Coding Auditor Educator
Core
Conducts internal, concurrent, and retrospective coding audits to ensure data quality and regulatory compliance for DRGs, APCs, CPT, and ICD codes; develops and delivers training programs to address identified deficiencies and optimize reimbursement.
Role type
Senior IC coding auditor and educator
Builds
Audit reports, training curricula, and documentation quality improvements
Domain
Healthcare administration and medical coding
Required skills
ICD-CM, ICD-PCS, CPT, HCPCS Level II coding; DRG/APC structure; audit planning and execution; training program development; regulatory compliance knowledge
Preferred skills
Claims processing; data management; external resource coordination
Technologies
Encoder, grouper, abstracting software
Responsibilities
Plan and conduct audits of documentation, coding, and billing; develop and deliver training programs to address audit deficiencies; validate code systems and ensure compliance with regulatory requirements; analyze case mix reports to identify trends and resolve coding variations; interpret medical information and classify into appropriate payor-specific groups; mentor new staff and provide coverage for coding managers
