Professional Coding Quality Auditing Coordinator

About This Role

This role is responsible for conducting second-level coding audits and providing real-time education to support quality assurance activities within the Coding Department and for healthcare providers. The coordinator will focus on ensuring compliance with regulatory coding guidelines for diagnosis, procedures, and Evaluation and Management (E/M) levels to maintain accurate coding for reimbursement and clinical service.

Responsibilities

• Serve as subject matter and decision support expert for Enterprise Coding, participating in committees and project teams to resolve issues and improve processes.
• Develop and deliver focused coding education, training plans, and tools to address risk areas, regulatory updates, and continuous improvement opportunities.
• Complete timely and accurate quality assurance coding audits using ICD-10-CM and CPT/HCPCS Coding Classification Systems, adhering to Ambulatory federal and state regulatory and payer guidelines.
• Translate quality auditing results into practical and actionable recommendations for improving audit policies and procedures.
• Build and maintain collaborative relationships with internal departments, providers, Compliance, and Revenue Management.

Requirements

• 2-5 years' experience coding Professional Evaluation and Management (E/M) and surgical coding
• Auditing experience
• Experience educating providers/coders
• CPC, CCS, or RHIT certification

Qualifications

• High School Diploma or GED
• 2-5 years' experience coding Professional Evaluation and Management coding (E/M) plus surgical coding (Cardio/Ortho/ENT,OBGYN/General Surgery), auditing experience, and educating providers/coders experience.

Nice to Have

• Associate's Degree or Bachelor's Degree
• 5-10 years experience

Skills

* Required skills

Benefits

Certifications