119 documentation coding auditor jobs found

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 appropriate Evaluation & Management (E/M) level...

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 word processing...

Community Care Plan is seeking a Medical Coding Auditor to conduct audits across pre- and post-payment records, ensuring accurate coding on claims and maintaining support for any identified fraud, waste, or abuse. The role requires Medicaid knowledge, coding certification, and experience with audits, investigations, and documentation. A hybrid work schedule is available with focus on compliance and accuracy. #J-18808-Ljbffr

We are an independent, Florida-focused organization with a long-standing commitment to delivering high-quality care to seniors and the communities we serve. Our work centers on improving health outcomes, enhancing the patient experience, and supporting value-based care models. As part of WellMed Optum Florida, team members collaborate across clinical and operational functions to support older adults with compassionate, coordinated care. We foster a culture of integrity, continuous improvement, and respect, offering opportunities for professional growth while making a meaningful impact. Our focus on seniors’ health drives innovation in care delivery, risk adjustment, and provider support across the Greater Tampa Bay Area and beyond. LOCATION The Risk Adjustment Coding Auditor & Provider Educator is a full-time hybrid role based in the Greater Tampa Bay Area, with a mix of onsite visits and some work-from-home flexibility. ABOUT THE ROLE The Coding Auditor / Educator is...

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....

Empower Healthcare and Compliance Partners, a subsidiary of CareCloud, seeks an Audit Defense Auditor/Coder to conduct detailed medical record reviews and coding audits. The role interfaces with clients and staff to ensure accurate findings and regulatory compliance in coding and documentation. Responsibilities include leading regulatory audits, delivering finalized reports, and collaborating with management to mentor audit teams. #J-18808-Ljbffr

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. Job Description 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 strict adherence to patient confidentiality according to MHS standards and regulatory requirements....

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...

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As an Inpatient Coding Auditor with Parallon you can be a part of an organization that is devoted to giving back! Job Summary and Qualifications As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. What you will do in this role: Leads,...

Valora Medical Group is seeking a Risk Adjustment (MRA) Coder/Auditor to ensure accurate identification of chronic conditions and ICD-10 coding to support correct billing. The role includes training providers, producing regular office reports, and improving documentation quality. This is a hybrid position with onsite training support. Required: Bachelor’s in healthcare or related field, 2+ years coding plus 1+ year risk adjustment experience, and Certified Professional Coder; Certified Risk #J-18808-Ljbffr

Job Description Job Description     PYA is seeking an Inpatient/Outpatient Facility Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will  support PYA’s Revenue and Compliance Advisory Program . RESPONSIBILITIES : Apply inpatient and outpatient facility/hospital coding and reimbursement methodologies to provide advisory services to PYA clients with a focus on the following: ICD-10-CM and PCS/CPT/HCPCS code assignment MS-DRG and other DRG validation APC validation and charge capture Clinical documentation improvement Regulatory compliance for third party payors Work in collaboration with the PYA executive team and other service lines to offer complete business solutions to clients Manage the preparation of excellent client deliverables and exhibit exceptional project management skills while balancing firm risk and compliance with appropriate professional...

Job Description Job Description Job Title: Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Auditors to contribute their specialized expertise to an innovative healthcare AI project. In this role, you will help improve next-generation AI systems by reviewing, evaluating, and refining medical coding and audit-related content. This opportunity is ideal for professionals with strong experience in outpatient professional fee coding, auditing, and academic medical center environments. No prior AI experience is required—your healthcare expertise is what matters most. Key Responsibilities Conduct detailed reviews and audits of outpatient professional fee coding records for accuracy, compliance, and quality. Identify coding trends, gaps, risks, and opportunities for improvement. Evaluate audit findings using knowledge of academic medical center protocols and industry best practices. Document audit results and...

Job Description Job Description Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Auditors with strong expertise in outpatient professional fee coding and coding audits , preferably within academic medical centers. You will review coding records, identify compliance risks, and provide expert feedback to support AI-focused projects. No prior AI experience is required. Key Responsibilities Conduct detailed audits of outpatient professional fee coding records. Review coding accuracy, documentation, and compliance. Identify coding trends, gaps, risks, and improvement opportunities. Apply academic medical center standards and coding guidelines. Document audit findings and provide clear recommendations. Evaluate complex coding and documentation scenarios. Contribute to AI training through expert coding and audit feedback. Support audit program management and quality improvement initiatives. Required Qualifications...

