Physician Audit-Educator (4332)

Position Summary:

The Physician Audit Educator supports the accuracy, integrity, and compliance of provider documentation through comprehensive chart audits and targeted education. This role conducts both prospective and retrospective medical record reviews to ensure alignment with federal, state, and payer regulations, as well as Trinity Health documentation standards. Working collaboratively with providers and clinical leaders, the Physician Audit Educator delivers individualized and group education on documentation practices, coding requirements, and regulatory updates to support accurate reporting and high-quality clinical documentation. Through data analysis, trend identification, and support of payer audit responses, this position contributes to continuous improvement efforts that strengthen organizational compliance and documentation excellence.

Key Responsibilities:

• Perform detailed audits of provider documentation, evaluating adherence to regulatory requirements, coding guidelines, and organizational standards.
• Develop and deliver one-on-one and group education sessions for providers, using phone, virtual platforms, or in-person meetings to improve documentation and coding accuracy.
• Analyze audit findings, prepare clear summaries, and communicate results to providers and leadership to support performance improvement efforts.
• Respond to payer audits by gathering documentation, reviewing findings, and collaborating with internal stakeholders to formulate appropriate responses.
• Create, update, and maintain specialty and provider specific tip sheets, training materials, and educational programs.
• Collaborate with compliance, revenue cycle, and clinical teams to monitor trends, recommend corrective actions, and enhance documentation quality across the organization.

Licenses and Certifications Required:

• Certification as a Professional Coder (CPC) or Certified Evaluation and Management Coder (CEMC) from the American Academy of Professional Coders (AAPC), or Certification as a Clinical Coding Specialist Physician (CCSP) through American Health Information Management Association.

Educational Requirements:

• Associates degree preferred

Experience Requirements:

• Three (3) years of professional fee coding/auditing experience

Special Skills or Training Requirements:

• Demonstrated advanced communication and interpersonal skills
• Excellent written and oral communication skills
• Self directed, attention to detail, proficient in Microsoft Office Suite applications including Outlook, Word and Excel

Physical Requirements:

The Physician Audit Educator primarily performs sedentary work involving prolonged periods of sitting, computer use, and detailed document review. Occasional walking, standing, and light lifting of files, training materials, or office supplies may be required. Adequate vision, hearing, and manual dexterity are essential for reviewing electronic records, conducting virtual or in-person education sessions, and preparing documentation.

Environmental Requirements:

This role functions in an office or remote work environment with extensive computer-based tasks and frequent virtual communication. Occasional travel to clinical sites may occur for in-person education or meetings. The position requires managing multiple deadlines, adapting to regulatory changes, and following organizational privacy and security standards to protect sensitive information.