143 provider coding auditor educator jobs found

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...

Physician Practice E&M Auditor EducatorBaptist 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...

ABOUT THE ROLE The Coding Auditor / Educator is responsible for conducting coding and documentation audits to evaluate compliance with federal and state regulations, payer requirements, and organizational policies. As a member of the Legal & Compliance Department, this individual contributor role supports the effectiveness of the organization’s compliance program by identifying coding risks, monitoring documentation accuracy, validating reimbursement integrity, and recommending corrective actions. This role ensures accurate risk adjustment coding, HCC capture, and E/M documentation in a full-risk, value-based care environment. The position supports compliance with CMS-HCC risk adjustment guidelines, OIG audit expectations, and RADV preparedness. Working closely with providers, clinical leadership, revenue cycle, population health, and compliance teams, the Coding Auditor / Educator performs retrospective and prospective audits, analyzes coding trends, supports regulatory...

ABOUT THE ROLE The Coding Auditor / Educator is responsible for conducting coding and documentation audits to evaluate compliance with federal and state regulations, payer requirements, and organizational policies. As a member of the Legal & Compliance Department, this individual contributor role supports the effectiveness of the organization’s compliance program by identifying coding risks, monitoring documentation accuracy, validating reimbursement integrity, and recommending corrective actions. This role ensures accurate risk adjustment coding, HCC capture, and E/M documentation in a full-risk, value-based care environment. The position supports compliance with CMS-HCC risk adjustment guidelines, OIG audit expectations, and RADV preparedness. Working closely with providers, clinical leadership, revenue cycle, population health, and compliance teams, the Coding Auditor / Educator performs retrospective and prospective audits, analyzes coding trends, supports regulatory...

Baptist Health seeks an E&M Coding Auditor/Educator to conduct comprehensive coding audits for physician and clinical services, identify documentation gaps, and ensure compliance with CMS guidelines. The role develops and delivers provider education materials and trainings, leading focused reviews and proactive improvements in coding accuracy. Minimum 4 years of experience in E&M coding and auditing preferred. #J-18808-Ljbffr

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...

Benefits Career growth and development opportunities, with clear pathways and ongoing support Comprehensive health and wellness resources that go beyond traditional benefits A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs Tuition reimbursement to support continued learning and advancement And so much more Description E&M Coding Auditor/Educator performs comprehensive audits to determine integrity of coding/billing for physician & clinical fees, detection/correction of documentation, coding/billing errors and/or medical necessity of services billed. Audits consist of evaluation of the accuracy of documentation, including E/M and other payer codes, medical necessity, reimbursement overpayments and underpayments, and compliance with other documentation standards. Researches and applies all federal guidelines & compliance with the overall audit delivery. Develops and executes provider...

ABOUT THE ROLEWhile professional experience and qualifications are key for this role, make sure to check you have the preferable soft skills before applying if required.The Coding Auditor / Educator is responsible for conducting coding and documentation audits to evaluate compliance with federal and state regulations, payer requirements, and organizational policies. As a member of the Legal & Compliance Department, this individual contributor role supports the effectiveness of the organization's compliance program by identifying coding risks, monitoring documentation accuracy, validating reimbursement integrity, and recommending corrective actions.This role ensures accurate risk adjustment coding, HCC capture, and E/M documentation in a full-risk, value-based care environment. The position supports compliance with CMS-HCC risk adjustment guidelines, OIG audit expectations, and RADV preparedness. Working closely with providers, clinical leadership, revenue cycle, population...

Certified Medical Coder Status: Non-Exempt Department: Coding Reports To: Coding Director Work Location: Remote Position Summary The Certified Coder is responsible for performing accurate and compliant coding of inpatient (IP) and outpatient (OP) medical records to support timely billing and maximize revenue integrity. This role ensures correct diagnostic and procedural coding in accordance with ICD-10-CM, CPT, HCPCS, CMS guidelines, and payer-specific requirements. The Certified Coder works closely with billing teams, clinical staff, and auditors to support clean claim submissions, reduce denials, and promote optimal reimbursement while maintaining the highest standards of coding compliance and data integrity. Key Responsibilities Review, analyze, and accurately assign ICD-10-CM, CPT, and HCPCS codes for inpatient and outpatient encounters, including surgeries, ancillary services, ER, observation, and clinic visits. Validate documentation to ensure it supports assigned codes and...

Job Title: Medical Clinic Biller/Coder Location: Northwest Florida Community Hospital – Chipley, FL Position Type: Full-Time Position Summary: 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...

Medical Coding Specialist Work Style: Onsite Location: Jacksonville, FL FTE: Full-Time (1.0 FTE) Schedule: Variable Shift Reviews and analyzes medical records to assign appropriate diagnostic and procedural codes in compliance with established coding guidelines and organizational policies. Collaborates with healthcare providers to clarify documentation and resolves coding discrepancies, ensures the integrity of coded data for billing and reporting purposes. Maintains current knowledge of coding standards such as ICD, CPT, and HCPCS, and supports the billing department by providing precise coded information for claims submission. Includes auditing coded data, training staff on coding procedures, and monitoring coding productivity and quality metrics to enhance departmental performance. Responsibilities Reviews and analyzes medical records to assign appropriate diagnostic and procedural codes. Ensures compliance with coding guidelines and organizational policies....

Medical Coding Specialist Turn accurate coding into cleaner claims, reliable data, and stronger reimbursement. Work Style: Remote Location Requirement: Must reside in an authorized state (FL, GA, MO, PA, SC, NC, TN, or TX) FTE: Full-Time (1.0 FTE) Reviews and analyzes medical records to assign appropriate diagnostic and procedural codes in compliance with established coding guidelines and organizational policies. Collaborates with healthcare providers to clarify documentation and resolves coding discrepancies, ensuring the integrity of coded data for billing and reporting purposes. Maintains current knowledge of coding standards such as ICD, CPT, and HCPCS, and supports the billing department by providing precise coded information for claims submission. Includes auditing coded data, training staff on coding procedures, and monitoring coding productivity and quality metrics to enhance departmental performance. Key Responsibilities Reviews and analyzes medical records to...

