Job Description

The E&M Multi-Specialty Auditor is responsible for conducting detailed reviews of Evaluation & Management (E&M) documentation, coding across various medical specialties. This role ensures compliance with CMS, AMA, and payer guidelines while supporting provider education and improving documentation quality. The auditor will analyze provider patterns, identify risks, and deliver actionable feedback to enhance revenue integrity and reduce compliance vulnerabilities.

Key Responsibilities

1. Coding & Documentation Audits

Conduct routine and complex audits of E&M services across multiple specialties, including (but not limited to) Internal Medicine, Cardiology, Orthopedics, Gastroenterology, Surgery, Neurology, Pediatrics, Pulmonology, and Emergency Medicine.

Review provides documentation for accuracy, completeness, and compliance with 2021 E&M guidelines (MDM and Time-based) and 2023 E&M guidelines changes.

Validate ICD-10, CPT, and HCPCS coding accuracy.

Identify under-coding, over coding, unbundling, and documentation gaps.

Analyze risk areas such as modifiers, MDM elements, time documentation, split/shared services, and telehealth compliance.

2. Education & Feedback

Provide detailed feedback to providers, coders, and operational teams regarding findings and improvement areas.

Develop customized training for providers on documentation standards, coding changes, and specialty-specific requirements.

Create educational materials (tip sheets, job aids, coding reference tools).

3. Compliance & Regulatory Monitoring

Stay current with CMS, AMA CPT, OIG, NCCI, and payer-specific regulations.

Assist with internal and external audits and help develop corrective action plans.

Monitor trends in documentation and coding to identify compliance risks.

Always Ensure HIPAA compliance and proper handling of PHI.

4. Reporting & Analysis

Prepare audit summaries, dashboards, and detailed reports with actionable recommendations.

Track provider performance, recurring errors, and documentation improvement trends.

Participate in quality assurance processes to validate coder accuracy and consistency.

5. Collaboration

Work closely with coders, revenue cycle teams, compliance staff, and providers.

Participate in meetings with internal leadership and specialty departments.

Support new initiatives such as EHR upgrades, charge capture improvements, and workflow optimization.

Required Qualifications

2+ years of experience in multi-specialty coding. Expertise in 2021 E&M guidelines (AMA and CMS). Strong knowledge of ICD-10-CM, CPT, HCPCS, modifiers, and NCCI edits. Proficiency with EMR/EHR systems such as Epic, Cerner, Meditech, Athena, or similar. Ability to interpret complex documentation and identify discrepancies. Strong analytical, communication, and reporting skills.

Preferred Qualifications

Certification is not mandatory. Experience auditing multiple specialties in a provider or hospital setting. Familiarity with payer policy variations and risk-based auditing. Experience providing provider education and leading training sessions.

Core Competencies

Exceptional attention to detail Strong critical thinking and clinical understanding High-level written and verbal communication Ability to deliver constructive feedback respectfully Advanced understanding of regulatory and payer guidelines Ability to meet productivity and quality goals independently

Work Environment

Work involves extensive review of digital documentation. Meetings and educational sessions with providers and leadership. Onsite.
Job Types: Full-time, Permanent

Pay: ?25,000.00 - ?40,000.00 per month

Benefits:

Leave encashment Paid sick time Paid time off
Work Location: In person