Coding Auditor, Physician Group

Apply for the Coding Auditor, Physician Group role at ECU Health
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Responsible for the creation and maintenance of audit and education programs that ensure success for all staff and employed providers, supporting accurate, compliant coding practices for ECU Health physicians in accordance with coding guidelines. Conduct internal audits of medical coding activities using concurrent, prospective, and retrospective models as appropriate. Review electronic health information to determine accuracy of coding, billing, and documentation, including validation of ICD‑10‑CM, CPT, HCPCS, and modifier assignments related to medical provider professional Part B services according to regulatory and institutional policy.

Report findings, written and verbal, to leadership as necessary to include provision of corroborating regulatory or policy guidance. Maintain documentation of all audit activities and communicate findings to leadership. Utilize findings to generate topics for education and training, including code assignment, process improvement, system logic, risk reduction, and reimbursement optimization. Develop and coordinate education based on the specific needs of the individual or functional unit.

Provide orientation and education to new provider hires. Assist coding leadership with education, training, and review of coding personnel activities as needed.

• Perform coding audits on professional fee encounters to determine accuracy of ICD‑10‑CM, CPT, HCPCS codes, and modifiers selected for claim submission.
• Document details of audit findings in auditing software and prepare and distribute reports of audit findings.
• Provide information to leadership on the status of coding audits and related activity.
• Take initiative to analyze, investigate, and research regulatory topics for guidance to efficiently develop educational plans.
• Assist with updating and developing Medical Group coding policies and procedures and other duties as assigned.

• Develop focused educational materials, including presentations, training classes, tip sheets, etc., based on needs outlined or requested by leadership.
• Provide individualized training based on audit results and ongoing support to individuals below organizational performance levels.
• Ensure all staff and employed providers engaged in coding and billing activities are appropriately and timely updated on changes in medical coding and reimbursement laws, regulations, and guidelines.
• Prepare and conduct education upon request for providers, coding staff, and external departments related to recognized documentation policy, medical coding guidelines, and billing requirements.
• Serve as an expert resource for questions on compliant coding practices and researching regulatory topics for guidance.

• Participate in education of new providers and/or coding staff.
• Participate in education of students as part of student internship experiences.

• Work closely with leadership to identify trends and areas of vulnerability.
• Identify revenue integrity opportunities via routine and special‑request audits.

• At least 5 years of multidisciplinary physician‑based coding or auditing experience.
• Bachelor's degree in Health Information Management or Associate's degree in Health Information Technology or Medical Office Administration, or higher.
• RHIA, RHIT, CCS, CPC, or CCS‑P certification required.
• CCS, CCS‑P, or CPC and a minimum of 8 years of physician‑based coding or documentation audit experience may be substituted for the education requirement.

• Remote role (based out of Greenville, NC).
• Monday – Friday day shift.
• Great Benefits.

• Mid‑Senior level

• Full‑time

• Accounting/Auditing and Finance.
• Hospitals and Health Care.

It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

Offers of employment are subject to successful completion of all pre‑employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal‑opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant’s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.