Coding Education & Audit Specialist

Rewarding career. Competitive salary. Outstanding benefits.

The Coding Education & Audit Specialist is responsible for advancing the accuracy, consistency, and compliance of professional and facility coding through targeted education and systematic auditing.  The role focuses primarily on developing and delivering coding and documentation education to providers and coding staff, performing coding and documentation audits, and partnering with operational and compliance leaders to implement corrective action and best practices.  This position may perform limited production coding as time permits to maintain proficiency and support departmental needs.

STANDARD EXPECTATIONS

• Promotes a Positive Working Environment
  • Conducts oneself in line with organization’s mission, values and standards of behavior.
  • Accepts change and challenges with a positive attitude.
  • Consistently adheres to organizational policy.
• Communicates Effectively
  • Builds relationships and works collaboratively with other staff.
  • Provides timely operational updates to supervisor.
  • Responds to communications in a timely manner.
• Performs Duties Efficiently and Effectively
  • Follows procedures.
  • Acts in compliance with applicable federal, state, and local regulations.
  • Performs other duties as assigned.

DUTIES & RESPONSIBILITIES

Education and Training

• Develop, implement, and maintain coding education programs for providers, coding staff, and other stakeholders, including new hire onboarding, refresher training, and targeted interventions.
• Create clear, accessible educational materials (presentations, tip sheets, job aids, workflows, FAQs) on coding, documentation, and billing requirements.
• Provide one-on-one and group education to providers and coders based on audit findings, regulatory changes, and organizational initiatives.
• Serve as a subject matter expert and resource for coding and documentation questions from providers, coders, practice managers, and revenue cycle staff.
• Monitor and communicate changes in coding, payer policies, and regulatory guidance; translate changes into practical training and workflow updates.

Auditing and Quality Assurance

• Plan and perform routine and focused coding and documentation audits for professional and facility encounters, using approved audit tools and sampling methodologies.
• Review coded encounters for accuracy, completeness, and compliance with official coding guidelines, payer rules, medical necessity criteria, and organizational policies.
• Review denials and billing issues and analyze results, identify trends and payer specific rules to identify areas needing improvement and training.
• Analyze audit results, identify trends and root causes, and develop recommendations to improve coding quality, provider documentation, and charge capture.
• Prepare clear, concise audit reports that summarize findings, financial impact, and recommended corrective actions, and present results to stakeholders as needed.
• Partner with Compliance, Revenue Integrity, and Coding leadership to support corrective action plans, monitoring activities, and ongoing quality improvement.

Collaboration and Process Improvement

• Collaborate with coding and billing leadership, clinic leadership, and compliance teams to develop and maintain standardized coding and documentation policies, procedures, and workflows.
• Participate in committees and workgroups focused on documentation improvement, revenue integrity, and regulatory readiness (e.g., internal audits, external reviews).
• Assist in designing and tracking coding quality metrics, provider education metrics, and audit follow-up to ensure sustained improvement.
• Provide feedback to IT/EMR teams on documentation templates, order sets, and charge workflows to support compliant coding and efficient processes.

Coding Support

• Perform limited production coding on an as-needed basis (e.g., back-up coverage, complex cases, or quality checks) to maintain current coding skills and support operational needs.
• Serve as a technical expert for complex coding scenarios and assist other coders with resolving escalated or unusual cases.

Other Duties

• Maintain confidentiality and handle protected health information in accordance with HIPAA and organizational policies.
• Participate in continuing education and maintain required professional certifications.

QUALIFICATIONS

Required

• High school education or equivalent.
• Current AAPC or AHIMA coding certification (e.g., CPC, CPC-I, COC, CIC, or equivalent).
• Minimum of 5 years of recent professional coding experience in an acute care hospital, multi-specialty clinic, or similar environment.
• Prior experience performing coding audits, quality reviews, or serving as a coding educator, trainer, or lead.
• Demonstrated experience interpreting and applying official coding guidelines, payer policies, and regulatory requirements (e.g., Medicare, Medicaid, commercial payers).
• Expert knowledge of ICD-10-CM, CPT, HCPCS, and modifier usage; familiarity with outpatient, professional, and (as applicable) facility coding guidelines.
• Strong understanding of documentation requirements that support medical necessity, coding specificity, and accurate risk adjustment (if applicable).
• Ability to clearly explain complex coding and documentation topics to providers and staff with varying levels of coding knowledge.

Preferred

• Associate’s or Bachelor’s Degree in Health Information Management, Healthcare Administration, Nursing, or related field.
• Critical access hospital coding experience.
• Advanced or master-level coding credential (e.g., CPC-M or equivalent) and/or coding instructor certification.
• Familiarity with Epic.

WORK ENVIRONMENT AND PHYSICAL DEMANDS

This position is primarily worked in a clinical environment. The position will require the ability to lift, and carry, up to 50 pounds and push or pull over 50 pounds. The position will require bending, twisting, squatting, reaching, reaching overhead, sitting and standing frequently. Occasionally the position requires climbing, kneeling and crawling. The position requires continuous finger dexterity and fine manipulation. All basic life functions such as hearing, seeing, speaking, standing and walking are required.

If you are looking for a rewarding career with a great team, you'll enjoy your career with us !

POSITION DETAILS

Hours per week:

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Pay Range:

Actual pay offered will vary based on years of experience.

EMPLOYEE BENEFITS

Our benefit package includes medical, dental, vision, life insurance, and retirement options (403(b) & 457). Medical insurance coverage begins on day one and is available to both full time and part time employees. Additionally, employees receive discounts on medical services provided by Whitman Hospital and Medical Clinics. Differentials apply for evening, night, and weekend shifts. Our unique PTO plan enables employees to increase their accrual with each year of service!