Coding Auditor and Educator Professional Fee

CommonSpirit Health • Englewood, CO

9d • Remote

About The Position

The Coding Auditor and Educator Professional Fee supports the professional fee coding team using ICD-10-CM, HCPCS, and CPT-4 classification systems. This role serves as a subject matter expert and resource for coding and billing inquiries, and helps standardize coding practices across the organization. The position conducts internal chart audits, provides follow-up education, and monitors regulatory changes to support accurate, compliant, and timely coding and billing.

The role is responsible for onboarding and training new staff and developing ongoing educational programs, including education on Risk Adjustment, HCCs, and MEAT criteria. In partnership with leadership, the position participates in short- and long-term strategic planning to maintain compliant coding and regulatory billing practices. The position is open to remote or out-of-state candidates residing in the states listed in the posting, as well as Colorado, Kansas, and New Mexico.

Requirements

• High school diploma or GED.
• Two years of recent experience in professional billing (PB) coder audits, education, and training.
• Five years of experience coding professional fee records.
• One of the following credentials: CPC (AAPC), CCS, CCS-P, RHIT, or RHIA.
• Epic experience.
• Knowledge of professional fee coding rules and guidelines.
• Understanding of rules and regulations governing Medicare billing.
• Advanced knowledge of NCCI, ICD-10-CM, CPT, HCPCS, and modifiers.
• Advanced knowledge of medical terminology, anatomy, and physiology.
• Strong organizational, planning, scheduling, and project management abilities.
• Strong analytical ability to develop and analyze data, recommend solutions, and solve complex problems.

Nice To Haves

• Associate degree, or equivalent work experience in lieu of a degree.

Responsibilities

• Maintain expertise in ICD-10, CPT, HCPCS, and regulatory guidelines and serve as a subject matter expert for complex billing inquiries.
• Conduct systematic chart audits to identify documentation gaps, track trends, and ensure productivity and accuracy standards are met.
• Lead onboarding for new hires and provide ongoing education on Risk Adjustment, HCCs, and MEAT criteria.
• Develop and deliver training programs covering evolving health plan requirements and regulatory changes.
• Build diplomatic relationships with coding teams to support standardized practices and cross-departmental communication.
• Manage deadlines, present educational findings, and drive improvements in coding compliance.
• Communicate regulatory updates to support timely and accurate implementation within professional billing coding teams.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED