Job Description
A major healthcare system in Atlanta, GA is looking for an experienced Coding Educator to join their Coding Education and Quality team and be responsible for performing quality assurance reviews on professional billing coding, follow-up, and claims management activities. This individual will serve as an objective reviewer, auditing completed work to ensure coding accuracy, compliance, and consistency across the revenue cycle organization. The ideal candidate will have a strong foundation in Professional Billing coding, auditing, and AR follow-up. They will review completed accounts, provide detailed scoring and feedback, identify trends, and help improve overall coding quality across a department of more than 200 employees. This role requires someone who enjoys researching complex claims issues, identifying opportunities for improvement, and partnering with leadership to maintain coding excellence. This is a fully remote permanent position that offers an opportunity to help build and scale a growing QA function while driving accuracy and consistency throughout the revenue cycle.
Day-to-Day Responsibilities
- Perform quality assurance audits on professional billing coding, claims, and follow-up activities
- Review completed patient accounts to evaluate coding accuracy, compliance, and documentation support
- Score audited accounts and provide objective feedback based on established quality standards
- Analyze audit findings and identify trends, gaps, and educational opportunities
- Partner with coding, AR, and follow-up teams to improve overall quality performance
- Investigate complex coding and claim issues requiring detailed research and problem solving
- Navigate Epic to review documentation, account history, transactions, and claim activity
- Utilize Codify, Encoder Pro, and other coding resources to validate coding accuracy
- Assist leadership in expanding and supporting a growing QA auditing function
- Contribute to the development of auditing standards and best practices across the department
- Help ensure consistency and fairness in employee quality scoring by providing independent reviews
Must Haves
- Professional Billing (PB/Profee) coding experience
- PB Claims Auditing / Quality Assurance auditing experience
- CPC certification through AAPC
- Strong Accounts Receivable (AR) and Follow-Up experience
- Experience auditing and coding across multiple specialties
- Ability to review complex physician claims and identify coding, billing, and follow-up errors
- Recent revenue cycle experience (not significantly removed from coding/follow-up functions)
- Strong analytical and investigative mindset with the ability to research discrepancies
- High School Diploma or GED
- Ability to navigate complex patient accounts and workflows within Epic
Plusses
- Epic Professional Billing (PB) experience
- Coding Educator, Auditor, or Trainer background
- Experience using Codify and Encoder Pro
- Previous experience creating QA scorecards, audit reports, or coding education
- Experience working in large health system environments
- Long-term employment history within coding, auditing, or revenue cycle functions