CCS, CCS-P, COC, or equivalent.
• Demonstrated professional medical coding experience.
• Strong knowledge of CPT, HCPCS, ICD-10-CM, modifiers, documentation requirements, and medical necessity.
• Experience reviewing clinical documentation and conducting coding/documentation audits.
• Experience educating or training healthcare providers regarding documentation and coding.
• Understanding of commercial insurance, Medicare, Medicaid, and payer-specific requirements.
• Knowledge of payer audits, medical record requests, recoupments, and audit responses.

Requirements

• Exceptional attention to detail.
• Excellent written and verbal communication skills.
• Strong organizational and time-management skills.
• Ability to work independently without continuous supervision.
• Highly dependable and responsive during scheduled working hours.

Proof of Experience Required

• Verification of current coding certification.
• Professional references.
• Examples or descriptions of previous coding/documentation improvement initiatives.
• Demonstrated experience training providers.
• Demonstrated experience conducting audits or responding to payer audits.
• Examples of measurable improvements they have helped achieve, when available.