Remote Coding Auditor & Educator – Professional Fee

Mountain Region Out of State Staffing; Virginia Beach (VA); Remote; USD 90,000 - 120,000; Full time

Job summary

CommonSpirit Health is seeking a Coding Auditor and Educator – Professional Fee to support the professional fee coding team using ICD-10-CM, HCPCS, and CPT-4 classification systems. You will perform internal audits, provide follow-up education to ensure accuracy and compliance, and onboard new staff with ongoing training programs.

You will monitor regulatory changes, communicate updates to the PB coding teams, and participate with leadership in short- and long-term strategic planning to uphold

Qualifications

• Two years of PB coder audits, education, and training.
• Five years of experience coding professional fee records.
• CPC, CCS, CCS-P or RHIT/RHIA certifications required.
• Epic experience.
• Knowledge of professional fee coding rules and Medicare rules.
• Advanced knowledge of NCCI, ICD-10-CM, CPT, HCPCS and modifiers.
• Advanced knowledge of medical terminology and anatomy.

Responsibilities

• Maintain mastery of ICD-10, CPT, HCPCS, and regulatory guidelines as a high-level SME for complex billing inquiries.
• Conduct systematic chart audits to identify documentation gaps and track trends to meet productivity and accuracy standards.
• Lead onboarding and provide ongoing education on Risk Adjustment, HCCs, and MEAT criteria to improve documentation quality.
• Develop and deploy training programs to keep coding teams current on evolving health plan requirements and regulatory changes.
• Build strong cross-departmental relationships to standardize practices and improve communication.
• Independently manage deadlines, present findings, and drive improvements in coding compliance.

Skills

PB coder audits

Professional fee coding

CPC/CCS/CCS-P/RHIT/RHIA

Medicare billing rules

ICD-10-CM/CPT/HCPCS/modifiers

Medical terminology & anatomy

Analytical & problem solving

Organizational & project management

Regulatory knowledge

Data analysis & reporting

Education

Associate degree or equivalent

Tools

Epic

Job description

CommonSpirit Health is seeking a Coding Auditor and Educator – Professional Fee to support the professional fee coding team using ICD-10-CM, HCPCS, and CPT-4 classification systems. You will perform internal audits, provide follow-up education to ensure accuracy and compliance, and onboard new staff with ongoing training programs.

You will monitor regulatory changes, communicate updates to the PB coding teams, and participate with leadership in short- and long-term strategic planning to uphold