Remote Provider Coding Auditor & Education Expert

Practice Resources, LLC; City of Syracuse (NY); Remote; USD 25,000 - 41,000; Full time

Job summary

Practice Resources LLC is seeking an experienced Provider Auditor & Educator to conduct coding, documentation, and compliance audits for healthcare providers. This remote role offers flexible hours after training to support work-life balance.

You will partner with physicians and staff to improve documentation accuracy, coding compliance, and risk-adjustment performance, while delivering education and updates on CPT, ICD-10-CM, HCPCS Level II, and E/M guidelines.

Qualifications

• CPC, CCS-P, RHIT, RHIA, CPMA, CEMC, or equivalent coding certification.
• Minimum of 5 years of professional coding, auditing, or documentation improvement experience.
• Minimum of 3 years auditing Primary Care, Internal Medicine, or Family Medicine providers.
• Strong knowledge of CPT, HCPCS Level II, ICD-10-CM, E/M coding guidelines, CMS regulations, and Medicare/Medicare Advantage requirements.
• Experience with provider education and physician documentation improvement.
• Excellent verbal and written communication skills.
• Strong analytical and problem-solving abilities.

Responsibilities

• Perform prospective and/or retrospective audits of provider documentation, coding, and compliance, for multiple specialties, with a concentration on Primary Care.
• Review medical records to ensure accurate assignment of ICD-10-CM, CPT, and HCPCS Level II codes in accordance with current coding guidelines and payer requirements.
• Audit office and outpatient E/M services utilizing current AMA and CMS documentation and coding guidelines.
• Evaluate documentation supporting chronic condition reporting, HCC/risk adjustment coding, quality reporting measures, and preventive services.
• Review coding and documentation related to Office and outpatient visits, AWV, preventive medicine services, TCM, CCM, RPM, ACP, behavioral health and screening services, minor office procedures, and hospital visits.
• Identify coding, documentation, and compliance opportunities and provide actionable recommendations to providers and leadership.
• Develop and deliver individualized provider education, group training sessions, coding updates, and documentation improvement initiatives.
• Provide guidance on medical decision making (MDM), diagnosis specificity, chronic condition management, and documentation best practices.
• Monitor compliance with CMS, Medicare Advantage, Medicaid, commercial payer, and regulatory requirements.
• Support quality, value-based care, and risk adjustment programs through accurate documentation and coding practices.
• Assist with denial analysis, appeal reviews, and coding-related payer inquiries.
• Maintain expertise in CPT, ICD-10-CM, HCPCS Level II, NCCI edits, CMS policies, and industry best practices.
• Track audit findings, provider performance trends, and educational outcomes.
• Collaborate with coding, compliance, quality, clinical operations, and provider leadership teams to achieve organizational goals.
• Serve as a coding and documentation subject matter expert for providers and operational leadership.

Skills

CPC

CCS-P

RHIT

RHIA

CPMA

CEMC

Tools

Epic

eClinicalWorks

MEDENT

NextGen

Athena

Job description

Practice Resources LLC is seeking an experienced Provider Auditor & Educator to conduct coding, documentation, and compliance audits for healthcare providers. This remote role offers flexible hours after training to support work-life balance.

You will partner with physicians and staff to improve documentation accuracy, coding compliance, and risk-adjustment performance, while delivering education and updates on CPT, ICD-10-CM, HCPCS Level II, and E/M guidelines.