Professional Coding Auditor & Educator

Trinity Health Grand Haven; United States; Remote; USD 39,000 - 60,000; Full time

Benefits offered by this job

tuition reimbursement

free parking

employee discounts

flexible work schedules

professional growth

Job summary

Holy Cross Health is seeking a Remote Coding Auditor Educator to perform medical record audits, validate diagnoses and procedures, and ensure proper coding per CMS guidelines. This role emphasizes education for practitioners and collaboration with leadership to maintain compliance.

Qualifications include CP/Coder or RHIT credentials, strong ICD-10/CPT knowledge, and 2–6 years coding and auditing experience.

Qualifications

• High school diploma or equivalent combination of education and experience.
• Certified Professional Coder or RHIT accreditation required.
• 2–5 years of professional coding experience with ICD-10, CPT, and HCPCS modifiers; knowledge of Medicare/Medicaid rules.
• 3–6 years of professional coding experience; ability to code from operative reports; auditing experience preferred.

Responsibilities

• Monitors accuracy of centralized coders' charge capture and coding with ICD-10, CPTs, and modifiers.
• Partners with leadership to improve HCC and high-risk scoring with provider and coder education.
• Conducts ongoing reviews of patient documentation and coding by practitioners.
• Responsible for practitioner education in coding, documentation, and compliance.
• Works with leadership to refine CDM methodology and pricing models for accuracy and regulatory compliance.

Skills

ICD-10 knowledge

CPT/HCPCS knowledge

Auditing

Verbal & written communication

Education

Certified Professional Coder or RHIT accreditation

High school diploma or equivalent

Job description

Coding Auditor And Educator (Remote)

Employment Type: Full-Time

Shift: Days

(SUMMARY) Position Highlights:

• Competitive pay
• Additional benefits: tuition reimbursement, free parking, employee discounts
• Quality of life: flexible work schedules
• Advancement: professional growth within the organization
• Location: Holy Cross Health has two hospitals and four healthcare centers all a short driving distance from Washington DC and Baltimore, MD.

The Professional Coding Auditor Educator performs medical record audits including but not limited to analysis of medical record documentation, validation of primary and secondary diagnoses and procedures; and ensuring proper assignment of diagnosis and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS).

Responsibilities:

• Monitors accuracy of centralized coders' charge capture and coding with proper ICD-10, CPTs, as well as proper modifiers, adhering to local ministry and Trinity practices and policies.
• Partners with leadership to improve HCC, high risk scoring, with provider and coder education.
• Conducts ongoing reviews of patient medical record documentation and procedural and diagnosis coding by each practitioner.
• Responsible for practitioner education in areas related to coding, documentation, and compliance.
• Works closely with leadership and the department to establish and modify the charge description master (CDM) methodology and pricing models to ensure accuracy and regulatory compliance.
• Reports to the Manager, Provider Revenue Operations

What you will need:

• High school diploma or equivalent combination of education and experience
• Certified Professional Coder or Registered Health Information Technician accreditation required.
• Minimum of 2-5 years of professional coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCs modifiers. Knowledge of Medicare, Medicaid, and other third-party billing rules and regulations.
• 3-6 years of professional coding experience; ability to code from operative reports; prior auditing experience (Preferred)
• Effective verbal, written, and interpersonal communication skills with the ability to comfortably interact with diverse populations.
• Ability to work collaboratively in a team-oriented environment with a strong customer-service orientation.
• Ability to handle patient and organizational information in a confidential manner.
• Ability to demonstrate competency with a standard desktop and Windows-based computer system, including a basic understanding of email, e-learning, intranet and computer navigation. Ability to use other software as required to perform the essential functions of the job.
• Demonstrated dependability and regular attendance.
• Solid understanding of ICD-10 and CPT coding and medical terminology, with knowledge of Medicare, Medicaid, Health Maintenance Organization and commercial insurance plans.
• Ability to exercise independent judgment as appropriate within standard practices and procedures.

Pay rate: $28.00 – $43.40

Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.

About us:

Holy Cross Health is a Catholic, not-for-profit health system that serves more than 240,000 individuals each year from Maryland's two largest counties — Montgomery and Prince George's counties. Holy Cross Health earns numerous national awards, clinical designations and accreditations across a wide range of specialties for providing innovative, high-quality health care services. We were named one of America's 100 Best Hospitals for 2021.

Holy Cross Health is an Equal Employment Opportunity (EEO) employer. Qualified applicants are considered for employment without regard to Minority/Females/disabled/Veteran (M/F/D/V) status.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.