The Provider Education and Audit Specialist supports accurate and compliant coding practices across the organization. This role focuses on educating healthcare providers on coding guidelines and best practices, while also performing regular audits to assess coding accuracy and compliance with regulatory requirements.
Key responsibilities include:
- Planning and executing annual audits of coding practices across departments
- Reviewing provider documentation and coding for accuracy, completeness, and compliance with CMS, CPT, ICD-10, and payer-specific guidelines
- Identifying improvement opportunities and providing feedback to providers and stakeholders
- Maintaining records of audit results, compliance issues, and corrective actions
- Preparing reports and presentations summarizing findings, trends, and recommendations
- Developing and delivering educational programs and materials for providers
- Conducting training sessions, workshops, and one-on-one coaching
- Educating providers on audit findings and regulatory updates
- Creating tip sheets and job aids tailored to provider specialties
- Supporting internal and external audits and corrective action plans
- Collaborating with revenue cycle, clinical, billing, and administrative teams
- Serving as a coding resource and analyzing trends to improve performance and compliance
Requirements & Qualifications
- Bachelor’s degree in Healthcare Administration or a related field
- One or more of the following certifications preferred/required:
- Certified Professional Coder Instructor (CPC-I)
- Certified Professional Coder (CPC)
- Certified Professional Medical Auditor (CPMA)
- Certified Physician Practice Manager (CPPM)
- Certified Documentation Expert Outpatient (CDEO)
- Certified Professional Compliance Officer (CPCO)
- Certified Coding Specialist (CCS)
- 3 years of relevant experience in medical coding, auditing, or coding education within a healthcare setting
- Strong knowledge of ICD-10, CPT, HCPCS, and related coding guidelines
- Equivalent combination of education and experience may be considered
Preferred qualifications:
- Master’s degree in Health Informatics, Public Health, or a related field
- 5 years of relevant experience in medical coding, auditing, or coding education
- Experience with MD Audit
- Experience with Athena
Location
Austin, Texas, US
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
From $63,000
Remote work allowed
No
Posted
5 months ago