Provider Coding Auditor & Educator

Munson Healthcare•Traverse City, MI

20h•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 (APPs), 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 physician coding, including CPT, ICD-10-CM, HCPCS, and E/M guidelines, and the ability to independently assess documentation, identify trends and risk areas, and apply regulatory standards. It also involves outpatient and physician CDI, medical necessity, documentation specificity, and communicating constructively with clinicians through individualized feedback, group training, and written guidance. The role works independently in a hybrid environment, balancing remote and on-site responsibilities and adapting to regulatory changes. Travel to physician offices and clinical sites is required as needed for audits and in-person education.

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.
Advanced knowledge of CPT, ICD-10-CM, HCPCS, and E/M coding guidelines, including payer-specific and regulatory requirements.
Strong understanding of outpatient and physician CDI principles, including documentation specificity, medical necessity, clinical decision-making, and accurate representation of patient complexity.
Ability to independently assess documentation and coding accuracy, identify patterns, trends, and risk areas, and apply regulatory standards consistently.
Ability to deliver clear, constructive, collaborative education to physicians and APPs through one-on-one feedback, group training, and written guidance.
Ability to collaborate effectively with clinicians, compliance, revenue cycle, CDI, and leadership.
Professionalism, discretion, confidence, and relationship-building skills 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.
Ability to travel to physician offices and clinical sites as needed.

Responsibilities

Perform independent professional fee coding and documentation audits for physicians and APPs, 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 support for medical decision-making.
Prepare clear, defensible written audit findings and recommendations identifying errors, trends, risks, and documentation improvement opportunities.
Provide one-on-one education to providers after 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 affecting 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, 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 coding and documentation education for new clinicians and 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 on 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.