Advantia Health · 3 hours ago
RCM CPC Auditor and Educator
United States
Full-time
Remote
Senior Level, Lead/Staff
10+ years expAdvantia Health is committed to providing unparalleled healthcare, and they are seeking an RCM CPC Auditor and Educator to audit and educate providers on coding and documentation. The role involves creating educational materials, conducting training sessions, and ensuring compliance with CMS guidelines while building relationships with external physicians.
Health CareHospitalWellness
Responsibilities
Comfortable and confident to communicate coding requirements to physicians/providers so that physicians understand what/how to document for the services they are performing
Audits and educates providers and coders on a quarterly schedule
Creates coding education curriculum to train providers how to document and understand how documentation relates to codes
Conducts virtual meetings with providers to provide one on one or group training and education
Creates an auditing system to effectively audit findings and deliver outcomes
Validates provider documentation for accuracy by reviewing and analyzing samples of coding and claims extracts compared to actual medical records
Develops education materials to assist physicians in accurately assessing patients’ overall health status
Provides feedback to providers on performance improvement opportunities; tracks and prioritizes projects to improve coding and documentation outcomes
Maintains a comprehensive tracking and management tool for assigned physicians within Advantia Health provider network
Identifies issues, and reports results timely to ensure that physicians remain in compliance
Presents progress and results to leadership on a routine basis
Assists with CMS Risk Adjustment Data Validation activities to ensure our external physicians and Alignment Healthcare is prepared for and will pass an audit
Regularly updates all Risk Adjustment materials with clinical and/or official guideline changes
Suggests, updates, and enhances clinical educational materials to assist in training physicians and clinical staff in Coding and Documentation including CMS Models, Clinician Chart Reviews, and Encounter Documentation
Suggest customizations of coding and documentation for various audiences; Support Staff, Providers, Specialists, and Employees
Stays current on industry coding, compliance and HCC issues
Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; and participating in professional societies
Qualification
Required
Proven experience as a CPC
Familiarity with all CMS guidelines
Working knowledge of MS Office and databases
Excellent communication and interpersonal skills
Ability to handle sensitive, confidential information
Self-starter, with the ability to work independently and resourcefully
2+ years of Athena experience and or super user
Certified Professional Coder and Registered Health Information Technician (RHIT)
At least 10 years in profee coding/auditing/education experience for OBGYN specialties: maternal fetal medicine, complex OB, Mammography. Needs strong surgical experience and E&M Leveling
5-7 years' experience within Revenue Cycle
Effective Communication, presentation and project management
Excellent problem solving, written and verbal communication skills, with the ability to clearly explain technical reasoning
Proficient experience in computer technology, including Microsoft word, PowerPoint and Excel
Strong Training and evaluative skills
Company
Advantia Health
Advantia Health is dedicated to helping women manage their health and the health of their families.
501-1000 employees
H1B Sponsorship
Advantia Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2022 (1)
Funding
Current Stage
Late StageTotal Funding
$167.98MKey Investors
Blue Mountain Capital ManagementDeerfield
2025-05-05Undisclosed· $4.96M
2024-07-10Series Unknown· $4M
2024-01-16Series Unknown· $82.72M
Leadership Team
Peter Glass
Co-Founder
Recent News
2025-09-02
SEC Filings
2025-05-20
Company data provided by crunchbase