[Hiring] Medical Coding Auditor/Educator @Pediatrix

Role Description

The Medical Coding Auditor/Educator will evaluate, prepare, and present audit results and educational instruction to physicians, coders, and other staff using corporate approved audit and education tools and materials. They will be responsible for accurate and compliant coding and documentation review of pertinent medical records and physician services to identify need for coding education.

• Provide coding education to physicians, coders, and other staff involved in the coding and billing process.
• Assist in the formulation and improvement of division medical coding audit and education plans, materials, and processes.
• Review clinical documentation to ensure adherence to Government and third-party billing guidelines, AMA/AAP/CMS standards, Pediatrix algorithms, and internal coding policies.
• Follow Medical Coding Audit & Education policies and procedures to provide compliant coding education to Pediatrix teams.
• Provide instruction on documentation standards and correct use of CPT‑4 and ICD‑10 codes.
• Assist in developing and maintaining Committee‑approved standardized coding education materials.
• Develop, review, and recommend updates to audit and education documents and templates to enhance overall auditing and education effectiveness.
• Evaluate coding requirements and prepare materials for physicians and staff prior to education sessions in a timely and effective manner.
• Produce accurate information when addressing coding inquiries and when preparing instructional session summaries.
• Perform miscellaneous compliance audits and participate in company audit and education projects as assigned by senior management.
• Resolve coding inquiries through coder email processes, patient dispute resolutions, and general education communication channels.
• Participate in audit, education, and coding team meetings to identify solutions for coding guidance or presentation issues.
• Meet or exceed departmental deadlines and performance goals consistently.
• Maintain strict confidentiality in accordance with HIPAA regulations and Company policies.

Qualifications

• Certified Professional Coder (CPC), Certified Coding Specialist – Physician (CCS-P) designation required with current active status.
• 3-5 years of experience in hospital administration and/or multi-specialty physician practice, with full exposure to managing the accounts receivables, physician billing, and CPT-4/ICD-10 coding with medical terminology.
• Ability to define problems, collect data, establish facts, and draw valid conclusions.
• Ability to interpret an extensive variety of technical instructions and communicate them to physicians, coders, and other staff in a way that facilitates understanding.

Requirements

• Software: NextGen EHR/EPM, GoTo Meeting, Microsoft PowerPoint, Excel and Word, FirstClass.

Benefits

• Comprehensive benefits in a vast array of plans that fit your life and lifestyle.
• Support for health and overall well-being.
• Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA and HSAs.
• 401k plan and Employee Stock Purchase Program.
• Some benefits are provided at no cost, while others require a cost share between employees and the company.
• Employees may select voluntary plans and pay for these benefits through convenient payroll deductions.