Professional Coding Auditor and Educator - Remote

Professional Coding Auditor and Educator – Remote

Join Tufts Medicine in this role that focuses on revenue cycle operations such as billing, collections, and payment processing, and performs Health Information Management duties including ensuring the accuracy, maintenance, security, and confidentiality of patient health information.

The position requires frequent daily interactions with physicians and providers, providing coding instruction, chart reviews, coding education, evaluation of denials, and ensuring regulatory compliance. It also involves collaboration with billing specialists and management to improve charge capture.

• Associate’s degree in Medical Record Technology.
• Completion of a Certified Medical Coding Program or at least two years of professional coding certification with courses in Medical Terminology, Anatomy & Physiology, or extensive training in physician coding.
• One of the following certifications:
  Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT).
• Four years of coding experience, with at least two years in surgical abstraction within multi‑specialty surgical practices.

• Support coding from final surgical/procedural operative reports and review complex records to ensure documentation is supported.
• Audit provider medical records and charges for compliance with coding and documentation standards.
• Provide continuing education to physicians and ACPs on appropriate coding and documentation.
• Maintain a thorough understanding of anatomy, physiology, medical terminology, disease processes and surgical techniques.
• Correlate information supporting clinical documentation from pathology, radiology, and physician consultations.
• Meet with physicians and ACPs to provide education on billable services and improve revenue capture.
• Provide trends and insights to management and revenue managers on coding issues.
• Resolve coding related problems and answer questions from providers, staff, and billing specialists.
• Collaborate with billing specialists and appeal/edit coders to expedite resolution of accounts.
• Work with billing specialists to develop plans to improve charge capture and billing/coding processes.
• Stay current with CPT and ICD‑10‑CM coding guidelines and communicate updates to stakeholders.
• Report potential compliance issues to the director.

• Typical office environment: computers, phones, photocopiers, filing cabinets.
• Sedentary role involving sitting most of the time, with occasional walking, standing, and reaching.
• Requires speaking, hearing, communicating and exchanging information.
• Ability to see and read computer displays and fine print.
• Occasional lifting of up to 25 pounds.

• Extensive knowledge of surgical coding procedures and modifiers.
• Proficiency in Medicare Service guidelines.
• Advanced CPT and ICD‑10‑CM coding conventions.
• Strong anatomical and medical terminology knowledge.
• Extensive OPPS/APC/ACO reimbursement knowledge.
• Familiarity with coding software.
• Effective written and verbal communication skills.
• Ability to perform error‑free data entry.
• Ability to abstract codes from surgical operative notes and communicate with specialty surgical providers.

$24.65 – $30.82 per hour (base pay). Individual offers consider experience, certifications, education, and skills.

At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring.