Remote Coding Quality Auditor & Educator

Brownhealth; United States; Remote; USD 68,000 - 112,000; Full time

Job summary

Brown University Health seeks a Coding Quality Reviewer and Educator to conduct comprehensive audits of professional coding and medical records in a fully remote environment. You will validate ICD-10-CM, CPT, and HCPCS coding, document findings, and identify improvement opportunities.

You will develop and deliver targeted education to coders, providers, and clinical departments, staying current on coding updates and compliance standards.

Qualifications

• High school diploma or equivalent required.
• CPC, CCS or CCS-P certifications preferred within one year of hire.
• Minimum five years of professional coding experience; audit experience preferred.

Responsibilities

• Perform prospective and retrospective audits of professional coding and medical records to validate accuracy of ICD-10-CM, CPT, HCPCS and modifiers.
• Evaluate documentation to ensure services billed are supported, medically necessary, and compliant with CMS and payer rules.
• Document findings in an audit-defensible format and identify root causes of discrepancies.
• Develop and deliver targeted education to coders, providers, and clinical departments.
• Track audit results to identify systemic risks and opportunities for improvement.

Skills

ICD-10-CM CPT HCPCS coding guidelines

E/M coding

Healthcare documentation

Regulatory guidance interpretation

Audit data analysis

Education delivery to staff

CMS payer policies

Review methodologies (ACDIS/AHIMA)

Coding trends identification

Communication of complex concepts

Education

High school diploma or equivalent

Tools

Epic experience

Microsoft Office (Word, Excel, PowerPoint)

Job description

Brown University Health seeks a Coding Quality Reviewer and Educator to conduct comprehensive audits of professional coding and medical records in a fully remote environment. You will validate ICD-10-CM, CPT, and HCPCS coding, document findings, and identify improvement opportunities.

You will develop and deliver targeted education to coders, providers, and clinical departments, staying current on coding updates and compliance standards.