Remote Coding Quality Auditor & Educator

Brown University Health; Town of Providence (NY); Remote; USD 68,000 - 112,000; Full time

Job summary

Brown University Health is seeking a Coding Quality Reviewer and Educator to audit professional coding and medical records for ICD-10-CM, CPT, and HCPCS accuracy across a multispecialty ambulatory setting. The role develops education for coders and providers, ensuring compliant documentation and optimal revenue integrity in a fully remote environment.

Ideal candidates bring expert coding knowledge, strong analytical skills, and at least five years in a similar environment; Epic experience is

Qualifications

• 5 years of professional coding experience in a large academic or multispecialty setting.
• Experience performing provider and coder education preferred.
• Ability to interpret complex medical documentation and apply coding guidelines accurately.

Responsibilities

• Perform prospective and retrospective audits of professional coding and medical records to validate accuracy and completeness of ICD-10-CM, CPT, HCPCS, and modifier assignment.
• Evaluate clinical documentation to ensure services billed are supported, medically necessary, and compliant with CMS, federal, payer-specific, and organizational requirements.
• Validate both coder and provider assigned codes; document findings, variance details, and supporting rationale in a clear, audit-defensible format.
• Apply non-leading, compliant review methodologies consistent with ACDIS/AHIMA guidance.
• Identify root causes of coding and documentation discrepancies and collaborate with leadership to develop corrective action plans.
• Develop and conduct targeted education to coders, providers, and clinical departments based on audit findings, coding updates, and identified trends.
• Track and trend audit results to identify systemic risks and opportunities for process improvement.
• Research coding and documentation guidelines from qualified sources, compiling that information into a user-friendly manual.
• Stays current on coding updates, certification requirements, and expertise pertinent to the position.

Skills

ICD-10-CM CPT HCPCS

E/M coding

Medical terminology

Anatomy knowledge

Billing requirements

Audit data analysis

Regulatory guidance research

Audit tools & methods

Communication skills

Attention to detail

EHR proficiency

Microsoft Office

Education

High school diploma or equivalent

CPC (Certified Professional Coder)

CCS or CCS-P (Certified Coding Specialist/Physician-based)

Tools

Epic EHR

Job description

Brown University Health is seeking a Coding Quality Reviewer and Educator to audit professional coding and medical records for ICD-10-CM, CPT, and HCPCS accuracy across a multispecialty ambulatory setting. The role develops education for coders and providers, ensuring compliant documentation and optimal revenue integrity in a fully remote environment.

Ideal candidates bring expert coding knowledge, strong analytical skills, and at least five years in a similar environment; Epic experience is