71 clinical coding auditor educator jobs found

Overview Baptist Health is the region’s largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 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 25 years, we’ve been named one of Fortune’s 100 Best Companies to Work For, and in the 2024-2025 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 45 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 relationships with patients and their families...

A leading not-for-profit healthcare organization in Florida seeks an experienced E&M Coding Auditor/Educator. You will be responsible for conducting comprehensive audits to ensure the integrity of coding and billing for clinical fees and develop educational programs based on the audit results. The ideal candidate must possess certifications in coding, have at least 4 years of relevant experience, and excel in customer service. A robust understanding of E&M regulations is essential. Competitive hourly pay of $26.13 - $33.97 is offered. #J-18808-Ljbffr

Job Description Job Description Description: At Sage Clinical RCM, you'll code high-acuity inpatient encounters across a national portfolio of health systems, from academic medical centers to community hospitals. No two client environments are identical, and that's the point. You'll sharpen your skills across specialties, payers, and documentation styles instead of coding the same census for years. What You'll Do Review inpatient encounters and assign accurate ICD-10-CM/PCS codes and DRGs that hold up to audit. Read documentation critically. When it doesn't support the coded services, flag it and escalate the gap. Code in full compliance with CMS requirements, payer-specific rules, and official coding guidelines. Move confidently between client workflows, systems, and audit expectations. Hold the line on quality (95% accuracy or better) while meeting realistic productivity standards. Requirements: What You Bring Active RHIA, RHIT, and/or CCS credential....

Job Description Job Description Description: Role Summary Responsible for reviewing medical records and assigning accurate CPT, HCPCS, ICD-10-CM, and appropriate modifiers for outpatient services. This role supports compliant coding and consistent performance across a variety of outpatient encounter types. Core Responsibilities Review medical records and assign accurate CPT/HCPCS, ICD-10-CM, and modifiers. Ensure documentation supports coded services and identify/escalate discrepancies or gaps. Ensure compliance with CMS, payer-specific rules, and official coding guidelines (including NCCI edits). Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards. Requirements: Minimum Qualifications Credentials: CPC, CCS, RHIA, or RHIT (active). Experience: Minimum 3+ years outpatient coding experience across multiple outpatient service types. Skills & Knowledge: Strong knowledge of CPT, HCPCS, ICD-10-CM,...

Job Description Job Description Description: The Professional Fee (ProFee) Coder is responsible for reviewing provider documentation and assigning accurate CPT, HCPCS, and ICD-10-CM codes for physician services. This role supports compliant coding, accurate charge capture, and overall revenue integrity across a variety of specialties and client environments. Coders may support single-specialty or multi-specialty engagements depending on client needs and experience. Requirements: Core Responsibilities (Sage Standards) Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes Ensure documentation supports coded services and identify discrepancies Apply appropriate modifiers, NCCI edits, and payer-specific coding rules Ensure compliance with CMS, AMA, and payer guidelines Maintain =95% coding accuracy and meet established productivity standards Identify documentation gaps and escalate for clarification when needed Participate in quality...

Join Our Caring Community Become a part of our caring community and help us put health first. The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS...

Job Description Job Description Description: Summary/Objective: Obtain accurate reimbursement for healthcare claims. Essential Functions Reviews and resolves all assigned charges thoroughly based on coding guidelines, chart documentation and related charges in billing system. Audits task manager work files with charges reviewed by Claims Manager that were found to have coding errors/omissions. When appropriate communicates approved coding changes and/or questions to Physician’s and their office staff. Also alerts providers of missing or late charges. Alerts management to coding trends discovered while working daily charges/edits. Stays informed and up to date on coding issues by attending seminars. Possesses a comprehensive understanding of carrier specific State of Florida billing guidelines. Consistently stays within the department production goal set for your area Requirements: Required Education and Experience: High School Graduate or Equivalent. Must be a...

