Medical Coder Auditor/Educator

Pediatrix

About The Position

The Medical Coding Auditor/Educator will evaluate, prepare, and present audit results and educational instruction to physicians, coders, and other staff using corporate approved audit and education tools and materials. They will be responsibile for accurate and compliant coding and documentation review of pertinent medical records and physician services to identify need for coding education; coding education to physicians, coders, and other staff involved in the coding and billing process. Assists in the formulation and improvement of division medical coding audit and education plans, materials, and processes. Reviews clinical documentation to ensure adherence to Government and third‑party billing guidelines, AMA/AAP/CMS standards, Pediatrix algorithms, and internal coding policies. Follows Medical Coding Audit & Education policies and procedures to provide compliant coding education to Pediatrix teams. Provides instruction to physicians, coders, and staff on documentation standards and correct use of CPT‑4 and ICD‑10 codes. Assists in developing and maintaining Committee‑approved standardized coding education materials. Develops, reviews, and recommends updates to audit and education documents and templates to enhance overall auditing and education effectiveness. Evaluates coding requirements and prepares materials for physicians and staff prior to education sessions in a timely and effective manner. Produces accurate information when addressing coding inquiries and when preparing instructional session summaries. Performs miscellaneous compliance audits and participates in company audit and education projects as assigned by senior management. Resolves coding inquiries through coder email processes, patient dispute resolutions, and general education communication channels. Participates in audit, education, and coding team meetings to identify solutions for coding guidance or presentation issues. Meets or exceeds departmental deadlines and performance goals consistently. Maintains strict confidentiality in accordance with HIPAA regulations and Company policies.

Requirements

Certified Professional Coder (CPC), Certified Coding Specialist – Physician (CCS-P) designation required with current active status.
3-5 years of experience in hospital administration and/or multi-specialty physician practice, with full exposure to managing the accounts receivables, physician billing, and CPT-4/ICD-10 coding with medical terminology will identify the appropriate candidate.
Ability to define problems, collect data, establish facts, and draw valid conclusions.
Ability to interpret an extensive variety of technical instructions and communicate them to physicians, coders, and other staff in a way that facilitates understanding.
NextGen EHR/EPM, GoTo Meeting, MicroSoft PowerPoint, Excel and Word, FirstClass.
this position may require travel to medical offices across an assigned geography as necessary.
Travel will range from 25% to 50% each month dependent upon audit and education schedules.

Responsibilities

Evaluate, prepare, and present audit results and educational instruction to physicians, coders, and other staff using corporate approved audit and education tools and materials.
Accurate and compliant coding and documentation review of pertinent medical records and physician services to identify need for coding education; coding education to physicians, coders, and other staff involved in the coding and billing process.
Assist in the formulation and improvement of division medical coding audit and education plans, materials, and processes.
Review clinical documentation to ensure adherence to Government and third‑party billing guidelines, AMA/AAP/CMS standards, Pediatrix algorithms, and internal coding policies.
Follow Medical Coding Audit & Education policies and procedures to provide compliant coding education to Pediatrix teams.
Provide instruction to physicians, coders, and staff on documentation standards and correct use of CPT‑4 and ICD‑10 codes.
Assist in developing and maintaining Committee‑approved standardized coding education materials.
Develop, review, and recommend updates to audit and education documents and templates to enhance overall auditing and education effectiveness.
Evaluate coding requirements and prepares materials for physicians and staff prior to education sessions in a timely and effective manner.
Produce accurate information when addressing coding inquiries and when preparing instructional session summaries.
Perform miscellaneous compliance audits and participates in company audit and education projects as assigned by senior management.
Resolve coding inquiries through coder email processes, patient dispute resolutions, and general education communication channels.
Participate in audit, education, and coding team meetings to identify solutions for coding guidance or presentation issues.
Meet or exceed departmental deadlines and performance goals consistently.
Maintain strict confidentiality in accordance with HIPAA regulations and Company policies.