85 coding auditor jobs found

Job Description Job Description Hybrid-Sunrise, Florida Position Summary: The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through post payment medical records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines and regulatory and contract requirements. Essential Duties and Responsibilities: Performs post payment medical record review audits of claims payments to identify potential fraud, waste, abuse and/or overpayment. Completes and maintains detailed documentation of audits including but not limited to coding guidelines reviewed, medical necessity documentation, decision methodology, and monetary discrepancies identified. Coordinates overpayment recoveries with the Fraud Investigative Unit Manager. Responsible for assisting the Fraud...

Physician Coding Auditor The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. Orlando Health proudly embraces and honors the individuality of our team members. By sharing different ideas and perspectives and working together as a team, we are better able to relate to, care for and authentically serve our patients and families who make up the collective...

Overview Certified Medical Coder required (AHIMA, AAPC, or PMI). Hybrid-Sunrise, Florida The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through post payment medical records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines and regulatory and contract requirements. Essential Duties and Responsibilities Performs post payment medical record review audits of claims payments to identify potential fraud, waste, abuse and/or overpayment. Completes and maintains detailed documentation of audits including but not limited to coding guidelines reviewed, medical necessity documentation, decision methodology, and monetary discrepancies identified. Coordinates overpayment recoveries with the Fraud Investigative Unit Manager. Responsible for assisting the Fraud...

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

Physician Coding Auditor The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. Orlando Health Is Your Best Place to Work is not just something we say, it's our promise to you. Orlando Health proudly embraces and honors the individuality of our team members. By sharing different ideas and perspectives and working together as a team, we are better able to...

A healthcare organization is seeking a Physician Coding Auditor to perform coding audits, ensuring compliance and efficiency. The role involves analyzing physician and coder charges, monitoring audit results, and collaborating with education teams. Candidates must have a high school diploma, coding certification, and at least 5 years of professional coding experience. Strong communication and organizational skills are essential. The position is remote, allowing flexibility in work location. #J-18808-Ljbffr

Overview Department : Patient Accounting- Physicians Status : Full Time Shift : Remote Location : Orlando, FL Title : Physician Coding Auditor Summary : The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the governing compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for surgical, procedural and E/M based coding. Responsibilities Responsible for internal auditing and analyzing professional coding for all service lines. Monitor the audit results closely to identify any potential coding inaccuracy. Provide the Educators the needed support in identifying coding errors. Provide results or trends with Education Team for physician education. Review medical records to ensure coding accuracy. Identify and communicate physician documentation and coding opportunities for improvement. Provide feedback to...

About the job Medical Record Audit / Coding Auditor 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 monitoring and review...

Position Summary Department : Patient Accounting- Physicians Status: Full Time Shift: Remote Location: Orlando, FL Title: Physician Coding Auditor Summary: The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding. Forbes has named Orlando Health as one of America's Best-In-State Employers. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. "Orlando Health Is Your Best Place to Work" is not...

A leading healthcare system based in souther Florida is now seeking an experienced Remote Medical Coding Auditor to join their award-winning healthcare organization!Regarded as a leading healthcare provider in the vibrant region of South Florida, this renowned hospital system encompasses a network of expansive facilities known for delivering outstanding medical services and excellent patient care.The organization boasts a comprehensive range of healthcare services, including state-of-the-art emergency care, advanced surgical procedures, and specialized medical practices across various fields.Recognized for its commitment to excellence, the network has achieved numerous awards for quality, safety, and patient satisfaction, reflecting its dedication to healthcare innovation and community wellness.The Remote Medical Coding Auditor is responsible for leading the continuous improvement of the inpatient coding staff.Responsibilities include leading complex coding audits, assess coding...

Sage Clinical RCM, LLC is seeking an experienced Outpatient Coding Auditor with a strong background in surgical coding. This role is responsible for auditing outpatient surgical encounters to ensure accurate code assignment, compliance with regulatory guidelines, and adherence to payer and client requirements. The ideal candidate has hands‑on experience auditing complex outpatient surgical cases and providing clear, constructive feedback to coding staff. Key Responsibilities Perform audits of outpatient surgical encounters, including operative reports and related documentation. Validate accurate assignment of CPT, ICD‑10‑CM, modifiers, and applicable APCs. Ensure compliance with CMS, payer, and official coding guidelines. Identify trends, risks, and educational opportunities based on audit findings. Provide written audit feedback and coding education to support quality improvement. Collaborate with coding leadership and quality teams to address identified issues Maintain...

