Medical Coding Auditor/Educator
Zarminali Pediatrics is building the nation's leading pediatric multispecialty group, focused on supporting families to shape healthy futures for their children – from birth through adulthood – by completely transforming the way pediatric care is delivered nationwide. We are tackling today's challenges of increased administrative burden on clinicians and a siloed approach to pediatric care through intentional design of care delivery, enhanced by leading technology and collaborative, expert care teams.
Our name, inspired by our founder's daughter's name – Zarmina – means “something that is more precious to you than gold”. We couldn’t think of anything that better represents the way parents and caregivers hold the relationship with their children as the most valuable gift, and how we at Zarminali approach care for each child with equal reverence.
We strive for a healthier future for pediatric patients and a happier future for pediatric clinicians nationwide, and we are looking for people to join us in achieving this vision. If you are eager to join a growth stage company and be part of the early team that is shaping the foundation of both the company and the delivery of pediatric care, then this opportunity might be for you!
The Medical Coding Auditor/Educator plays a key role in ensuring coding accuracy, documentation integrity, and regulatory compliance across Zarminali Pediatrics' growing multi-state network. This individual partners closely with providers and operational leaders to improve documentation quality, reduce compliance risk, and support accurate reimbursement through comprehensive coding audits and targeted provider education.
This role combines technical coding expertise with a passion for education, serving as a trusted resource for providers by translating audit findings into actionable coaching, training, and process improvements. The ideal candidate is analytical, collaborative, and committed to driving continuous improvement while supporting exceptional patient care.
WHAT YOU'LL NEED
- Conduct pre-bill and post-bill audits of ICD-10-CM, CPT, and HCPCS Level II coding to ensure accuracy, compliance, and appropriate reimbursement.Review provider documentation for completeness, specificity, and medical necessity while identifying documentation improvement opportunities.
- Audit Evaluation & Management (E/M) coding using current Medical Decision Making (MDM) and time-based guidelines.
- Evaluate modifier usage and identify coding trends, compliance risks, and opportunities for provider and coder education.
- Design, perform, and maintain routine coding audits across multiple specialties, providers, and markets.
- Maintain audit documentation, coding accuracy scorecards, and audit reports while supporting internal and external compliance reviews.
- Develop and deliver one-on-one and group education sessions focused on coding accuracy, documentation best practices, and regulatory compliance.
- Create coding resources, tip sheets, educational materials, and training programs for providers and operational teams.
- Support onboarding and ongoing coding education for new and existing providers.
- Partner with Revenue Cycle, Clinical, and Operational leaders to improve documentation workflows, optimize templates, and support coding automation and AI initiatives.
- Analyze coding quality metrics, audit trends, denial patterns, and provider performance, presenting findings and recommendations to leadership.
- Ensure compliance with CMS, AMA, HIPAA, payer-specific regulations, and organizational policies.
- Effectively communicate findings and recommendations through virtual meetings, phone, and written communication.
- Support a multi-state organization by managing competing priorities and meeting audit deadlines.
WHAT YOU'LL NEED
- 3+ years of professional medical coding experience with coding audits, provider education, or documentation improvement experience.
- Pediatric, behavioral health, therapy, or multi-specialty healthcare experience preferred.
- Active coding certification (CPC, CCS, CCS-P, or equivalent) required.
- CPMA certification preferred or willingness to obtain within six months of hire.
- Strong knowledge of CPT, ICD-10-CM, HCPCS Level II, NCCI edits, modifier usage, and Evaluation & Management (E/M) coding.
- Experience interpreting complex clinical documentation and applying coding guidelines accurately.
- Strong analytical skills with the ability to identify trends, root causes, and process improvement opportunities.
- Excellent presentation, facilitation, and communication skills with the ability to educate clinicians and provide constructive feedback.
- Strong organizational skills with the ability to manage multiple priorities while maintaining a high level of accuracy.
- Comfortable working independently while collaborating across clinical, operational, and revenue cycle teams.
- Ability to work flexible hours when needed to support multiple markets and provider schedules.
WHAT WE OFFER
- Competitive compensation, comprehensive medical, dental, and vision insurance, company-paid life insurance, 401(k) with company match and generous paid time off and company holidays
- Collaborative, mission-driven culture focused on improving pediatric healthcare
- Opportunity to make a direct impact on provider performance, compliance, and patient care across a rapidly growing organization
At Zarminali Pediatrics, we are committed to our empowering clinicians and team members to deliver better pediatric care, altogether. This commitment requires building an inclusive culture and a team that represents the diverse communities we serve.
We believe that when people from all backgrounds, experiences, and perspectives come together, we create a stronger team and better care for our patients and their families. We realize the importance of an environment where clinicians and team members feel cared for, supported, and valued. We believe in the basics: treating everyone with kindness, respect, and fairness.
We do not tolerate discrimination or harassment of any kind. This includes, but is not limited to, race, color, sex, gender, age, religion or religious creed, national origin, ancestry, citizenship, marital status, sexual orientation, gender identity, gender expression, genetic information, physical or mental disability, military or veteran status, or any other characteristic protected by law.
We recruit and hire based on skills, talent, and potential, ensuring everyone has a fair chance to succeed. Together, we strive to build an inclusive and welcoming space where we can achieve our goal of building a happier future for the pediatric workforce.
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