Remote Coding Quality Auditor & Educator

Rhode Island Hospital; United States; Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Remote work

Job summary

Brown University Health is seeking a remote Coding Quality Reviewer and Educator to audit professional coding across a multispecialty ambulatory environment, ensuring accurate ICD-10-CM, CPT, and HCPCS coding per CMS regulations and payer policies. The role includes delivering targeted education to coders, providers, and departments to support compliant documentation and revenue integrity.

Ideal candidates will possess expert coding knowledge, strong analytical skills, and the ability to work

Qualifications

• Audits professional coding and medical records for ICD-10-CM, CPT, HCPCS accuracy.
• Provides education to coders and providers on compliant documentation and billing.
• Maintains expert knowledge of CMS regulations, NCCI edits, MAC guidance, and payer policies.
• Works effectively in a remote environment with independent judgment.

Responsibilities

• Perform prospective and retrospective audits of professional coding and medical records.
• Evaluate documentation to ensure services billed are supported, medically necessary, and compliant.
• Document findings in audit-defensible format and identify trends.
• Develop targeted education for coders, providers, and clinical departments.
• Track audit results to identify systemic risks and opportunities for improvement.

Skills

ICD-10-CM, CPT, HCPCS guidelines

E/M & surgical/procedural coding

Medical terminology & anatomy

Teaching physician & incident-to rules

Interpret complex medical docs

Identify trends & process improvement

Regulatory guidance from CMS/MAC/payer

Detailed audit reviews & tools

Communicate coding concepts clearly

Attention to detail & organization

Excellent written/verbal communication

Epic EHR proficiency

MS Office proficiency

Tools

Epic

Job description

Brown University Health is seeking a remote Coding Quality Reviewer and Educator to audit professional coding across a multispecialty ambulatory environment, ensuring accurate ICD-10-CM, CPT, and HCPCS coding per CMS regulations and payer policies. The role includes delivering targeted education to coders, providers, and departments to support compliant documentation and revenue integrity.

Ideal candidates will possess expert coding knowledge, strong analytical skills, and the ability to work