Coding Education Specialist

Description

Position: Coding Education Specialist

Department: Revenue Cycle Management/ Compliance 

FLSA Status: Exempt

Reports To: Coding Education Manager

JOB DESCRIPTION 

JOB SUMMARY: The Coding Education Specialist is responsible for overseeing medical coding operations and compliance audits to ensure accurate, timely, and ethical coding practices in accordance with federal regulations and payer guidelines. Assist the coding education manager in developing training programs, and partner with clinical, billing, and compliance departments to mitigate risk and support revenue integrity.

Supervisory Responsibilities:

None

Duties/Responsibilities:

· Conduct routine and targeted coding audits to assess accuracy, compliance, and adherence to coding guidelines (ICD-10, CPT, HCPCS, and payer-specific rules).

· Develop and implement corrective action plans and training initiatives based on audit findings.

· Ensure all coding staff maintain appropriate certifications and adhere to best practices.

· Collaborate with providers, clinical staff, and billing teams to resolve coding discrepancies and improve documentation quality.

· Stay current on regulatory changes (e.g., CMS, OIG, HIPAA) and communicate updates to affected stakeholders.

· Monitor coding productivity and quality metrics and report trends and risks to coding manager.

· Support internal and external audits, including responses to RAC, MAC, and payer inquiries.

· Assist in developing and maintaining coding policies, procedures, and training materials.

· Other duties as assigned.

Required Skills/Abilities:

· Excellent communication, and interpersonal skills.

· Analytical mindset with strong problem-solving abilities.

· Proficient in coding software, EHR systems, and Microsoft Office Suite.

· High ethical standards and attention to detail.

Experience:

· Minimum of 3 years of progressive experience in medical coding.

· Strong knowledge of coding systems, E/M guidelines, medical terminology, and regulatory compliance.

Education:

· Associate or bachelor’s degree in health information management, Healthcare Administration, or related field preferred.

· Certifications (Required): CPC, CCS, RHIT, or RHIA

· CRC or CPMA preferred

OTHER KEY SKILLS:

• Team player - possess a positive attitude and demonstrates honesty and integrity in all endeavors.
• Ability to understand, apply and analyze financial data.
• Strong work ethic with the ability to self-start and work independently or as part of a diverse team.
• Detail oriented and organized with the ability to easily identify areas that require improvement.