Professional Coding Auditor-Educator

Professional Coding Auditor-Educator

WVU Medicine

Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Oversees or performs overall auditing and education plans for the coding staff. The position performs coding quality audits, provides ongoing feedback and education, and utilizes coding classifications (ICD‑10‑CM, ICD‑10‑PCS, CPT, MS‑DRG, HCC, APR‑DRG) to ensure accurate coding.

• Graduate of a Health Information Technology (HIT) or equivalent program AND five (5) years of coding experience.
• OR Graduate of a Medical Coding Certification Program AND five (5) years of coding experience.
• OR High School Diploma or Equivalent AND eight (8) years of coding experience.
• Certification in one of the following:
  RHIA or RHIT (AHIMA);
  COC (AAPC);
  CCS (AHIMA);
  CPC (AAPC).

• Benefit:
  Bachelor’s degree in Health Information Management or a related field.
• Extensive experience with ICD‑10‑CM/PCS, CPT, MS‑DRG, HCC, and APR‑DRG assignment for multiple specialties.
• Knowledge of governmental billing and coding regulations, including “Teaching Physician Guidelines” for Professional Coding Positions.
• Previous supervisory or project‑management experience.

• Manage training activities for WVU Healthcare coding staff and monitor their developmental progress.
• Conduct quality improvement audits and training of coding personnel.
• Serve as an expert coding resource for coders, clinical documentation improvement teams, providers, revenue cycle, and specialty groups.
• Act as super‑user for all coding‑related EMR systems, update policies and procedures, and provide in‑services regarding system changes.
• Develop and maintain coding‑related policies, procedures, query development, work queues, and training materials in collaboration with management.
• Facilitate internal quality reviews and track trends; design audit tools (e.g., ROC).
• Coordinate external audits, liaise between agencies and HIM personnel, facilitate exit conferences, and provide final reports.
• Coordinate denial reviews, facilitate appeal letter preparation, and ensure completion of audit recommendations.
• Assist with onboarding of new coding specialists, update them on compliance and regulatory changes, and keep abreast of coding resources.
• Potentially develop curriculum for the WVU Healthcare Coding Certificate Program and manage related educational projects.

• Must be able to sit for long periods of time.
• Visual and hearing acuity within the normal range.
• Manual dexterity to operate computer and office equipment.
• May need to lift, push, or pull 10–20 pounds.

• Standard office environment with visual strain from computer screens and spreadsheets.
• May require occasional travel.

• Excellent written and verbal communication skills.
• Knowledge of provider healthcare compliance, revenue cycle operations, and auditing techniques.
• Ability to mentor, educate, and train others.
• Ability to ensure quality and productivity standards, handle high stress, maintain accuracy, and adapt to workplace changes.
• Strong organizational, time‑management, analytical, and problem‑solving skills.
• Proficient in office and medical record/billing software.
• Knowledge of anatomy, physiology, and medical terminology.

• Scheduled weekly hours: 40.
• Exempt/Non‑exempt:
  Exempt.
• Shift: United States of America (Exempt).
• Company:
  West Virginia University Health System.
• Cost Center: 539 SYSTEM HIM Provider‑Based Coding Analysis.
• Seniority level:
  Mid‑Senior level.
• Employment type:
  
  Full‑time.
• Job function:
  Accounting/Auditing and Finance.
• Industry: Hospitals and Health Care.