Job Description Job Description Description: Precision Healthcare Specialists is seeking an experienced and detail-oriented Certified Medical Coder to support our ENT & Allergy Specialists division. The Certified Medical Coder is responsible for accurately reviewing provider documentation and assigning appropriate diagnosis and procedure codes for otolaryngology, allergy, audiology, and related services. This role plays a critical part in ensuring coding accuracy, regulatory compliance, clean claim submission, and optimal reimbursement. The ideal candidate will possess strong knowledge of ICD-10, CPT, and HCPCS coding guidelines, have experience coding specialty physician services, and demonstrate exceptional attention to detail in a fast-paced healthcare environment. Essential Duties and Responsibilities Review and accurately code physician documentation, office visits, procedures, diagnostic testing, and surgical services. Assign ICD-10-CM, CPT, and HCPCS codes in...

Become a part of our caring community Become a part of our caring community and help us put health first The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating...

Join Our Caring Community Become a part of our caring community and help us put health first. The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS...

Coding Specialist Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts pertinent data points for billing and quality reviews. Communicates with various departments as needed to ensure accuracy of patient data. Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing). May assign and sequence basic CPT...

IPA Consultative Coding Professional Become a part of our caring community and help us put health first. The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating...

Job Description Job Description Location: Miami, FL (On-site preferred; Hybrid/Remote may be considered) Employment Type: Part-Time (25–35 hours per week) About the Position We are seeking an experienced Senior Medical Coding Auditor (CPC) to join our growing multi-specialty medical practice specializing in Primary Care and Gynecology . The ideal candidate will be responsible for reviewing clinical documentation before claims are submitted to ensure accurate coding, appropriate E/M level selection, documentation compliance, and optimal reimbursement while maintaining full regulatory compliance. This position works closely with providers, clinical staff, and the billing department to improve documentation quality, reduce claim denials, maximize appropriate reimbursement, and ensure coding accuracy. Primary Responsibilities Review approximately 300 provider notes per week for coding accuracy and documentation compliance prior to claim submission. Validate...

Medical Coding SpecialistAt Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.Location:Miramar, FloridaSummary:Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance.Responsibilities:Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category),...

Description Join the Team at PedIM Healthcare! Delivering exceptional care, together. Who We Are PedIM Healthcare is the first private medical office of its kind in Citrus County – offering top-quality care for children, adults, and seniors all under one roof. We provide pediatric, adult internal medicine, family practice, geriatrics, women’s care, medical weight‑loss, sleep‑medicine services and more. Our dedicated, community‑focused team is committed to excellence, pride in service, and making a real difference for patients and families across Citrus County. Why Work With Us? A broad, multi-discipline practice where you can grow: pediatrics, internal medicine, weight‑loss & sleep medicine specialties. A values‑driven environment: we listen, we help, we understand—and we care. Community‑oriented and recognized: voted “best of the best” in the region. Opportunity to make a meaningful impact by supporting patients over their full life span—from children to seniors. A...

Coding Auditor The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals. Responsibilities Reviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment Informs manager of any activities which do not meet federal or state coding and billing requirements Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and responds...

Porter is hiring a Risk Adjustment Coder to join our Team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home health...

Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. The Patient Safety DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients. Specializes in...

Physician Billing & Coding Specialist I The Physician Billing & Coding Specialist I is responsible for supporting the professional billing lifecycle, including physician coding, charge review and reconciliation, billing, and A/R follow-up. This role reviews clinical documentation for accurate ICD-10, CPT, and HCPCS code assignment; ensures compliance with regulatory and payer requirements; resolves patient and third-party account issues; and serves as a liaison between providers, payers, and patients to promote timely, accurate reimbursement. Education High school diploma or equivalent required Associate's or Bachelor's degree preferred (Health Information Management, Business, or related field) Experience Minimum of two (2) years' experience in healthcare coding, billing, patient accounting, or revenue cycle operations Hospital or physician billing experience preferred Certifications (Required) CPC, CCS-P, CCSP, or equivalent coding certification...

Our Promise to You Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. Benefits Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 3100 E FLETCHER AVE City: TAMPA State: Florida Postal Code: 33613 Job Description Performs quality reviews on coded...

Join Our Caring Community Become a part of our caring community and help us put health first. The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS...

Risk Adjustment Coder Porter is hiring a Risk Adjustment Coder to join our team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in...

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...

Health Information Management Coder Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities Reviews and validates accuracy of Admission-Discharge-Transfer (ADT) data fields; abstracts discharge disposition, physicians, procedure dates, and present on admission (POA) indicators. Maintains strict adherence to patient confidentiality according to MHS...