A healthcare auditing firm in Florida is looking for an experienced Outpatient Coding Auditor to ensure compliance with coding standards and regulatory guidelines. The role involves auditing outpatient surgical encounters to guarantee proper code assignment while providing essential feedback to coding staff. Candidates should have over 3 years of auditing experience in surgical specialties, strong analytical skills, and a relevant coding credential. Familiarity with coding tools is preferred. This position offers a vital role in enhancing coding quality and accuracy. #J-18808-Ljbffr

A healthcare organization in Sunrise, Florida is seeking a Certified Medical Coder to conduct audits related to potential fraud, waste, and abuse. The role involves post-payment medical records reviews to ensure compliance with coding guidelines. Candidates must have medical coding certification and knowledge of Medicaid rules. The position offers a hybrid work schedule and requires strong analytical and communication skills. #J-18808-Ljbffr

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. All the benefits and perks you need for you and your family: 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:...

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 25 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2024-2025 & 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 that extend beyond...

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. All the benefits and perks you need for you and your family: 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:...

A leading health care organization in Pensacola is seeking a Compliance Auditor to audit outpatient services claims. This entry-level role requires a Bachelor's Degree in Health Information Management and 5 years of healthcare experience. You will analyze records for compliance and educate staff on coding practices. The ideal candidate has excellent communication skills and a strong attention to detail. This position offers the opportunity to significantly impact healthcare compliance and reimbursement. #J-18808-Ljbffr

Job Title HIM Coding/Compliance Auditor 2 Department Health Information Management Location 1611 NW 12 Ave, Miami, FL 33163 Shift Details Monday to Friday, Days. This is a remote position and is only open to candidates in Florida. Summary The HIM Coding/Compliance Auditor 2 analyzes abstracted, coded data for the purpose of ensuring coding accuracy. Serves as a resource for expert knowledge in coding and documentation requirements. Performs coding audits on inpatient and outpatient coders, reviews SMART edits, external coding audits, claim denials and audits from insurance companies, as well as, any other coding audits. Works very closely with the CDI Department. Must be an expert on ICD-9 and CPT Coding systems. Must have ICD-10 knowledge. Responsibilities Performs internal coding audits on inpatient and outpatient coders providing feedback and re-training as required. Reviews findings from external coding audits for validity of DRG assignment and provide responses if...

Location: Remote Position Pay Range: $20.78 - $36.53 Position Summary: Responsible for performing E/M audits, summarizing the results, communicating the outcomes to all parties and completing any follow up or educational needs as required. Responsible for the review and completion of email requests in a timely manner as well as reviewing and completing ticket requests. Assigned list review and update in a timely and accurate manner. Contributes to the completion of government audits when requested. Key Performance Areas: Provide coding support for physicians. Provide coding support for Claims Resolution Specialists. Meet with Manager to discuss coding trends and report any coding issues. Attend seminars and training sessions and report any changes or concerns to Manager/Compliance Officer. Maintain and ensure the confidentiality of all patient and employee information at all times. Assist in training new employees to related job duties. Will be...

About the Job Position Highlights: Compliance Auditors conduct Compliance Department audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including detection and correction of documentation, coding, and billing errors. The Compliance Auditor evaluates the adequacy and effectiveness of controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to professional or hospital documentation, coding and billing, and federal and state regulations and guidelines. The Compliance Auditor communicates audit results to physicians, physician leadership, senior management, management, and staff and provides physician and coder education. The Compliance Auditor will act as a liaison with assigned faculty members, developing relationships and functioning as a resource to all providers and their staffs and will serve as an...

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...

Medical Coder Educator - USFTGP UMSA RCO Back End Serves as the coding reviewer and documentation educator for USFTGP Revenue Cycle Operations. Collaborate extensively with compliance; utilizing approved coding industry tools and approved internal documentation. This position is responsible for providing coding literacy and awareness using adult methodologies to revenue cycle, coding professionals, department managers, medical staff and others, ensuring proficiency is accurate and within compliant coding practices for billing. Analyze and report review findings indicating documentation gaps reimbursement and data internation, inpatient, outpatient and professional service coded. Report to compliance focused areas of improvements, recommendations and actions taken to improve medical staff knowledge and coding accuracy. Conduct individual and group coding and documentation support instructions as assigned and acts as an internal coding expert resource. Qualifications Required:...

Outpatient 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 Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance. Responsibilities For hospital encounters, routes to billing charge entry errors and/ or account edits preventing completion of coding and/or billing. Makes appropriate coding corrections when advised and follows procedure to notify billing. Reviews chargemaster generated CPT/HCPCS codes, when errors are found Coding Management is notified to alert Charge Management to educate department making errors. Makes appropriate coding corrections when advised and follows...

Summary Position is located in the Health Information Management (HIM) section at the Business Office at the Bay Pines VA Healthcare System (BPVAHCS). MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi­specialty clinics, and specialty centers. Responsibilities Duties and task of the Medical Records Technician (Coder) - Auditor include, but are not limited to the following: Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection. Reviews assigned codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural Terminology...