Professional Fee Coding Auditor & Educator

Employment Duration: 3 months (w/ strong potential for extension)

The Patient Records Abstractor 4 fulfills a role as a Medical Coder for UCSF's physician practices. This position reviews patient records, discharge summaries, operative reports, and other clinical documentation to assign standardized codes for diagnoses, procedures, and services. The role applies national and international coding classifications to ensure records accurately reflect the care delivered, supporting compliant reimbursement and reliable clinical data.

This position also serves as a Coding Educator responsible for providing education and training for physicians, staff, and other providers on professional fee coding and clinical documentation standards. Responsibilities include conducting coding quality reviews, analyzing findings, and providing follow-up education to coding staff and providers. The incumbent outlines and annotates applicable laws and coding compliance mandates and delivers written and verbal training, teaching, and policy guidance.

The role operates within a healthcare records or billing team and requires close collaboration with clinicians, clinical coders, and administrative staff to resolve documentation queries. The incumbent is expected to maintain current knowledge of coding updates, compliance requirements, and professional standards while participating in regular audits to monitor coding quality and support process improvements.

• Conduct coding quality reviews and provide education to coding staff based on audit findings.
• Provide ancillary supervision of coding quality activities related to coding and charge edit resolution.
• Perform physician education reviews to ensure quality and consistency of documentation and adherence to state and federal guidelines.
• Consult with and educate providers on coding practices and conventions.
• Provide feedback to providers regarding coding accuracy and clinical documentation of services performed.
• Serve as the primary liaison with providers and clinical departments for clarification of documentation deficiencies and coding questions.
• Mentor and assist in training coders.
• Participate in the development of coding policies and procedures.
• Research and develop presentation materials for continuing education programs for physicians and staff.
• Identify coding and edit trends and recommend opportunities for improvement.
• Prepare teaching and training presentations, handouts, analyses, and tip sheets for providers and staff.
• Research annual CPT and ICD-10 updates and collaborate with Revenue Integrity to update the Charge Description Master (CDM).
• Assess the impact of coding changes on reimbursement and coordinate training for impacted staff and faculty.
• Complete pre- and post-payment audit reviews to identify reimbursement impacts related to coding changes.
• Conduct wRVU impact analyses for annual CMS and AMA CPT code updates and provide reporting to management and department leadership.
• Collaborate with Revenue Managers to support coding quality and provide input regarding coder performance concerns.
• Assist in the creation of department-wide coding and compliance policies and procedures.
• Participate with the FPO Revenue Manager Team to support operational improvements and department initiatives.

Required Qualifications:

• Certified Professional Coder (CPC), Certified Coding Specialist - Physician Based (CCS-P), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or equivalent licensure as evaluated by FPRMO management.
• Certified Professional Coder in good standing with AAPC or AHIMA, with maintenance of required continuing education credits.
• Minimum of 5-7 years of demonstrated coding experience, including training experience, or an equivalent combination of education and experience.
• Demonstrated advanced knowledge of medical terminology, CPT, ICD-10 coding conventions, and clinical documentation requirements.
• Knowledge of federal, state, and commercial carrier coding and billing standards.
• Strong analytical and communication skills.
• Ability to complete required training related to UCSF Medical Center computer systems and coding and billing applications, including partner hospital billing systems as applicable.
• Prior experience in a healthcare-related setting.

Preferred Qualifications:

• Bachelor's degree in a related field and/or equivalent experience or training.
• Prior experience in an Academic Medical Center.
• Prior experience with Epic.
• Prior experience with Encoder Pro.

Required Qualifications:

• Certified Professional Coder (CPC), Certified Coding Specialist - Physician Based (CCS-P), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or equivalent licensure as evaluated by FPRMO management.
• Certified Professional Coder in good standing with AAPC or AHIMA, with maintenance of required continuing education credits.
• Minimum of 5-7 years of demonstrated coding experience, including training experience, or an equivalent combination of education and experience.
• Demonstrated advanced knowledge of medical terminology, CPT, ICD-10 coding conventions, and clinical documentation requirements.
• Knowledge of federal, state, and commercial carrier coding and billing standards.
• Strong analytical and communication skills.
• Ability to complete required training related to UCSF Medical Center computer systems and coding and billing applications, including partner hospital billing systems as applicable.
• Prior experience in a healthcare-related setting.

Preferred Qualifications:

• Bachelor's degree in a related field and/or equivalent experience or training.
• Prior experience in an Academic Medical Center.
• Prior experience with Epic.
• Prior experience with Encoder Pro.