Network Coordinator, Coding Audit & Education

St. Luke's University Health Network • Allentown, PA

12d • Onsite

About The Position

The Network Coordinator, Coding Audit & Education performs internal, concurrent, prospective and retrospective coding audit activities. Reviews/validates coded medical records of Professional Coding (PC) staff to determine data quality and accuracy of coding, billing and documentation related to ICD-10, PCS, DRGs.CPT, APC's, and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements.

Requirements

• Must maintain and be credentialed in at least ONE of the following AHIMA and/or AAPC recognized Professional Coding Certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Auditor (CPMA); Certified Professional Coder (CPC); Certified); Certified Coding Specialist (CCS);
• In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems.
• Must be proficient in DRG/APC structure, National Correct Coding Initiatives, ICD CM/PCS/CPT Official Guidelines, Outpatient Prospective Payment System and Coding Clinic References.
• Current working knowledge of encoder/grouper.
• Strong analytical and communication skills.
• 5 years of coding experience required.

Nice To Haves

• Experience in auditing education techniques and methods preferred, but not required.

Responsibilities

• Coding audits of Professional Coding staff in accordance with regulatory requirements, official coding guidelines, and Network audit standards.
• Reviews and validates coded medical records to assess coding accuracy, documentation integrity, compliance risk, and reimbursement impact related to ICD-10-CM/PCS, CPT/HCPCS, DRG/APC assignment, modifiers, and applicable payment methodologies.
• Analyzes audit results to identify trends, patterns, and areas of risk or opportunity, including recurring errors, documentation gaps, and compliance vulnerabilities across the hospital system.
• Develops audit summaries, reports, and tracking tools to communicate findings, monitor improvement over time, and support leadership review and decision-making.
• Provides targeted, audit-driven education and training to Professional Coding staff, including one-on-one feedback and department-level education based on validated audit findings.
• Collaborates with Coding Management and Compliance to recommend corrective actions, process improvements, and risk mitigation strategies based on audit outcomes.
• Supports onboarding and ongoing education of coding staff by contributing audit-based insights, educational materials, and coding guidance aligned with official standards and Network expectations.
• Participates in external audit activities, including preparation, review, validation of findings, and assistance with response development, in collaboration with Coding Management and Compliance.
• Promotes accurate, compliant documentation and coding practices through consistent application of coding principles, official guidelines, and regulatory requirements.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed