14 coder auditor professional jobs found in Miami

Description Job Summary The Sr Billing Compliance Auditor serves as the liaison responsible for monitoring and auditing NCPS coding and documentation functions for professional fee services. Conducts independent ongoing reviews of vendor and provider-coded professional fee services to ensure practices meet federal requirements. Works closely with NCPS to communicate monitoring / auditing results and provide feedback to support necessary actions taken accordingly. Functions as the subject matter expert for professional fee coding and documentation, and partners with NCPS administrators to ensure consistent, compliant, and accurate coding practices. Job Specific Duties * Conducts audits of NCPS professional fee encounters to validate accuracy of CPT, HCPCS, ICD‑10‑CM, and modifier assignment. * Serves as the coding, documentation, and billing expert for NCPS, ensuring focused expertise on pediatric, Fl AHCA / Medicaid, and CMS regulatory requirements. * Monitors professional fee...

Physician Practice E&M Auditor Educator Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 26 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2025-2026 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 63 high-performing honors. What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful...

Medical Record Audit / Coding Auditor Miami, Florida, United States About the Job Our client is a contracting and data management services organization dedicated to primary care physicians throughout Florida. In this role you are responsible to assist in the development, undertaking and maintenance of a long term comprehensive, clinical coding audit program for inpatient and outpatient activity. To develop and implement policies to support the clinical coding audit function Receive, review and communicate findings on patient billing coding related complaints. Identify training needs through the audit program of work and liaise with the clinical coding training manager and audit manager to provide the necessary training identified Conduct routine, risk based, proactive or reactive compliance reviews of procedural and diagnosis coding/billing and medical record documentation performed by clinical service providers Prepare reports as required relative to these...

A healthcare services organization is seeking a Medical Record Audit / Coding Auditor to oversee the development of a clinical coding audit program. The role involves conducting compliance reviews, training coding associates, and ensuring adherence to coding regulations. Candidates must have at least five years of experience in physician coding and be a certified professional coder. This job offers an opportunity to impact billing accuracy and training processes within the organization. #J-18808-Ljbffr

Job Summary The Sr Billing Compliance Auditor serves as the liaison responsible for monitoring and auditing NCPS coding and documentation functions for professional fee services. Conducts independent ongoing reviews of vendor and provider‑coded professional fee services to ensure practices meet federal requirements. Works closely with NCPS to communicate monitoring/auditing results and provide feedback to support necessary actions taken accordingly. Functions as the subject matter expert for professional fee coding and documentation, and partners with NCPS administrators to ensure consistent, compliant, and accurate coding practices. Key Responsibilities Conduct audits of NCPS professional fee encounters to validate accuracy of CPT, HCPCS, ICD‑10‑CM, and modifier assignment. Serve as the coding, documentation, and billing expert for NCPS, ensuring focused expertise on pediatric, Florida AHCA / Medicaid, and CMS regulatory requirements. Monitor professional fee vendor‑coding...

NACBA is seeking a Senior Billing Compliance Auditor located in Miami, Florida. This role involves conducting audits of NCPS professional fee encounters, ensuring compliance with federal and state coding and documentation requirements. The ideal candidate will have at least 7-10 years of experience in coding and compliance, along with a Certified Professional Coder designation. Responsibilities include preparing audit trends, collaborating with administrators, and maintaining compliance standards. #J-18808-Ljbffr

Outpatient Coder 3 The University of Miami/UHealth Department Health Information Management has an exciting opportunity for a full-time Outpatient Coder 3 to work in Miami, FL. Under the general direction of the Outpatient Coding Manager, the Outpatient Coder 3 reviews documentation in the electronic medical record (EMR) and assigns and sequences ICD-10-CM diagnosis codes and CPT procedure codes in accordance with national coding guidelines. The primary focus of this role is to capture all encounter specific diagnoses and procedure codes for accurate reimbursement, data collection, and research purposes. Core Job Functions Review, analyze, and interpret the entire electronic medical record (EMR) to identify all diagnoses and procedures documented during a patient's admission. Guidelines and knowledge of anatomy and physiology, medical terminology, and disease processes. Reviews documentation and reaches out to physicians for additional information when information for proper...

MRA Coder The MRA Coder will be responsible for coordinating/supporting retrospective and concurrent chart reviews using knowledge of Hierarchical Condition Categories (HCC) coding to translate, input, extract and validate medical record data. Review patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries in order to verify whether the diagnosis codes are supported by the documentation to ensure they are within Guidelines for Coding and Reporting Schedule chart reviews with Physician practices Assist in obtaining medical records from Physicians to support audits requested by Health Plans Ensure compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment. Educate Physicians regarding proper billing and documentation policies, procedures, and conflicting/ambiguous or...

