73 medical 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...

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...

Summary: Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. 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. Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts...

Summary: Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. 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. Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts...

Physician Compliance Auditor Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal...

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 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, care 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. 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...

Medical Coder TekSystems is currently hiring for a medical coder that can sit anywhere in the US as it is fully remote, this position does work on EST time zone hours! Must have: 1-3 years of medical coding experience preferably outpatient experience but open to other medical coding experience, must have an active CPC license! These coders will be taking the work from the client coordinators. They will be looking at what the provider sends and coded for payment and what the payer sends and coded for payment. They will be reviewing the case to decide which one is correct, is the correct code being used, and make a determination of what code and payment is recommended by MCMC. Then they pass it off to QA for review. They will do these cases over and over again to push them through. All of the cases are going to be emergency services, so they would like for everyone to have experience in emergency services, inpatient coding, or DRG (diagnosis-related group) coding. This would allow...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

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 This is not a virtual Position 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 are responsible for maintaining current knowledge of the various regulatory guidelines and...

Medical Record Technician (Coder) Auditor 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 include: Abstracting medical record data and assigning codes using current clinical classification systems appropriate for the type of care provided. Performing audits of encounters to identify areas of non-compliance in coding. Providing recommendations on appropriate coding and maintaining current knowledge of regulatory guidelines and requirements. Assisting facility staff with documentation requirements to completely and accurately reflect the patient care provided. Using computer applications to produce reports, abstract...

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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...

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...

Medical Records Technician (Coder) Auditor 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. This is not a virtual position. 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 recommendations on appropriate coding; and are responsible for maintaining current knowledge of the various...

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...

Memorial Healthcare System Coding Specialist 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. Location: Miramar, Florida 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. For physician billing, collaborates with billing department to ensure all bills are satisfied. For...

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 10,000 who are shaping the future we envision. Moffitt has been recognized as a Best and Brightest Company to Work for in the Nation, a Digital Health Most Wired Organization and continually named one of the Tampa Bay Time's Top Workplaces. A National Cancer Institute (NCI)-designated Comprehensive Cancer Center since 2001. Summary 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...

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...

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...

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...

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...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

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...