73 coding auditor and 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

Medical Coder Educator - USFTGP Revenue Cycle Operations 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...

Medical Coder Educator - USFTGP RCOServes 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.QualificationsRequired:High School Diploma or...

Job Description Job Description Description: Role Summary Responsible for reviewing inpatient coding to validate accuracy, compliance, and documentation support. This role identifies risks, ensures consistency in DRG assignment, and provides actionable feedback to improve coding quality. Core Responsibilities Perform retrospective and/or concurrent audits of inpatient coding. Validate ICD-10-CM/PCS code assignment and MS-DRG/APR-DRG accuracy. Follow and adhere to AHIMA’s Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policies. Identify trends, risks, and opportunities for coding improvement. Provide clear, actionable audit feedback and education to client & internal coding staff. Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards. Requirements: Minimum Qualifications Credentials: CCS, RHIA, or RHIT (active). Experience: Minimum 3+ years of...

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...

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. Requirements: 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. 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, modifiers, and...

Job Description Job Description Description: 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...

Job Description Job Description 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...

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, womens 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 understandand 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 spanfrom...

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, womens 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 understandand 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 spanfrom...

Summary The Medical Record Technician (Coder) Auditor position is located in the Health Information Management (HIM) section at the Thomas H. Corey VA Medical Center. Medical Record Technician (Coder) Auditors hold a mastery level certification, able to perform all duties of a MRT (Coder), and serve as experts of medical coding conventions and guidelines related to professional and facility coding. Responsibilities PLEASE NOTE: This Medical Records Technician (Coder) Auditor position is not remote and requires physical presence on-site. The Medical Records Technician (Coder) Auditor is responsible for abstracting medical record data and assigning codes using current clinical classification systems appropriate for the type of care provided. Auditors serve as experts of current coding conventions and regulations related to professional and facility coding; perform audits of encounters to identify areas of non-compliance in coding; provide recommendation son appropriate coding; and...

Coding Auditor 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 Responsible for auditing coded inpatient or outpatient medical records applying ICD-10 CM/PCS and/or CPT-4. Reviews Ambulatory Payment Classification (APC), Medicare Severity Diagnosis Related Groups (MSDRG) and All Patients Refined Diagnosis Related Groups (APRDRG) assignment and queries following official coding guidelines and regulatory requirements. Provides training and education based on audit results and any regulatory changes that effect Federal, State and American Health Information Management Association (AHIMA) guidelines. Responsibilities Maintains thorough knowledge of ICD-10CM/PCS, and CPT coding principles and guidelines; possesses substantial...

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...

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, womens 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 understandand 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 spanfrom...

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 is home to our support departments like Finance, Accounting, Human Resources, Marketing and more. Join us now to do purposeful work with our 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 Audits PACE medical record to ensure accuracy, upon enrollment and disenrollment, and assigns appropriate HCC codes per established department guidelines Performs follow up coding of medical records as a result of internal and external reviews which identify coding discrepancies Meet with PACE providers via MS Teams to assist with documentation improvement tied to reimbursement Assists with other...

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...

Job Title 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. Job Description 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 Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up....

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

Company Overview :Upward Health is an in-home, multidisciplinary medical group providing 24 / 7 whole-person care.Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help.Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients.We are able to treat a wide range of needs - everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals - because we know that health requires care for the whole person.It's no wonder 98% of patients report being fully satisfied with Upward Health!Job Title & Role Description :The Certified Medical Coder is responsible for analyzing provider documentation to accurately select ICD-10 and CPT / HCPCS codes, ensuring compliance with coding guidelines, third-party reimbursement policies, and accreditation standards.This role...

Join Evara HealthDriven by Purpose, Powered by People Evara Health provides essential, high-quality care to the communities who need it most through 17 centers and mobile units offering primary care, dental, behavioral health, pediatrics, and more. Evara Health is recognized for its innovative, team-based approach, commitment to community health, and dedication to making healthcare accessible for all. Our people fuel our impact. Team members come for the purpose and stay for the supportive culture and strong, community-focused teams. Build a career that goes beyond a jobit changes lives. About This Role Medical Coding & Charge Review Review and validate diagnosis and procedure codes to ensure accuracy, compliance, and appropriate reimbursement. Audit patient encounters across departments for completeness and coding accuracy before claims submission. Verify ICD, CPT, and HCPCS code assignments using coding guidelines, reference materials, and industry best practices....

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...

Medical Clinic Biller/Coder Northwest Florida Community Hospital is seeking a detail-oriented and experienced Medical Clinic Biller/Coder to join our team. This position is responsible for accurate coding, billing, and claims processing for clinic services to ensure timely reimbursement and compliance with federal regulations and payer requirements. The ideal candidate will have strong knowledge of medical terminology, coding systems, and insurance billing procedures. Responsible for all activities in the Clinic accounts receivable function. Manages billing and collection activities such as sending follow-up inquiries, negotiating with past due accounts, and referring accounts to collection agencies. Codes and sequences all diagnoses and procedures using established ICD-10-CM coding rules for each patient encounter; coding will be subject to accuracy and productivity rates as determined by department manager. Maintains accurate records. Audits methods and procedures of accounts...