Provider Coding Auditor & Educator

Munson Healthcare•Traverse City, MI

2d•Hybrid

About The Position

The Provider Coding Auditor & Educator is responsible for auditing clinician coding and documentation, delivering targeted provider education and supporting clinical documentation improvement (CDI) initiatives. This role promotes accurate, compliant coding and documentation practices for physicians and advanced practice providers. and partners with clinical, compliance, revenue cycle, and quality leadership to improve documentation quality, reduce compliance risk and support revenue integrity.

Requirements

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 patterns, trends, and risk areas, and apply regulatory standards with consistency and professional judgment.
Strong understanding of outpatient/physician CDI principles, including documentation specificity, medical necessity, clinical decision‑making, and accurate representation of patient complexity.
Skilled in delivering clear, constructive, and collaborative education to physicians and advanced practice providers through one‑on‑one feedback, group training, and written guidance.
Ability to work effectively with clinicians, compliance, revenue cycle, CDI, and leadership to support documentation quality, audit readiness, and organizational goals.
Demonstrates professionalism, discretion, and confidence when interacting with clinicians and leadership, fostering trust and engagement across clinical settings.
High level of precision in reviewing medical records, audit findings, and educational materials to ensure reliable outcomes and defensible documentation practices.
Ability to manage priorities independently in a hybrid environment, adapt to regulatory changes, and balance remote and on‑site responsibilities.
High School Diploma/GED and 7 yrs total experience in professional coding experience including E/M and procedural coding across multiple specialties with at least 2 years of experience in professional coding audits, provider education, compliance reviews, and/or CDI OR Associates Degree in Health Information Management or a related healthcare field and 5 yrs total experience in professional coding experience including E/M and procedural coding across multiple specialties with at least 2 years of experience in professional coding audits, provider education, compliance reviews, and/or CDI
CPC or CCS-P Required to obtain within 18 months of hire - CDEO

Responsibilities

Perform independent professional fee coding and documentation audits for physicians and advanced practice providers (APPs), including Evaluation and Management (E/M), procedural, and diagnosis coding
Evaluate clinician documentation to ensure 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 documentation improvement opportunities
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 related to coding guidelines, documentation requirements, CDI principles, and identified risk areas
Identify Clinical Documentation Integrity (CDI) gaps impacting 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 key stakeholders
Collaborate with coding, CDI, compliance, revenue integrity, and clinical leadership to support documentation quality, audit readiness, denial prevention, and organizational initiatives
Assist with documentation and coding education for new clinicians and support ongoing organizational coding and documentation 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 to support reporting, trending, and continuous improvement
Provide broad refresher education related to 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