Coding Compliance Audit & Education Specialist
Core
Audits medical records for compliance with federal coding regulations and provides education to providers on proper documentation and code assignment.
Role type
Senior IC medical coding compliance auditor and educator
Builds
Audit reports and provider education programs
Domain
Healthcare administration / Medical coding
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
CPT code auditing, ICD-10-CM code auditing, HCPCS code auditing, federal and state healthcare regulations interpretation, provider education delivery, audit report preparation, HIPAA compliance
Preferred skills
MDAudit platform experience, Athena platform experience, 5+ years in audit and provider education
Technologies
MDAudit, Athena
Responsibilities
Conduct baseline, routine periodic, and focused audits comparing medical records to reported codes; Research and interpret CMS and Medicare laws; Prepare audit reports summarizing findings; Conduct post-audit provider education and training; Provide coding assessment, consultation, and issue resolution to stakeholders; Communicate audit findings to track education completion.
Seniority
Mid-Senior level, independent contributor
