CPMA Educator, Auditor

Presbyterian Healthcare Services

. Support implementation and compliance with enterprise-wide and department coding policies and procedures .

Posted 10/15/2026full-timeRemote • New Mexico • United StatesMid-LevelSenior💰 $57,242 - $97,469 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in coding compliance, auditing, and regulatory standards, with a strong focus on ICD-9, ICD-10, CPT-4, and HCPCS. Capable of developing training programs and conducting audits to ensure adherence to coding policies and improve operational efficiency.

Highest-signal resume keywords

Coding ComplianceAuditing ExperienceICD-10 KnowledgeRHIT CertificationMedicare and Medicaid Regulations

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CodingAuditingMedical TerminologyICD-9CPT-4HCPCSQuality AuditsCorrective Action PlansData AnalysisDocumentation Compliance

Soft Skills

Excellent Communication SkillsDetail OrientedOrganizational SkillsIndependent Decision-MakingAbility to Prioritize Tasks

Tools & Technologies

Microsoft WordMicrosoft PowerPointMicrosoft ExcelEPIC EMR

Certifications & Qualifications

RHITRHIACPCCCS

Industry Keywords

Coding PoliciesRegulatory ComplianceBilling RegulationsPayer CommunicationInternal Audits

Tech Stack

Tools & technologies

PHP

About the role

Key responsibilities & impact

Support implementation and compliance with enterprise-wide and department coding policies and procedures
Ensure compliance with external regulatory agency coding rules and regulations
Perform and/or manage on-site internal audits and quality reviews
Serve as a resource for documentation, coding, billing, and coding compliance questions
Work on special coding compliance-related projects
Develop and present educational programs and tools
Audit and train enterprise-wide corrective action plans for low-performing coding, audit, physician, and clinician personnel
Review denied and appealed claims and take appropriate action to ensure accurate payment
Coordinate review and tracking of appealed claims and communicate with affected payers
Research and interpret regulatory agency regulations
Liaise with Information Services, Finance/Patient Financial Services, hospitals, PMG sites, PHP, Home Health, Albuquerque Ambulance, Compliance, and ancillary departments
Maintain and disseminate current legal and regulatory information, including ICD-9, ICD-10, CPT-4, HCPCS, and APC updates
Research coding, billing, and charging compliance issues and implement corrective action plans
Identify risks, lost revenue opportunities, and overpayments due to coding or documentation errors
Assist in creating the CDQA Annual Audit Work-plan
Respond to daily coding and auditing inquiries and ad-hoc analysis requests
Maintain working knowledge of PHS coding and auditing IT applications
Gather and analyze information and recommend solutions for business issues
Conduct coding, documentation, and compliance training classes, including ICD-10 and EPIC EMR documentation education
Conduct focused internal audits through medical record and charge ticket review
Analyze and communicate medical record and account audit findings to management
Develop methods and processes to improve coding efficiency and effectiveness
Research and investigate patient care and billing concerns
Monitor reports and quality audits to ensure coding functions meet quality and performance standards

Requirements

What you’ll need

High school diploma/GED required
Must possess at least one of: RHIT, RHIA, CPC, CCS
Minimum of three (3) years experience in coding and/or auditing required
Audit experience preferred
Excellent written and verbal communication skills
Detail and results oriented
Ability to work independently and make independent decisions
Medical terminology, ICD-9, CPT-4 and HCPCS knowledge required
Proficient knowledge of Medicare, Medicaid, and other third party payer documentation, coding, and billing regulations
Excellent organizational and planning skills
Ability to prioritize multiple tasks and perform them accurately and simultaneously
Computer skills, especially Microsoft Word, PowerPoint, and Excel
Ability to use the internet and other resource applications for research
Ability to communicate complex regulatory information in layman's terms
Must be able to travel to all PHS/PMG sites, including overnight
Must be able to work varying hours based on assigned projects

Benefits

Comp & perks

Medical insurance
Dental insurance
Vision insurance
Short-term disability
Long-term disability
Group term life insurance
Optional voluntary benefits
Employee Wellness rewards program
Gift cards and more through wellness activities
Wellness challenges
Webinars
Preventive screening
Full-time employment