Physician Practice E&M Auditor Educator, BHMG Auditing & Coding, FT, 8A-4:30P
About The Position
The E&M Coding Auditor/Educator performs comprehensive audits to assess the integrity of physician and clinical fee coding and billing. Audits evaluate documentation accuracy, E/M and other payer codes, medical necessity, reimbursement overpayments and underpayments, and compliance with documentation standards. The role researches and applies federal guidelines and supports compliance across the audit process. The position develops and delivers provider education based on audit findings, trends, and changes in coding compliance and regulatory guidelines. Educational resources may include materials, tools, webinars, and campaigns. The educator leads events to review audit results, identify trends, and develop action plans. The role also supports or manages related audit and coding initiatives, works with relevant stakeholders as a subject matter expert on coding compliance risks and requirements, and performs other related duties as required by executive leadership.
Requirements
- At least 2 years of professional E&M coding experience and 2 years of E&M provider education experience.
- Minimum required experience: 4 years.
- Prior physician coding and auditing, revenue cycle, or coding-related billing experience.
- CPC and/or CCS-P certification required upon hire.
- CPMA certification required upon hire or to be completed within 1 year.
- Strong knowledge of E&M regulations and CMS Documentation Guidelines.
- Experience with data abstraction, analyzing patient encounters for focused review samples, and developing comprehensive coding education materials and resources.
- Proficiency in ICD-10-CM, CPT, and HCPCS coding, policies, and procedures for physician practices.
- Strong organizational skills and attention to detail.
- Ability to prioritize provider medical record reviews, projects, and coding education opportunities in alignment with audits and trends.
- Ability to work independently with little or no supervision.
- Ability to provide excellent customer service.
- Excellent computer skills, including proficiency in Microsoft Office and report generation.
Responsibilities
- Perform comprehensive audits of physician and clinical fee coding and billing.
- Evaluate documentation accuracy, E/M and other payer codes, medical necessity, reimbursement overpayments and underpayments, and compliance with documentation standards.
- Research and apply federal guidelines and support compliance in audit delivery.
- Develop and execute provider education opportunities and curricula, including coding resources, materials, tools, webinars, and campaigns, based on audit results, trends, and regulatory or coding changes.
- Lead provider education events to review audit results, identify trends, and establish action plans.
- Provide support or project management for related audit and coding initiatives.
- Serve as a subject matter expert and establish positive working relationships with stakeholders to provide input on risk and support understanding of federal coding compliance requirements.
- Perform other related responsibilities as required by the executive leadership team.
Benefits
- Career growth and development opportunities, with clear pathways and ongoing support.
- Comprehensive health and wellness resources.
- A wellness program that can help employees eliminate their medical plan deductible.
- Tuition reimbursement.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
