Coding Quality Auditor & Education Specialist (Remote)

Rhode Island Hospital; United States; Remote; USD 70,000 - 100,000; Full time

Job summary

Brown University Health is seeking a Coding Quality Reviewer and Educator to audit professional coding and clinical documentation across a multispecialty ambulatory setting. The role ensures accurate ICD-10-CM, CPT, and HCPCS coding per CMS regulations and payer policies.

The candidate will educate coders and clinicians to support compliant documentation and revenue integrity. This position is fully remote within the United States.

Qualifications

• Expertise in ICD-10-CM, CPT, HCPCS coding and modifiers.
• Ability to review clinical documentation for accuracy and compliance.
• Strong analytical, audit, and non-leading communication skills.
• Proficiency with EHRs and reporting tools.
• Knowledge of CMS, MAC guidance, and payer policies.

Responsibilities

• Perform prospective and retrospective audits of professional coding and records for accuracy.
• Evaluate documentation for medical necessity and compliance with CMS and payer policies.
• Document audit findings in a clear, objective, defensible format.
• Identify root causes and collaborate on corrective action plans.
• Develop and deliver targeted education to coders and clinicians.
• Track trends to identify systemic risks and improvement opportunities.
• Stay updated on coding guidelines and regulatory changes.

Skills

ICD-10-CM

CPT

HCPCS Level II

E/M coding

Surgical/procedural coding

Medical terminology

Audit data analysis

CMS/MAC guidance

EHR proficiency

Education

High school diploma

Tools

Epic

Job description

Brown University Health is seeking a Coding Quality Reviewer and Educator to audit professional coding and clinical documentation across a multispecialty ambulatory setting. The role ensures accurate ICD-10-CM, CPT, and HCPCS coding per CMS regulations and payer policies.

The candidate will educate coders and clinicians to support compliant documentation and revenue integrity. This position is fully remote within the United States.