Professional Services Auditor and Educator

Trinity Health; Fort Lauderdale (FL); Remote; USD 65,000 - 85,000; Full time

Job summary

A leading healthcare provider seeks a Coding Auditor to enhance documentation accuracy and compliance. The role involves performing audits, educating providers, and ensuring revenue integrity. Candidates should have relevant experience and certifications, with a commitment to quality patient care and education.

Qualifications

• 3-5 years of coding or auditing experience required.
• Certifications such as CPC, CRC, RHIT, CDEO mandatory.
• Knowledge of Medicare, Medicaid, and payer regulations essential.

Responsibilities

• Educate providers on documentation guidelines.
• Analyze code utilization and perform audits.
• Coordinate compliance projects related to healthcare.

Skills

Medical data auditing

Documentation analysis

Provider education

Compliance knowledge

Education

Associate degree in Health Information Management

Bachelor's degree preferred

Job description

Employment Type: Full time

Shift: Description:

POSITION PURPOSE

Performs annual and targeted medical record audits including analysis of documentation, validation of diagnoses and procedures, and proper assignment of codes by providers. Monitors coding accuracy and collaborates with leadership to improve scoring and provider education. Responsible for practitioner education in coding, documentation, and compliance.

ESSENTIAL FUNCTIONS

Responsibilities include:

• Educate providers on documentation guidelines through sessions and individual training.
• Review and update organizational policies for effectiveness.
• Ensure revenue capture and defend against audits, litigation, and denials.
• Analyze code utilization, identify outliers, and perform audits of documentation versus billed services.
• Coordinate with compliance benchmarks and standards.
• Conduct audits and compliance projects related to specific healthcare services.
• Serve as a resource for documentation, coding, and billing regulations.
• Prepare and deliver educational sessions on audits and compliance.
• Train and support the Centralized Coding team.

MINIMUM QUALIFICATIONS

Associate degree in Health Information Management or related field, or equivalent experience. Bachelor's preferred. 3-5 years of coding or auditing experience. Certifications such as CPC, CRC, RHIT, CDEO required. Additional preferred certifications include CPMA or CCDS-O.

Extensive knowledge of medical data auditing, interpretation, and analysis. Ability to code from various note types and review clinical documentation for accurate coding. Knowledge of Medicare, Medicaid, and other payer regulations. Ability to work remotely following company guidelines.

Our Commitment

We value diversity and are committed to providing equitable employment opportunities. Our mission is to deliver compassionate, person-centered care, respecting each individual's dignity and talents.