VMG Coding Auditor & Educator

VMG Coding Auditor & Educator

Virtua Health

Responsible for professional fee (pro‑fee) coding quality and audits, education and training for CPT, ICD‑10‑CM, and HCPCS codes for Virtua Medical Group clinicians and the coding department. Includes performing internal audits, overseeing external audits, providing education and training to pro‑fee coders, resolving coding issues that prevent accounts from being processed, and developing, implementing and maintaining a compliance plan for pro‑fee coding and abstracting.

• Provide training and education for newly hired coders, using medical records in conjunction with coding rules and regulations.
• Audit new coders after approval to submit charges, giving timely feedback.
• Develop coding and training resources for the entire team (modules, scenarios, tip sheets, etc.).
• Conduct external coding audit response: train coders, prepare rebuttals and appeals, correct data, and educate providers and coders.
• Respond to daily coding guideline questions from VMG coders.
• Provide initial onboarding education for all clinicians billing under the VMG tax  (CMS 1995, 1997, AMA 2021 E/M guidelines).

• Perform chart audits of CPT, ICD‑10‑CM, and HCPCS codes assigned by VMG coding staff; deliver timely feedback.
• Oversee the annual external audit process for all clinicians, creating audit samples, communicating results, and providing annual coding education.
• Audit charts for clinicians scoring below 80% on external audit, review work‑queue edits, and identify coding trends and education needs.

• Assist with monitoring pre‑AR aging reports and troubleshoot complex account issues to reduce A/R.
• Code charts urgently to meet A/R goals.
• Collaborate下午 with Practice Directors and Managers to streamline clinical coding workflows.

• Partner with VMG practices and third‑party billing companies to resolve coding and reimbursement issues, serving as escalation point完成。
• Provide education to clinicians and billers on pro‑fee coding issues and recommend workflow changes to ensure proper documentation and reimbursement.

• Develop and enforce coding, data abstraction, and compliance policies; document and provide feedback to supervisors.
• Recommend changes to charge master, documentation requirements, and workflow to guarantee appropriate reimbursement.
• Monitor and report on productivity and quality standards.

• Minimum 3 years of professional fee (provider) coding OR a combination of 3 years coding and healthcare auditing experience.
• Preferred multi‑specialty professional fee coding experience.
• Proficiency with PC database applications, Microsoft Office,consistently spreadsheet design and encoder use.
• Subject‑matter expertise in CPT, Liga‑10‑CM and HCPCS coding.
• Ability to develop, present, and lead education sessions.
• Required education:
  Coding Certificate Program or equivalent experience leading to appropriate certification.
• Required certification: CPC Certification by AAPC.
• Preferred certification: CPMA Certification by AAP(