177 compliance coding auditor jobs found

Baptist Health in Florida seeks a Compliance Auditor (RN) to support audits across hospital service lines, focusing on documentation, coding accuracy, and compliance. The role collaborates with clinical and operational leaders to mitigate risk and strengthen controls. Ideal candidates hold an RN license with 5+ years of nursing and healthcare auditing experience, including DRG validation and CDI practices. Remote Florida position with reporting to leadership. #J-18808-Ljbffr

American Oncology Management Company is seeking a Remote Auditor with 2+ years of E/M coding experience to support physicians and resolution specialists. The role focuses on auditing, reviewing emails and tickets, and ensuring compliance with federal and state regulations. CPC/CCS credentials are preferred. Overtime may be required with advance notice, and confidentiality is essential. The candidate will work across multiple sites, maintain spreadsheets, and contribute to training manuals and #J-18808-Ljbffr

Location: Remote Position Hiring Range: $21.00 - $35.54 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 expected to work...

AdventHealth in Orlando, FL is hiring a Coding Auditor to perform post-bill coding audits across inpatient and/or outpatient services. You will validate DRG assignments, MCC/CC integrity, modifiers, and APCs while ensuring compliance with coding guidelines. The role requires 5+ years of acute care coding, CCS/RHIA/RHIT/CPC/CIRCC credentials, and strong analytical skills. Excellent communication and time management are essential. #J-18808-Ljbffr

Baptist Health Care in Pensacola, FL is seeking an entry-level Compliance Auditor for OP-Ambulatory Services. The role audits outpatient and professional service claims to ensure compliance with federal, state, and payer rules, and guides staff to reduce errors under False Claims Act and CMS guidelines. Responsibilities include reviewing ICD-10-CM/PCS codes, CPT codes, and provider documentation; producing audit reports; and delivering education on coding practices. #J-18808-Ljbffr

Emory Healthcare is seeking a Remote Medical Coding Auditor responsible for ensuring accuracy, completeness, and regulatory compliance of professional coding services. You will review patient records and coding data, collaborate with providers and compliance teams, and support accurate reimbursement. Key tasks include chart reviews, auditing, training staff on coding standards, and reporting on findings. Candidates should have coding certification and experience in medical billing or revenue #J-18808-Ljbffr

Riverside Health System is seeking a Clinical Coder with extensive experience in acute care coding to ensure high-quality documentation and coding compliance across inpatient and outpatient settings. You will audit records, support denial management, and educate teams to improve revenue integrity. Responsibilities include applying coding guidelines, mentoring staff, coordinating with CDI and payor relations, and preparing audit reports for leadership. #J-18808-Ljbffr

Emory Healthcare is seeking a remote Medical Coder to ensure accurate professional coding and compliant documentation across patient records. You will collaborate with clinicians, coders, and compliance teams to support proper reimbursement and regulatory adherence. The role emphasizes chart reviews, coding audits, and ongoing education to improve documentation quality while maintaining strict privacy standards and timely reporting. #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

Job Title Auditor for Outpatient and Professional Services Claims Job Description This entry-level position is responsible for auditing outpatient and professional services claims to federally funded healthcare payors across the Baptist Physician Enterprise (BPE) organization. The position analyzes coded records for accuracy and compliance with federal, state and third-party insurer rules and regulations and applicable coding guidelines. The position provides guidance to Operations and staff on error trends and how to prevent/reduce errors to strengthen compliance with the False Claims Act, the Federal Overpayment Rule, CMS and Medicaid billing and coding requirements. This role requires a keen eye for detail, excellent communications and critical thinking skills, and a commitment to maintaining the highest ethical standards. Responsibilities Performs routine and targeted audits of patient services and corresponding claims submitted to government payors. Audits...

Baptist Health System, Inc. in Florida is seeking a Compliance Auditor (RN) to support compliance, clinical, and revenue-focused auditing activities across hospital service lines. This role partners closely with operational and clinical leadership to evaluate documentation, coding accuracy, regulatory compliance, and internal controls while identifying process improvement opportunities and mitigating organizational risk. #J-18808-Ljbffr

About Baptist Health Recognized as a top place to work in health care, Baptist Health cares for more patients in Northeast Florida than any other provider, ranking as “most preferred” for more than 30 years. We’re Jacksonville's only locally governed, faith-based, not-for-profit health system and provide a full spectrum of preventive and specialty care through 200+ locations and six hospitals. Our centers of excellence include Baptist MD Anderson Cancer Center, Baptist Heart Hospital, Baptist Neurological Institute and Wolfson Children's Hospital. Job Summary Baptist Health is seeking a Compliance Auditor (RN) to support compliance, clinical, and revenue-focused auditing activities across hospital service lines. This role partners closely with operational and clinical leadership to evaluate documentation, coding accuracy, regulatory compliance, and internal controls while identifying process improvement opportunities and mitigating organizational risk. The ideal candidate will...

