Coding Auditor/Educator

Job Type


Full-time

Description

Job Title: Provider Coding Educator / Auditor

Department: Revenue Integrity & Compliance

Employer: Southeast Primary Care Partners / Southeast Medical Group, P.C.

FLSA Status: Non-Exempt (Hourly)

Position Summary

The Provider Coding Educator/Auditor is responsible for driving accurate clinical documentation, compliant coding, and revenue integrity across Southeast Primary Care Partners' ambulatory practices. The role combines prospective and retrospective E/M, procedural and risk-adjustment auditing with in-person and virtual provider education. Up to 50 % regional travel is required to meet with physicians on flexible schedules, including early-morning huddles and occasional after-hours sessions. This is an hourly, non-exempt position governed by the Fair Labor Standards Act (FLSA) overtime provisions and subject to Occupational Safety and Health Administration (OSHA) workplace safety standards.

Requirements

Essential Functions

• Perform focused and random audits of provider documentation and coding for ICD-10-CM, CPT, HCPCS and HCC/RAF accuracy; document findings and recommended corrective actions.
• Deliver one-on-one and group education using adult-learning principles, translating complex regulations into practical guidance for busy clinicians.
• Monitor payer policy, CMS updates, and industry best practices; update internal reference materials and workflows accordingly.
• Partner with Compliance, Billing, and Population Health teams to resolve coding-related denials and mitigate audit risk.
• Prepare aggregate audit reports, scorecards and dashboards for leadership; identify trends and training opportunities.
• Serve as a subject-matter expert during EMR template builds, clinical documentation improvement initiatives, and new-provider onboarding.
• Maintain strict confidentiality of PHI and adhere to HIPAA, OSHA, and company compliance policies at all times.

Required Qualifications

• Active CPC (Certified Professional Coder) and CPMA (Certified Professional Medical Auditor) credentials; CPA also required to support value-based reimbursement analyses.
• Minimum 5 years direct physician-practice coding experience and 5 years working alongside physicians in primary or multi-specialty settings.
• Demonstrated expertise in outpatient E/M leveling, surgical and diagnostic procedure coding, and risk-adjustment methodologies.
• Strong verbal & written communication skills; able to present complex regulatory content in plain language.
• Advanced auditing, critical-thinking, and root-cause-analysis abilities.
• Proficiency with EMR/EHR platforms, encoder software, Microsoft 365, and data analytics tools.
• Valid driver's license and ability to travel 50 % within assigned market; mileage reimbursed per company policy.

Preferred Qualifications

• Experience with Athenahealth and/or Epic ambulatory modules.
• Prior training responsibilities or AAPC Approved Instructor credential.
• Familiarity with MACRA/QPP, MIPS scoring, and value-based care contracts.

Other Requirements:

• Self-motivated and able to work independently and as part of a collaborative team.
• Flexible and adaptable to changing priorities and regulations.
• Willingness and ability to travel up to 25-40%, including occasional overnight stays for onsite education or audit support.

Key Physical & Mental Requirements:

• Ability to lift up to 50 pounds.
• Ability to push or pull heavy objects using up to 50 pounds of force.
• Ability to sit or stand for extended periods during training sessions or on-site support.
• Ability to use fine motor skills to operate office equipment and/or machinery.
• Ability to receive and comprehend instructions verbally and/or in writing.
• Ability to apply logical reasoning for simple and complex problem-solving.
• Ability to travel to multiple locations as required to support business needs.

Equal Opportunity Employer Statement:

Southeast Primary Care Partners is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.