Remote Coding Quality Auditor & Educator

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

Job summary

Brown University Health seeks a Coding Quality Reviewer and Educator to audit professional coding and clinical documentation across a multispecialty ambulatory environment. You will validate ICD-10-CM, CPT, and HCPCS codes, review provider and coder work, and deliver education to improve revenue integrity.

This fully remote role requires expert coding knowledge, strong analytical skills, and the ability to work independently.

Qualifications

• Minimum of five (5) years of professional coding experience, preferably in a large academic or multispecialty setting.
• Prior coding audit experience strongly preferred.
• Prior experience performing provider and coder education strongly preferred.

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, collects relevant information and compiles 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 & surgical coding

Medical terminology

Teaching physician billing

Interpret complex docs

Audit trend analysis

CMS/MAC guidance

Audit tools

Clear communication

Attention to detail

Excellent communication

Epic/EHR proficiency

MS Office

Education

High school diploma

Tools

Epic Systems/EHR

MS Office Suite

Job description

Brown University Health seeks a Coding Quality Reviewer and Educator to audit professional coding and clinical documentation across a multispecialty ambulatory environment. You will validate ICD-10-CM, CPT, and HCPCS codes, review provider and coder work, and deliver education to improve revenue integrity.

This fully remote role requires expert coding knowledge, strong analytical skills, and the ability to work independently.