What’s Upstate
Utica, NY
Coding Auditor and Educator - Full Time - Days
Department: MEDICAL GRP ADMIN
Job Summary
The Medical Group Coding Auditor and Educator is responsible for auditing clinical documentation and coding practices to ensure accuracy, compliance, and adherence to national standards. This role involves educating both medical coders, providers and staff on coding best practices, documentation requirements, and payer‑specific guidelines. The Auditor will apply expertise in coding principles, identify areas for improvement, and provide training to enhance the skills of both coders and healthcare providers.
Core Job Responsibilities
Perform thorough reviews of coded claims, ensuring compliance with ICD‑10, CPT, HCPCS, HIPAA, HITECH and other coding standards and payer‑specific requirements.
Identify coding errors, documentation inconsistencies and discrepancies in claims submitted for reimbursement. Coach and educate coders and providers.
Conduct detailed audits on medical records and...