Auditor CodingLocation: Miramar, FloridaAt 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.SummaryResponsible 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.ResponsibilitiesConducts and reports on electronic medical record audits to verify ICD-10CM/PCS, CPT and APC, MSDRG, and APRDRG coding and grouping...

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 Investigative...

Location: Orlando, FL Job Id: 266 # of Openings: 1 Valora Medical Group is a visionary company focused on high-quality primary care services and consisting of healthcare providers and professionals dedicated to the health and well-being of our patients. At Valora, we treat our patients like family. With multiple locations throughout the Dallas-Fort Worth and Central Florida area, we understand that providing quality medical care and an exceptional patient experience across all our centers requires having an outstanding team. A Risk Adjustment (MRA) Coder ensures all significant chronic conditions found in the patient’s chart affecting the risk score are identified to allow the Clinical Provider to determine which conditions are current so they can be addressed during the patient visit. This role is also responsible for proper identification of respective ICD-10 codes to ensure the accuracy of billing for addressed diagnoses. In addition, the MRA Coder/Auditor provides...

All inclusive preventive care in Miami, FL, is seeking a Senior Medical Coding Auditor (CPC) to join our multi-specialty practice focusing on Primary Care and Gynecology. The role reviews provider notes before submission to ensure accurate coding, proper E/M levels, and compliance while supporting optimal reimbursement. You will work with providers and the billing team to reduce denials, improve documentation quality, and maintain regulatory compliance. #J-18808-Ljbffr

Empower Healthcare and Compliance Partners (Empower HCP) (subsidiary of CareCloud) is a leading healthcare compliance and networking firm dedicated to equipping providers and systems with the necessary tools, resources, and expertise to navigate the ever-changing regulatory landscape. We understand that compliance is the foundation of providing safe, ethical, and high-quality care to patients. Our mission is to empower healthcare organizations to meet compliance standards effectively, fostering better outcomes and trustworthy services in the healthcare industry. Audit Defense Auditor/Coder This job is responsible for the successful delivery of detailed and complex medical record reviews for Audit Defense and Regulatory Audits. The incumbent is responsible for interface with clients and staff. The incumbent is responsible for completion of coding audits review of medical records and coding for appropriate interpretation and designations including chart documentation review, ICD10...

Northeast Georgia Health System is seeking a Coding Education & Quality Auditor (CEQA) to perform coding and documentation audits across NGPG/NGHS. You will ensure the accuracy of ICD-9/ICD-10/CPT/HCPCS coding, determine medical necessity, and report findings to physicians and leadership. You will educate providers and propose corrective actions to improve documentation and billing quality. The role requires strong knowledge of coding standards, regulatory requirements, and the ability to #J-18808-Ljbffr

## Professional Practice Pathology CoderApply: Virtual (Remote Eligible Position ): Moffitt Business Center: Full time: Posted Today: R-3598### Working at Moffitt is both a career and a mission: to contribute to the prevention and cure of cancer.### As the only National Cancer Institute-designated Comprehensive Cancer Center based in Florida, Moffitt employs some of the best and brightest minds from around the world. Join a dedicated team of nearly 11,000 who are shaping the future we envision. Moffitt has been recognized as a Best and Brightest Company to Work For in the Nation and is continually named one of the Tampa Bay Times’ Top Workplaces.**Summary**The Professional Practice Pathology Coder position is responsible for coding clinical documentation to capture the accurate disease burden of the patient while adhering to ICD-10 CM and CPT-4 coding guidelines and regulations at a state and federal level. This position is responsible for reviewing medical record...

Health Information Management (HIM) Coding SpecialistLocation: Miramar, FloridaAt 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...

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...

Sign On Bonus: $1,500; paid in two installments: $500 at the time of hire and $1,000 after one year of service. DRG Coding Auditor - MS-DRG and APR-DRG Virtual: This role enables associates to work virtually full-time, with the exception of 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 an accommodation is granted as required by law. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of...