Provider Coding Auditor & Educator

Munson Healthcare•Traverse City, MI

4d•Hybrid

About The Position

The Provider Coding Auditor & Educator audits clinician coding and documentation, delivers targeted provider education, and supports clinical documentation improvement (CDI) initiatives. The role promotes accurate, compliant coding and documentation practices for physicians and advanced practice providers, partnering with clinical, compliance, revenue cycle, and quality leadership to improve documentation quality, reduce compliance risk, and support revenue integrity. The position requires expertise in professional coding, audit judgment, outpatient and physician CDI principles, provider-focused education, collaboration, and attention to detail. The successful candidate works independently in a hybrid environment, adapts to regulatory changes, and balances remote work with on-site responsibilities. Travel to physician offices and clinical sites may be needed for audits and in-person education. Munson Healthcare describes itself as northern Michigan’s largest healthcare system, with eight community hospitals serving residents across 29 counties. Its stated values include excellence, teamness, positivity, creativity, and a commitment to exceptional experiences for patients and colleagues.

Requirements

High school diploma or GED and 7 years of total professional coding experience, including E/M and procedural coding across multiple specialties, with at least 2 years in professional coding audits, provider education, compliance reviews, and/or CDI; OR an associate degree in Health Information Management or a related healthcare field and 5 years of total professional coding experience, including E/M and procedural coding across multiple specialties, with at least 2 years in professional coding audits, provider education, compliance reviews, and/or CDI.
CPC or CCS-P certification required.
Advanced knowledge of CPT, ICD-10-CM, HCPCS, and E/M coding guidelines, including payer-specific and regulatory requirements.
Ability to independently assess clinician documentation and coding accuracy, identify trends and risk areas, and apply regulatory standards consistently and with professional judgment.
Strong understanding of outpatient/physician CDI principles, including documentation specificity, medical necessity, clinical decision-making, and accurate representation of patient complexity.
Ability to provide clear, constructive, collaborative education to physicians and advanced practice providers through individual feedback, group training, and written guidance.
Ability to work effectively with clinicians, compliance, revenue cycle, CDI, and leadership.
Professionalism, discretion, and confidence when interacting with clinicians and leadership.
High level of precision in reviewing medical records, audit findings, and educational materials.
Ability to manage priorities independently in a hybrid environment, adapt to regulatory changes, and balance remote and on-site responsibilities.
Must obtain CDEO certification within 18 months of hire.
Employees must be vaccinated or have lab-confirmed immunity for measles, mumps, rubella, and varicella. Employees must also receive an annual flu vaccine or have an approved medical or religious exemption.

Responsibilities

Perform independent professional fee coding and documentation audits for physicians and advanced practice providers, including E/M, procedural, and diagnosis coding.
Evaluate clinician documentation for accurate CPT, HCPCS, and ICD-10-CM code assignment, including E/M level selection and supporting medical decision-making documentation.
Prepare clear, defensible written audit findings and recommendations identifying errors, trends, risks, and opportunities to improve documentation.
Deliver one-on-one provider education following audits to reinforce compliant coding and documentation practices.
Develop and present targeted education for clinicians and coding staff on coding guidelines, documentation requirements, CDI principles, and identified risk areas.
Identify CDI gaps that affect accuracy, medical necessity, and defensibility, and support improvement efforts.
Support the development and maintenance of clinician documentation guidelines, best practices, and reference materials.
Monitor coding and documentation trends, including audit outcomes and denial drivers, and report findings to leadership and stakeholders.
Collaborate with coding, CDI, compliance, revenue integrity, and clinical leadership to support documentation quality, audit readiness, denial prevention, and organizational initiatives.
Assist with coding and documentation education for new clinicians and support ongoing organizational improvement efforts.
Participate in compliance and revenue integrity activities, including internal reviews, payer inquiries, and audit-related initiatives.
Maintain audit tracking tools and quality metrics for reporting, trending, and continuous improvement.
Provide refresher education about annual, quarterly, or interim coding and documentation changes and regulatory updates.
Travel to physician offices and clinical sites as needed to conduct on-site audits and deliver in-person education.