Provider Coding Auditor, Educator

🔥 13 hours ago

🚗 Michigan – Remote

🚗 Michigan – Remote

⏰ Full Time

🟠 Senior

🔴 Lead

🔎 Auditor

👻 Ghost score 10%

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Munson Healthcare

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1915

🏥 Healthcare

Healthcare

Munson Healthcare is northern Michigan’s largest integrated healthcare system, operating multiple hospitals and care facilities including Munson Medical Center, Cadillac Hospital, Charlevoix Hospital, Grayling Hospital, Kalkaska Memorial Health Center, Manistee Hospital, Otsego Memorial Hospital, and Paul Oliver Memorial Hospital. The system offers a broad range of inpatient and outpatient services — cancer care, cardiology, maternity, neurosciences, orthopedics, primary care, radiology and imaging, stroke care, surgery, home health, hospice, laboratory and pharmacy services, physical therapy, urgent care and virtual/telehealth visits — and supports patients with tools such as a patient portal, an Ask‑a‑Nurse hotline, and price/transparency and financial assistance resources. Munson Healthcare also provides community health programs, clinical education, and employment opportunities across its regional network.

📋 Description

• 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 written audit findings and recommendations identifying errors, trends, risks, and documentation improvement opportunities • Deliver one-on-one provider education following audits • Develop and present targeted education for clinicians and coding staff on coding guidelines, documentation requirements, CDI principles, and risk areas • Identify CDI gaps affecting accuracy, medical necessity, and defensibility, and support improvement efforts • Support development and maintenance of clinician documentation guidelines, best practices, and reference materials • Monitor coding and documentation trends, audit outcomes, and denial drivers; report findings to leadership and stakeholders • Collaborate with coding, CDI, compliance, revenue integrity, and clinical leadership on documentation quality, audit readiness, denial prevention, and organizational initiatives • Assist with documentation and coding education for new clinicians • Participate in compliance and revenue integrity activities, 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 coding and documentation changes and regulatory updates • Travel to physician offices and clinical sites as needed for on-site audits and in-person education

🎯 Requirements

• 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 certification • Required to obtain CDEO within 18 months of hire • Advanced knowledge of CPT, ICD‑10‑CM, HCPCS, and E/M coding guidelines, including payer-specific and regulatory requirements • Strong understanding of outpatient/physician CDI principles, including documentation specificity, medical necessity, clinical decision-making, and accurate representation of patient complexity • Ability to independently assess clinician documentation and coding accuracy, identify patterns, trends, and risk areas, and apply regulatory standards • Skilled in delivering education to physicians and advanced practice providers through one-on-one feedback, group training, and written guidance • Ability to collaborate with clinicians, compliance, revenue cycle, CDI, and leadership • High level of precision in reviewing medical records, audit findings, and educational materials • Ability to manage priorities independently in a hybrid environment and balance remote and on-site responsibilities • Must meet Munson Healthcare vaccination requirements or have approved exemptions

🏖️ Benefits

• Tuition reimbursement • In-person and online development • Access to career hub • Full benefits • Paid holidays • Generous PTO • Employee discounts • Free individual retirement counseling • Free wellness platform for you and your family • Personalized support for personal or family challenges • Opportunities to share ideas and help shape the way work is done through improvement huddles, employee surveys, and town hall meetings