Job Description Job Description Position Summary: The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through pre and post payment medical records review and appeal 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, coverage policies and regulatory and contract requirements. Qualifications:  Medical Coder certification from accredited source (e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) required. Prior experience in Medicaid claims role and/or post payment medical coding auditor role preferred. Knowledge of Medicaid rules, claims processing, medical terminology and coding principles and practices. Knowledge of auditing, investigation, and research. Knowledge of...

North Florida Medical Services, located in Mandarin/Jacksonville, FL, is seeking a Medical Coding Quality Auditor to lead retrospective quality reviews of physicians and coders. The role emphasizes coding accuracy and ongoing education, reporting findings to management, and collaborating with the Coding and Compliance Manager. Requirements include CPC/CCS-P or CPMA credentials, with CPMA preferred within 12 months. #J-18808-Ljbffr

Emory Healthcare is seeking a diligent medical coder/auditor to ensure accurate coding and compliant documentation for professional services. You will review records, identify coding discrepancies, and collaborate with clinicians and compliance teams to improve accuracy and reimbursement. The role emphasizes audits, education, and continuous knowledge of coding guidelines and regulations, with remote work options within eligible states and a focus on revenue integrity. #J-18808-Ljbffr

Location Miramar, Florida 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 Using encoder, reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments. Reviews coding edits. Reviews Local Coverage Determination (LCD) edits and guidance for codes meeting medical necessity. Research electronic medical record for any additional diagnoses documented to meet medical necessity. Codes various OP service lines for all MHS specialties that include encounters with high complexity of surgical procedures and assign anesthesia procedure codes (hospital) following specific payer requirements. Reads and interprets all provider documentation which includes all dictated, scanned, and electronically created documents, imaging, pathology reports, and labs pertaining to...

Physician Coding Education SpecialistPerforms, develops, and implements coding related efficiency processes to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Education Specialist is responsible for analyzing physician coding trends and providing educations that will contribute to effective productivities.Responsibilities Essential Functions:Responsible for internal auditing and analyzing professional coding for all service lines.Guide and educate coding team members by addressing errors, performance issues, and trends identified through reporting.Takes an active role in developing and presenting educational programs to physicians, physician extenders, and physician offices.Effectively communicates best practice physician coding related feedback with physicians, non-physician providers, physician office staff, administration, practice managers, and team members of...

The Physician Services Coding Auditor performs comprehensive coding and compliance audits to support the Revenue Cycle Compliance auditing and education team. This position evaluates physician and advanced practice provider documentation and coding to ensure accuracy and compliance with applicable local, state, and federal regulatory guidelines. The Physician Services Coding Auditor identifies potential compliance concerns, coding discrepancies, and opportunities for documentation improvement. This role prepares detailed audit findings and provides education and feedback to physicians, advanced practice providers, clinical teams, leadership, and Revenue Cycle partners to promote accurate coding, compliant documentation, and continuous improvement. Key Responsibilities Perform in-depth audits of physician and advanced practice provider documentation, coding, and billing practices. Review coding for accuracy and compliance with ICD-10 and CPT/HCPCS guidelines. Identify potential...

Coding Auditor SeniorLocation: Any PulsePoint office. St. Louis, MO preferred.Virtual: 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 Coding Auditor Senior is responsible for auditing diagnosis data collected from physician and hospital medical records to ensure proper ICD-9/ICD-10 coding and compliance with risk adjustment requirements.How you will make an impact:Audits diagnosis data retrieved from physician and...

Job Description Medical Coder Educator - USFTGP RCO - ( 250004UJ ) Overview 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. Responsibilities Analyze and report review findings indicating documentation gaps, reimbursement and data inaccuracies across 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...

Medical Coder EducatorServes 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 GED...

Coding Auditor Senior Location : Any PulsePoint office. St. Louis, MO preferred. Virtual : 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 Coding Auditor Senior is responsible for auditing diagnosis data collected from physician and hospital medical records to ensure proper ICD-9/ICD-10 coding and compliance with risk adjustment requirements. How you will make an imp act: Audits diagnosis...

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 relationships with patients and their families that...

About Baptist Health Recognized as a top place to work in health care, Baptist Health cares for more patients in Northeast Florida than any other provider, ranking as “most preferred” for more than 30 years. We’re Jacksonville's only locally governed, faith-based, not-for-profit health system and provide a full spectrum of preventive and specialty care through 200+ locations and six hospitals. Our centers of excellence include Baptist MD Anderson Cancer Center, Baptist Heart Hospital, Baptist Neurological Institute and Wolfson Children's Hospital. Job Summary Baptist Health is seeking a Compliance Auditor (RN) to support compliance, clinical, and revenue-focused auditing activities across hospital service lines. This role partners closely with operational and clinical leadership to evaluate documentation, coding accuracy, regulatory compliance, and internal controls while identifying process improvement opportunities and mitigating organizational risk. The ideal candidate will...