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Professional Coding Auditor, Educator
Trinity Health. Research, collect, and analyze information supporting organizational objectives .
About the role
Key responsibilities & impact- Research, collect, and analyze information supporting organizational objectives
- Identify opportunities, develop solutions, and lead issues through resolution
- Collaborate on performance improvement activities related to program efficiency and patient experience
- Distribute analytical reports
- Use multiple system applications to perform analysis, create reports, and develop educational materials
- Research and compile information for ad-hoc operational projects and initiatives
- Synthesize and analyze data, create graphical trend presentations, and recommend practical solutions
- Define and demonstrate progress, ROI, and operational impacts using program data and measurements
- Provide technical expertise in coding and documentation review for complex services, including surgical procedure code selection and high-acuity services
- Conduct comprehensive audits of professional coders and providers for accuracy, compliance, CPT, ICD-10, HCPCS, HCC, and payer-specific guideline alignment
- Analyze documentation and coding patterns to identify compliance, revenue integrity, and regulatory risks
- Provide actionable feedback to providers, coders, and leadership to improve documentation quality and coding accuracy
- Develop and deliver targeted education and training based on audit findings, regulatory updates, and knowledge gaps
- Train and onboard new audit and education colleagues and providers
- Maintain at least 95% accuracy in coding audits and complete the audit and education workplan
Requirements
What you’ll need- Associate degree in Health Information Management or a related field, or an equivalent combination of years of education and experience
- Extensive knowledge of ICD-10, HCPCS, CPT, and HCC guidelines
- Knowledge of medical terminology, Medicare and Medicaid regulatory guidelines, and payer policies
- Five (5) or more years of professional coding experience, including surgical procedures
- Two (2) years of auditing and/or education experience
- Must possess one of: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), or Coding Professional Certification (CPC)
- Bachelor's degree in health information management or related healthcare field preferred
- Preferred experience in auditing and provider education
- Preferred credentials: Certified Professional Medical Auditor (CPMA), Certified Risk Coder (CRC), or Clinical Documentation Expert – Outpatient (CDEO)
- Ability to use multiple system applications and computer technology
- Ability to maintain confidentiality, safety, and compliance with applicable laws and policies
Benefits
Comp & perks- Equal Opportunity Employer commitment
- Mission- and values-driven workplace
- Professional development through audit education and training responsibilities