Coding Auditor and Educator Professional Fee

Mountain Region Out of State Staffing; Virginia; Remote; USD 95,000 - 125,000; Full time

Job summary

CommonSpirit is hiring a Coding Auditor and Educator for Professional Fee coding. You will audit coding using ICD-10-CM, HCPCS, and CPT-4, educate staff, and standardize coding practices across the organization.

You’ll onboard new hires, deploy training programs, and stay ahead of regulatory changes to ensure compliant billing. The role emphasizes risk adjustment, MEAT criteria, and collaboration with leadership to maintain high accuracy and productivity in PB coding teams.

Qualifications

• High School Diploma/G.E.D.
• Two years PB coder audits, education, and training
• Five years coding professional fee records
• CPC/CCS/CCS-P or RHIT/RHIA certifications
• Epic experience
• Knowledge of professional fee coding rules
• Understand Medicare billing rules
• Advanced knowledge of 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

Responsibilities

• Lead onboarding for new hires and provide ongoing education on Risk Adjustment, HCCs, and MEAT criteria.
• Develop and deploy training programs to keep coding teams current on health plan requirements.
• Perform internal audits and provide follow-up education for accuracy and compliance.
• Monitor regulatory changes and communicate updates for timely implementation in PB coding teams.
• Collaborate with leadership on short- and long-term strategic planning for compliant coding and billing practices.
• Build strong cross-departmental relationships to standardize coding practices and communication.

Skills

ICD-10-CM

CPT-4

HCPCS

Auditing

Education & Training

Regulatory Updates

Onboarding

HCCs

MEAT criteria

Data analysis

Epic

Education

CPC/CCS/CCS-P/RHIT/RHIA certification

Tools

Epic

Job description

Where You’ll Work

With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Job Summary and Responsibilities

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.

Every day, you will perform internal audits and provide necessary follow-up education to ensure accuracy and compliance. You will also monitor evolving regulatory changes, effectively communicating these updates to ensure timely and precise implementation within the PB coding teams.

In this role, you will be responsible for the onboarding and training of new staff, as well as the development and deployment of ongoing educational programs. Working in conjunction with leadership, you will 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

Job Requirements

Required

• 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)
• 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