Coding Educator/Auditor - Remote

Mountain Region Out of State Staffing; Florida; Remote; USD 90,000 - 130,000; Full time

Job summary

CommonSpirit Health is seeking a Coding Auditor and Educator Professional Fee to support the professional fee coding team across ICD-10-CM, CPT-4, and HCPCS. You will audit, educate, and standardize coding practices while staying compliant with evolving regulations.

You will onboard and train staff, monitor regulatory changes, and work with leadership on strategic coding initiatives to maintain excellence in compliant billing practices.

Qualifications

• Two years of PB coder audits, education, and training experience.
• Five years of experience coding professional fee records.
• CPC or CCS or RHIT/RHIA certifications per AHIMA or AAPC.
• Knowledge of professional fee coding rules and Medicare billing.
• Advanced knowledge of ICD-10-CM, CPT, HCPCS, and modifiers.
• Strong analytical and organizational abilities.

Responsibilities

• Audit professional fee coding for accuracy and compliance using ICD-10-CM, CPT-4, and HCPCS.
• Provide onboarding and ongoing education to coding staff.
• Monitor regulatory changes and implement updates across PB coding teams.
• Lead training programs on Risk Adjustment, HCCs, and MEAT criteria.
• Collaborate with leadership on short- and long-term coding initiatives.
• Maintain mastery of coding guidelines to address complex billing inquiries.
• Manage onboarding for new hires and coordinate cross-department communication.

Skills

PB coder audits

Education and training

Coding professional fee rules

Medicare billing rules

ICD-10-CM knowledge

CPT/HCPCS knowledge

NCCI knowledge

Epic experience

Data analysis

Education

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

Associate degree or higher

Tools

Epic system

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

• 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