DISCOVER IES Integrative Emergency Services (“IES”) LLC, is a physician founded, owned, and led company whose goal is to empower physician leaders to create the best places to give and receive care. We are a clinically integrated and outcomes-based organization with a commitment to doing the right thing for our clinicians, patients, and communities. Through our commitment to patient care and reinvestment in our physicians, IES has a proven track record of improving patient outcomes and producing results that uphold the hospitals' reputations in which we operate. We strive to create a culture of continuous improvement, community, and recognizing our Physician leaders. To learn more, visit our website IES.Healthcare and click to see a highlight of our 12th Annual Quality Summit. POSITION SUMMARY Integrative Emergency Services, LLC (“IES”) is seeking a certified Medical Coding Specialist with emphasis on surgical services. The Medical Coding Specialist responsible for accurate...

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 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, supporting single-specialty or multi-specialty engagements.  Core Responsibilities   Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes.  Ensure documentation supports coded services and identify/escalate discrepancies or gaps.  Ensure compliance with CMS, payer-specific rules, and official coding guidelines (including AMA and NCCI edits).  Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards.  Requirements: Minimum Qualifications   Credentials: CPC, CCS-P, RHIA, or RHIT (active and in good standing).  Experience: Minimum 2–3+ years professional fee coding experience....

Coding Auditor The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals. Responsibilities Reviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment Informs manager of any activities which do not meet federal or state coding and billing requirements Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and responds...

Job Description Job Description Join Evara Health—Driven by Purpose, Powered by People.  At Evara Health, we believe healthcare is about more than treating patients—it’s about transforming lives and strengthening the communities we serve. As a nonprofit community health center with 17 locations and mobile health units across Pinellas County, we provide high-quality, accessible care while creating meaningful opportunities for our employees to make a difference every day. Recognized as a USA TODAY Top Workplace, Evara Health is proud to foster a mission-driven culture where people are valued, collaboration matters, and employees can grow while doing work that has a real impact. If you’re looking for more than just a job—and want to be part of a team committed to improving lives and serving our community—we invite you to explore a career with Evara Health. Build a career that goes beyond a job—it changes lives.  About This Role: The Certified Coder is responsible...

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...

The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals. Responsibilities Reviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment Informs manager of any activities which do not meet federal or state coding and billing requirements Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and responds within 5 working...

Turn Your Coding Expertise Into A Meaningful Impact On Patient Care Work Style: Remote Location Requirement: Must reside in an approved state (FL, GA, MO, PA, SC, NC, TN, or TX) FTE: Full-Time (1.0 FTE) Reviews and analyzes medical records to assign appropriate diagnostic and procedural codes in compliance with established coding guidelines and organizational policies. Collaborates with healthcare providers to clarify documentation and resolves coding discrepancies, ensures the integrity of coded data for billing and reporting purposes. Maintains current knowledge of coding standards such as ICD, CPT, and HCPCS, and supports the billing department by providing precise coded information for claims submission. Includes auditing coded data, training staff on coding procedures, and monitoring coding productivity and quality metrics to enhance departmental performance. Responsibilities: Reviews and analyzes medical records to assign appropriate diagnostic and procedural codes....

Become a part of our caring community The Medical Coding Coordinator confirms appropriate diagnosis related to the appropriate Outpatient CPT and ICD-10 code assignments. As a Medical Coding Coordinator, you will provide medical coding expertise and support for accurate code assignment and documentation review. Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals and often oversees work of others and/or is the primary administrative owner of a main process, program, product or technology. The Medical Coding Coordinator confirms appropriate diagnosis related to the appropriate Outpatient CPT and ICD-10 code assignments. As a Medical Coding Coordinator, you will provide medical coding expertise and support for accurate code assignment and documentation review. Decisions are regarding the daily priorities for an administrative work group and/or...

Healthcare Claims Reimbursement Specialist Summary/Objective: Obtain accurate reimbursement for healthcare claims. Essential Functions Reviews and resolves all assigned charges thoroughly based on coding guidelines, chart documentation and related charges in billing system. Audits task manager work files with charges reviewed by Claims Manager that were found to have coding errors/omissions. When appropriate communicates approved coding changes and/or questions to Physician's and their office staff. Also alerts providers of missing or late charges. Alerts management to coding trends discovered while working daily charges/edits. Stays informed and up to date on coding issues by attending seminars. Possesses a comprehensive understanding of carrier specific State of Florida billing guidelines. Consistently stays within the department production goal set for your area Required Education and Experience: High School Graduate or Equivalent. Must be a certified coder either...

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...

Medical Coding Specialist Turn accurate coding into cleaner claims, reliable data, and stronger reimbursement. Work Style: Remote Location Requirement: Must reside in an authorized state (FL, GA, MO, PA, SC, NC, TN, or TX) FTE: Full-Time (1.0 FTE) Reviews and analyzes medical records to assign appropriate diagnostic and procedural codes in compliance with established coding guidelines and organizational policies. Collaborates with healthcare providers to clarify documentation and resolves coding discrepancies, ensuring the integrity of coded data for billing and reporting purposes. Maintains current knowledge of coding standards such as ICD, CPT, and HCPCS, and supports the billing department by providing precise coded information for claims submission. Includes auditing coded data, training staff on coding procedures, and monitoring coding productivity and quality metrics to enhance departmental performance. Key Responsibilities Reviews and analyzes medical records to...