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Provider Coding Auditor – Educator
Munson HealthcareCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates advanced knowledge of CPT, ICD-10-CM, HCPCS, and E/M coding guidelines, with a strong focus on documentation accuracy and compliance. Capable of delivering effective provider education and collaborating with clinical leadership to enhance documentation quality and audit readiness.
Highest-signal resume keywords
CPC CertificationCCS-P CertificationAdvanced Knowledge Of CPT CodingE/M Coding ExpertiseProvider Education Skills
About the role
Key responsibilities & impact- 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, 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 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 education for new clinicians and ongoing coding and documentation improvement
- 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/documentation changes and regulatory updates
- Travel to physician offices and clinical sites as needed for on-site audits and in-person education
Requirements
What you’ll need- High School Diploma/GED and 7 years total experience in professional coding, 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's Degree in Health Information Management or a related healthcare field and 5 years 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 required
- CDEO certification required 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, 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
- Skilled in provider education through one-on-one feedback, group training, and written guidance
- Ability to collaborate with clinicians, compliance, revenue cycle, CDI, and leadership
- Professionalism, discretion, confidence, and relationship-building skills
- High level of precision in reviewing medical records, audit findings, and educational materials
- Ability to manage priorities independently in a hybrid environment and adapt to regulatory changes
- Ability to travel to physician offices and clinical sites as needed
- Employee vaccination requirements for measles, mumps, rubella, varicella, and influenza, unless an approved medical or religious exemption applies
Benefits
Comp & perks- Tuition reimbursement
- In-person and online development
- Access to a 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 through improvement huddles, employee surveys, and town hall meetings
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Professional CodingDocumentation AuditsCPT Code AssignmentICD-10-CM Code AssignmentHCPCS Code AssignmentDocumentation ImprovementCoding Guidelines ComplianceAudit TrackingRisk Area IdentificationClinical Decision-Making
Soft Skills
ProfessionalismRelationship-BuildingDiscretionConfidenceAdaptability
Tools & Technologies
Audit Tracking ToolsQuality Metrics Reporting
Certifications & Qualifications
CPC CertificationCCS-P CertificationCDEO Certification
Industry Keywords
Clinical Documentation ImprovementOutpatient CDI PrinciplesMedical NecessityRegulatory StandardsDenial Prevention