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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive knowledge of ICD-10, HCPCS, CPT, and HCC guidelines, along with the ability to analyze coding and documentation for compliance and accuracy. Proven experience in auditing, education, and leveraging operational data to improve program efficiency and patient experience.
Highest-signal resume keywords
ICD-10 KnowledgeCPT Coding ExperienceAuditing ExperienceRHIT CertificationRegulatory Compliance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Coding AccuracyData AnalysisReport CreationEducational Material DevelopmentSurgical Procedure CodingCompliance AuditingDocumentation ReviewPerformance ImprovementOperational Data AnalysisTrend Analysis
Soft Skills
CollaborationCommunicationProblem-SolvingFeedback DeliveryTraining and Onboarding
Tools & Technologies
Multiple System ApplicationsComputer Technology
Certifications & Qualifications
RHITRHIACCSCPCCPMACRCCDEO
Industry Keywords
Health Information ManagementRegulatory GuidelinesMedicareMedicaidPayer PoliciesRevenue IntegrityCoding StandardsAudit WorkplanHealthcare ComplianceMedical Terminology
About the role
Key responsibilities & impact- Research, collect, and analyze information
- Identify opportunities, develop solutions, and lead 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, provide detailed summaries, and present graphical data illustrating trends
- Recommend practical options or solutions while considering business strategy and leadership decision-making
- Leverage program and operational data to define and demonstrate progress, ROI, and impacts
- Analyze coding and documentation 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
- Adhere to coding quality and productivity standards established by Revenue Excellence
- Complete the audit and education workplan defined by the Service Area Manager of Coding Audit and Education
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
- Knowledge of regulatory guidelines including Medicare and Medicaid
- Knowledge of payer policies
- Five (5) or more years of professional coding experience, including surgical procedures
- Two (2) years of auditing and/or education experience
- RHIT, RHIA, CCS, or CPC certification required
- Bachelor's degree in health information management or related healthcare field preferred
- CPMA, CRC, or CDEO credentials preferred
- Ability to maintain coding accuracy of 95% or greater
- Ability to complete audit and education workplan
- Ability to use multiple system applications and computer technology
- Ability to comply with applicable laws, regulations, policies, procedures, guidelines, and Code of Conduct
- Ability to lift a maximum of 30 pounds unassisted occasionally
- Ability to provide assistance in an emergency
Benefits
Comp & perks- Equal Opportunity Employer
- Person-centered care culture
- Personal protective equipment (PPE) available
- Temperature-controlled and well-lit indoor work environment