Note: The job is a remote job and is open to candidates in USA. Munson Healthcare is a healthcare system serving communities across northern Michigan. The Provider Coding Auditor & Educator audits physician and advanced practice provider coding and documentation, delivers targeted education, and supports clinical documentation improvement, compliance, and revenue integrity initiatives.
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
Skills
- 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
- 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
Benefits
- Tuition reimbursement
- In-person and online development
- Access to the career hub to help you advance
- 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
- Hybrid work environment with remote and on-site responsibilities
Company Overview