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Coding Auditor – Educator
WVU Medicine. Educate and train WVU Healthcare coding staff as directed by Coding Managers .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in coding practices, including ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG assignment, while effectively training and mentoring coding staff. Proficient in auditing techniques and healthcare compliance, with strong communication and organizational skills.
Highest-signal resume keywords
ICD-10-CM CodingCPT CodingMS-DRG AssignmentRHIA CertificationAuditing Techniques
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
ICD-10-PCS CodingMulti-Specialty CodingE&M CodingProcedural/Surgical CodingGovernmental Billing RegulationsData AnalysisQuality AuditingCurriculum DevelopmentMedical TerminologyHealthcare Compliance
Soft Skills
Excellent Communication SkillsMentoring AbilityOrganizational SkillsProblem-Solving SkillsTime Management Skills
Tools & Technologies
Electronic Medical Record SystemsOffice SoftwareBilling Systems
Certifications & Qualifications
RHIARHITCOCCCSCPC
Industry Keywords
Healthcare CodingRevenue Cycle OperationsQuality Improvement AuditsCoding EducationCompliance Regulations
About the role
Key responsibilities & impact- Educate and train WVU Healthcare coding staff as directed by Coding Managers
- Oversee and perform auditing and education plans for coding staff
- Perform coding quality audits and provide ongoing feedback and education
- Use ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC, and APR-DRG assignment
- Manage training activities for designated coding personnel and monitor and report employee development
- Manage quality improvement audits and training of designated coding staff
- Serve as an expert coding resource to coders, clinical documentation improvement, providers, revenue cycle, specialty groups, and meetings
- Act as super user for coding-related electronic medical record systems and support EMR data governance
- Update policies, procedures, work queues, and training materials
- Communicate with coding staff, medical staff, Physician Advisor, Department Chairmen, and Department Administrators
- Organize, facilitate, perform, track, trend, and report internal quality reviews
- Design and use audit tools to monitor coding accuracy, documentation gaps, and billing
- Coordinate external agency audits, data gathering, exit conferences, and final reports
- Coordinate coding/documentation denial reviews and facilitate appeal letter formation
- Communicate coding, documentation, audit, and activity issues to Coding Leadership
- Ensure completion of audit recommendations, including coding education, coding changes, and rebills
- Extract and analyze data and develop action plans when necessary
- Assist with onboarding new Coding Specialists
- Update Coding Specialists on compliance and regulatory changes
- Keep abreast of coding changes, state and federal regulations, and coding resources
- Develop curriculum for the WVU Healthcare Coding Certificate Program and support special EMR data governance projects when needed
- Utilize systems for curriculum and educational courses, administer exams, and support testing and installation of system upgrades
Requirements
What you’ll need- Graduate of a Health Information Technology (HIT) or equivalent program and five (5) years of coding experience; OR graduate of a Medical Coding Certification Program and five (5) years of coding experience; OR high school diploma or equivalent and eight (8) years of coding experience
- Certification in one of: RHIA, RHIT, COC, CCS, or CPC
- Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, MS-DRG, HCC, and APR-DRG assignment, multi-specialty coding, E&M coding, procedural/surgical coding, and governmental billing and coding regulations preferred
- Previous supervisory or project management experience preferred
- Excellent written, verbal, and interpersonal communication skills
- Knowledge of healthcare compliance, revenue cycle operations, and auditing techniques
- Ability to mentor, educate, and train others
- Ability to ensure quality and productivity standards
- Ability to handle high-stress and critical situations calmly and professionally
- Ability to maintain accuracy during constant interruptions
- Independent decision-making ability
- Ability to prioritize job duties and adapt to workplace changes
- Organizational and time management skills
- Knowledge of anatomy, physiology, and medical terminology
- Analytical and problem-solving skills
- Proficiency in office software, medical record, and billing systems
- Ability to analyze complex data and reports
- Ability to sit for long periods, operate computer and office equipment, and lift, push, or pull 10–20 pounds
- May require travel