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Senior Coding Compliance Auditor and Educator
Tryon Medical PartnersUnited States - Remote, United StatesRemotefull_timeVerifiedPosted 7 Aug 2025
About the role
Senior Coding Compliance Auditor and Educator
General Job Summary: The Senior Coding Compliance Auditor and Educator will be responsible for auditing outpatient professional services documentation ensuring compliance with coding and billing guidelines, identifying areas for improvement, and providing training to clinicians and coders to support accuracy, compliance, and adherence to industry standards. This role involves both auditing medical records and educating coders, providers, and staff on professional coding guidelines and best practices.
(this is a full-time position that will support our Compliance team, Monday to Friday 8 am to 5 pm, with the ability to work full remote)
Primary Job Responsibilities:
Requirements:
Education and Experience:
General Job Summary: The Senior Coding Compliance Auditor and Educator will be responsible for auditing outpatient professional services documentation ensuring compliance with coding and billing guidelines, identifying areas for improvement, and providing training to clinicians and coders to support accuracy, compliance, and adherence to industry standards. This role involves both auditing medical records and educating coders, providers, and staff on professional coding guidelines and best practices.
(this is a full-time position that will support our Compliance team, Monday to Friday 8 am to 5 pm, with the ability to work full remote)
Primary Job Responsibilities:
- Perform thorough reviews of outpatient professional claims and supporting documentation, ensuring compliance with ICD-10, CPT, HCPCS, HIPAA, HITECH and other coding standards and payer-specific requirements.
- Identify coding errors, documentation inconsistencies and discrepancies in claims submitted for reimbursement.
- Collaborate with coders to ensure accurate code assignment and provide feedback for improvement.
- Review and stay up to date with coding practices against payer-specific rules and regulations to ensure compliance.
- Act as a liaison with the billing department, coding teams, healthcare providers, and other stakeholders to resolve coding and documentation-related claim rejections and denials.
- Develop and deliver one-on-one and/or group training sessions for medical coders and healthcare providers on current coding standards that align with coding requirements, best practices, and ensure comprehensive and clear clinical notes for documentation improvements. Assist in creating educational materials.
- Provide ongoing education to coders regarding updates to coding systems, regulations, and payer policies. Offer practical solutions to improve processes.
- Monitor the effectiveness of training programs through assessments and feedback to ensure continuous improvement.
- Track and report coding errors and trends, making recommendations for process improvements.
- Assist in maintaining up-to-date coding policies, training content, and reference materials to ensure the organization stays compliant with regulatory changes.
- Perform related duties as required.
Requirements:
Education and Experience:
- Bachelor’s degree in business or healthcare related field required.
- CPC (Certified Professional Coder), or CCS (Certified Coding Specialist), or equivalent certification through AAPC, AHIMA, or another nationally recognized credentialing body required.
- Certified Coding Specialist – Physician-based (CCS-P), or additional specialty certifications (e.g., CPMA (Certified Professional Medical Auditor) preferred.
- 5 years of experience as a medical coder, with at least 3 year2 in a coding review and/or ed
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