The Quality Educator is responsible for developing, delivering, and maintaining comprehensive education programs that support coding accuracy, compliance, and documentation quality across Kaleida Health Enterprise. This role leads onboarding for new physicians, provides targeted education following audit results, and ensures providers and coders fully understand identified issues and required corrective actions. The Quality Educator plays a key role in promoting operational excellence, reducing compliance risks, and supporting organization-wide adherence to federal, state, and payer-specific regulations.
Essential Functions
Audit-Based Education & Communication
- Communicates audit findings clearly and professionally to departments, coders, providers, and workforce members to ensure full understanding of identified issues.
- Conducts training sessions following audits to support operational improvement and correct deficiencies.
- Assists in developing corrective action plans (CAPs) and performs follow-up assessments to verify successful implementation.
- Collaborates with Quality leadership to align educational strategies with audit outcomes and compliance needs.
Provider & Coder Education
- Leads onboarding education for new physicians, including documentation standards, coding expectations, regulatory requirements, and organizational workflows.
- Provides ongoing training to coders and providers in areas including coding accuracy, documentation improvement, billing compliance, and payer rule interpretation.
- Develops and delivers general and specialized training sessions to address identified problem areas, trends, and compliance risks.
- Serves as a subject matter expert and resource for coding, documentation, billing, and reimbursement questions.
Program Coordination & Compliance Support
- Assists with creating, updating, and disseminating educational materials, policies, workflows, and job aids.
- Tracks, monitors, and evaluates the effectiveness of training programs through feedback, audit trends, and performance metrics.
Cross-Department Collaboration
- Engages Clinical Documentation Improvement (CDI), Coding, Compliance, Revenue Cycle, and physician leadership to align education with organizational needs.
- Supports interdisciplinary initiatives aimed at reducing denials, improving documentation quality, and enhancing coding accuracy.
- Ensures consistent educational messaging and standards across all affiliated entities (Kaleida Health, UAHS, GPPC).
Education and Experience/Certification or License
Education: Degree in Healthcare Administration, Health Information Management, Nursing, Education, or a related field required.
Work Experience
- Five (5) to seven (7) years of experience in medical coding, provider education, clinical documentation improvement, or healthcare compliance.
- Experience conducting training for physicians or coding staff is highly preferred.
- Prior involvement in audits, audit response, or regulatory compliance initiatives is desirable.
Certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Professional Medical Auditor (CPMA), Certified Healthcare Compliance (CHC), or AHIMA certifications (RHIT/RHIA). Must maintain all required professional certifications and credentials in good standing throughout employment.
Knowledge, Skills and Abilities
- Strong working knowledge of ICD-10, CPT, HCPCS, E/M guidelines, and documentation standards.
- Maintains current knowledge of coding standards and regulatory requirements through regular self-directed education and professional development.
- Ability to translate complex audit findings, coding rules, and compliance regulations into understandable educational content.
- Skilled in creating engaging presentations and leading effective training sessions for diverse audiences.
- Strong communication skills with the ability to influence and instruct physicians, providers, and operational staff.
- Ability to identify coding/documentation gaps and recommend targeted educational interventions.
- Highly organized, with strong attention to detail and the ability to manage multiple training programs simultaneously.
- Proficiency in Microsoft Office Suite, especially PowerPoint, Excel, and Teams. Professional demeanor with the ability to build rapport and credibility across multiple entities.
Physical Requirements/Working Conditions
This position may require occasional travel for meetings or training sessions
Our Billing Co. offers a competitive benefits package.
Pay range: $80,000 - $100,000
Individual annual salaries/hourly rates will be set within job's compensation range, and will be determined by considering factors including, but not limited to market data, education, experience, qualifications, and experience, qualifications, and expertise of the individual and internal equity considerations.
This position requires constant sitting in an office environment. Employees may be asked to occasionally perform other movements or physical tasks. Workplace accommodations may be available for employees in accordance with the Americans with Disabilities Act.