Job Description Job Description Benefits: 401(k) matching Competitive salary Dental insurance Health insurance Paid time off About Us We are a fast-growing, innovative medical billing company committed to transforming the healthcare revenue cycle through technology, transparency, and top-tier customer service. Our team is passionate about simplifying the complexities of medical billing so healthcare providers can focus on what matters most—patient care. We're seeking a highly motivated and experienced Charge Posting (Coder) Supervisor to join our leadership team and help us continue delivering exceptional results to our clients across the country. Job Overview As the Medical Coder Supervisor, you will lead group of certified coders to accurately review and approval encounters using industry coding guidelines, optimize workflow efficiency, and oversee a high-performing medical coding team. You'll be responsible for the training, on-going development, quality...

Miami, FL | Full-Time Health Information Management Department: Health Information Management Address: 1611 NW 12 Ave, Miami, FL 33136 Shift Details: Monday to Friday, 7.30 AM to 4 PM [Remote but open to applicants who reside in the state of Florida] Summary HIM Outpatient Coder 1 is responsible for coding and abstracting outpatient medical records, including Emergency Room visits, Clinic visits and Recurrent visits. The Coder 1 is responsible for reviewing the clinical documentation contained in the patient health record to accurately assign and sequence ICD-9 and CPT codes for use in reimbursement and data collection. Able to transition to ICD-10-CM. Responsibilities Codes outpatient diagnostics/outpatient clinics/recurring visits/emergency room visits using ICD-9 or CPT codes as appropriate. Maintains a yearly average accuracy rate of 94% during internal and/or external Coding audits. Verifies patient information to identify any discrepancies...

Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here (https://www.myworkday.com/umiami/d/task/1422$7248.htmld) to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER_eRecruiting_ApplyforaJob.pdf) . The University of Miami/UHealth Department Health Information Management has an exciting opportunity for a full-time Outpatient Coder 3 to work in Miami, FL. Under the general direction of the Outpatient Coding Manager, the Outpatient Coder 3 reviews documentation in the electronic medical record (EMR) and assigns and sequences ICD-10-CM diagnosis codes and CPT procedure codes in accordance with national coding guidelines. The primary focus of this role is to capture all encounter specific diagnoses and procedure codes for accurate reimbursement, data collection, and research...

Every day is a good day to prepare for a healthy tomorrow. Providing children and their families with equitable access to quality pediatric care to build a foundation for a lifetime of optimal health and wellness is what drives our team to deliver its best every day. It’s our purpose. Offering focused care from tots to teens, our pediatric primary care providers and teams partner with families to foster good health and strong, thriving communities. Second-to-none medical staff and top-tier administrative professionals keep our practices running smoothly and make each patient experience the best we can offer. Working in partnership with patients, families, and communities who put their trust in us for their care, we hold ourselves accountable to ensure equitable access to care, advocate to create impactful change, and continually learn and progress to create better outcomes and brighter futures. Together, we’re paving the way for kids to develop into healthy young...

Brief Description: Miami Jewish Health is one of the largest providers of healthcare and living options for aging adults in the Southeast. Our main campus is located on 20+ acres just north of mid‑town Miami and houses support departments such as Finance, Accounting, Human Resources, Marketing, and more. Join us to do purposeful work with a diverse and respectful team. Job Title: HCC Risk Adjuster and Coder Job Summary: Reviews medical records and accurately codes and sequences diagnosis in order to obtain maximum reimbursement. Essential Job Functions Audit PACE medical records to ensure accuracy upon enrollment and disenrollment, and assign appropriate HCC codes per established department guidelines. Perform follow‑up coding of medical records resulting from internal and external reviews that identify coding discrepancies. Meet with PACE providers via MS Teams to assist with documentation improvement tied to reimbursement. Assist with other department duties as...

Miami Jewish Health is seeking an HCC Risk Adjuster and Coder to review medical records and accurately code and sequence diagnoses to maximize reimbursement. The role requires a minimum of 1 year of HCC/ ICD-10-CM coding experience, an associate degree in health information management, and strong knowledge of medical terminology. You will audit PACE records, interface with providers via MS Teams, and support documentation improvement while maintaining confidentiality and accuracy. #J-18808-Ljbffr