79 documentation coding auditor jobs found

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...

Banyan Treatment Centers is seeking a detail-oriented and experienced Billing and Coding Auditor to support the accuracy and compliance of our billing practices across our behavioral health services. This critical role ensures the integrity of our claims processes and supports continuous quality improvement, staff education, and adherence to payer regulations. As a nationally recognized provider of addiction and mental health care accredited by The Joint Commission—with 18 locations, robust Telehealth services, and backed by TPG’s Rise Fund since 2023—our 1,600+ employees are dedicated to delivering compassionate, high-quality care that transforms lives. Positions Details Location: Flexible |On-site (Pompano Beach, FL), Hybrid or Remote (USA) Reports to: Auditing Manager & Director of RCM Schedule: Full-time Key Responsibilities Conduct regular audits of behavioral health billing and claims for accuracy and compliance. Review coding of all services...

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...

Position Summary Elite DNA Behavioral Health is seeking a detail-oriented Certified Medical Coder / Clinical Chart Auditor (AAPC certified) to support our internal compliance and quality assurance program. This role focuses on chart auditing, documentation review, and provider education , with an emphasis on CMS, Florida Medicaid, and behavioral health documentation standards . This position goes beyond CPT coding alone. The Auditor will review each element of the medical record-including assessments, treatment plans, progress notes, and billing documentation-to ensure services meet regulatory, payor, and internal compliance requirements. The Auditor will also provide constructive feedback and education to providers to improve documentation accuracy and reduce audit risk. This is an excellent opportunity for early-career coders (0-3 years experience) looking to build expertise in healthcare compliance and auditing. Essential Duties and Responsibilities Conduct...

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...

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. Required: High School Diploma or GED Certification And/Or Certified...

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 institutional subject matter...

Billing and Coding Auditor Banyan Treatment Centers is seeking a detail-oriented and experienced Billing and Coding Auditor to support the accuracy and compliance of our billing practices across our behavioral health services. This critical role ensures the integrity of our claims processes and supports continuous quality improvement, staff education, and adherence to payer regulations. As a nationally recognized provider of addiction and mental health care accredited by The Joint Commissionwith 18 locations, robust Telehealth services, and backed by TPG's Rise Fund since 2023our 1,600+ employees are dedicated to delivering compassionate, high-quality care that transforms lives. Positions Details Location: Flexible | On-site (Pompano Beach, FL), Hybrid or Remote (USA) Reports to: Auditing Manager & Director of RCM Schedule: Full-time Key Responsibilities Conduct regular audits of behavioral health billing and claims for accuracy and compliance. Review coding of all...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Senior auditor responsible for clinical or physician compliance topics. Assigned the most complex clinical/documentation/coding/billing reviews. Provides guidance to other auditors within AHN on audit approach and analysis. Responsible for creating and overseeing orientation of auditors. Leads all hospital or physician audits/investigations, auditing support and responses related to external audit activity. ESSENTIAL RESPONSIBILITIES: Establishes and implements orientation for all members of the AHN audit compliance team. Evaluates the progress of team members including review of reports and audit activities. Works with senior management responsible for AHN-wide case management/physician programs to develop processes that meet Medicare and 3rd party payor requirements. Provides guidance to staff auditors on audit topics and reports. (20%) Conducts educational sessions for...

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 relate to,...

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. Competitive Pay Evening, nights, and weekend shift differentials offered for qualifying positions. All Inclusive Benefits (start day one) Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility...

Physician Practice E&M Auditor Educator, MCVI Administration, FT, 8A-4:30P (Remote) 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...

HIM Coding/Compliance Auditor 2 Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of medical excellence and community care for more than a century. Throughout its rich and storied history, Jackson Memorial - located in the heart of the City of Miami - has been ground zero for some of the world's greatest medical breakthroughs and important moments in South Florida. We've grown into one of the nation's largest public hospitals, and one of the few that is also a world-class academic medical center with a proud mission and proven success. Jackson Memorial is an accredited, tertiary teaching hospital with 1,500 licensed beds, where nearly every medical specialty is provided by some of the world's most skilled and highly regarded multidisciplinary team of healthcare professionals. The HIM Coding/Compliance Auditor 2 analyzes abstracted, coded data for the purpose of ensuring coding accuracy. Serves as a resource for expert knowledge...

Health Information Management (HIM) 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...

Healthcare Compliance Specialist/Auditor Join a purpose-driven team at Caron Treatment Centers, where for nearly 70 years, we've been helping people find a path to recovery from addiction and rebuild their lives. We offer real careers with real opportunities for growth, comprehensive training, and a commitment to work-life balance. Our benefits include generous paid time off, company-paid life and disability insurance, professional growth and development, tuition reimbursement, a competitive 401(k) plan, and robust medical, dental, and vision plans. We're proud to foster a diverse and inclusive environment, with a culture of teamwork, compassion, and dedication to our mission. Start a career that saves lives at a company that values yours! Position will be full time, working Monday-Friday 8:30-5pm. Candidates can work a hybrid schedule, with a few days in office each week at our Wernersville or Delray Beach campus. Must also be available on-site during audits. Duties and...

Medical Coder Educator - USFTGP RCO 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: High...

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: 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), procedural and...

Job Description This entry-level position is responsible for auditing outpatient and ambulatory services claims to federally funded healthcare payors across the Baptist Physician Enterprise (BPE) organization. The position audits and provides feedback as needed and attends BPE department meetings as needed to respond to compliance related coding and billing questions and provide feedback on audit findings and necessary remediation/corrective action requirements. The position analyzes coded records for compliance with federal, state and third-party insurer rules and regulations and note trends. The position educates physicians and staff on error trends and how to prevent/reduce errors to demonstrate compliance with the False Claims Act, the Federal Overpayment Rule, CMS and Medicaid billing and coding requirements; and maximize reimbursement. This role requires a keen eye for detail, excellent communications and critical thinking skills, and a commitment to maintaining the...

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...

At **ModMed**, we’re not just building software—we’re reimagining the healthcare experience. Founded in 2010 by a practicing physician and a successful tech entrepreneur, we took a radically different approach: **we hired doctors and taught them how to code.** This "for doctors, by doctors" philosophy has allowed us to create an AI-enabled, specialty-specific cloud platform that places patients at the center of care.* Responsible for analyzing, reviewing and providing feedback when performing quality assurance activities and completing QA audits, including but not limited to: + Ensuring all federal and state coding guidelines and regulations are met as well as payer guidelines + Provide effective feedback to the global coding teams to aid in their successful coding of BOOST clients + Maintaining a communication log to show successful training of the global coding team when coding trends or issues are found + Report all coding trends and issues to the department lead as they are...

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...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant 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 Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

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...

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...