[Hiring] Coding Auditor and Educator @Mountain Region Out of State Staffing

Role Description

As our Coding Auditor and Educator Professional Fee, you will utilize ICD-10-CM, HCPCS, and CPT-4 classification systems to support the professional fee coding team. You will serve as a key resource for coding and billing inquiries while facilitating the standardization of coding practices across the organization.

• Perform internal audits and provide necessary follow-up education to ensure accuracy and compliance.
• Monitor evolving regulatory changes and effectively communicate these updates to ensure timely and precise implementation within the PB coding teams.
• Responsible for the onboarding and training of new staff, as well as the development and deployment of ongoing educational programs.
• Participate in both short-term and long-term strategic planning to maintain excellence in compliant coding and regulatory billing practices.
• Maintain mastery of ICD-10, CPT, HCPCS, and regulatory guidelines to serve as a high-level subject matter expert for complex billing inquiries.
• Conduct systematic chart audits to identify documentation gaps, track trends, and ensure the team meets all established productivity and accuracy standards.
• Lead the onboarding process for new hires and provide continuous education on Risk Adjustment, HCCs, and MEAT criteria to improve documentation quality.
• Develop and deploy specialized training programs to keep coding teams current on evolving health plan requirements and regulatory changes.
• Build and maintain strong, diplomatic relationships with coding teams to facilitate the standardization of practices and effective cross-departmental communication.
• Utilize strong organizational and problem-solving skills to independently manage deadlines, present educational findings, and drive improvements in coding compliance.

Along with CO, KS and NM, this position is open to remote/out of state candidates residing in only these states:

• Alabama
• Arizona
• Arkansas
• Colorado
• Florida
• Georgia
• Idaho
• Indiana
• Iowa
• Kansas
• Kentucky
• Louisiana
• Missouri
• Mississippi
• Nebraska
• New Mexico
• North Carolina
• Ohio
• Oklahoma
• South Carolina
• South Dakota
• Tennessee
• Texas
• Utah
• Virginia
• West Virginia
• Wyoming

Qualifications

• High School Diploma/G.E.D.
• Two (2) years of recent experience in PB coder audits, education, and training.
• Five (5) years of experience coding professional fee records.
• CPC Source: AAPC or CCS or CCS-P, or RHIT, or RHIA Source: AHIMA Certified Professional Coder (CPC Certification) CCS (Certified Coding Specialist) CCS-P (Certified Coding Specialists Physician based) RHIT (Registered Health Information Technician) RHIA (Registered Health Information Administrator) Required.
• Epic experience.
• Knowledge of professional fee coding rules and guidelines.
• Understand rules and regulations governing Medicare billing.
• Advanced Knowledge of NCCI, ICD-10-CM, CPT, HCPCS, and modifiers.
• Advanced knowledge of medical terminology and anatomy and physiology.
• Strong organizational, planning, scheduling and project management abilities.
• Excellent analytical ability to develop and analyze data to recommend solutions and solve complex problems.

Preferred

• Associate degree or equivalent work experience in lieu of degree.