Physician Practice E&M Auditor, Educator

🔥 8 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $26 - $34 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 0%

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Baptist Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🤝 Non-profit

Healthcare • Non-profit

Baptist Health is the region's largest not-for-profit healthcare organization in South Florida. It operates 12 hospitals, more than 29,000 employees, 4,500 physicians, and roughly 200 outpatient centers, urgent care facilities, and physician practices across Miami-Dade, Monroe, Broward, and Palm Beach counties. The system includes renowned centers of excellence in cancer, heart and vascular, brain and spine, and orthopedic care, and is supported by philanthropy and a faith-based mission. Baptist Health emphasizes clinical quality, patient safety, staff development, and community-oriented care.

📋 Description

• Perform comprehensive audits to determine integrity of coding/billing for physician and clinical fees. • Detect and correct documentation, coding/billing errors, medical necessity issues, and reimbursement overpayments or underpayments. • Evaluate documentation accuracy, including E/M and other payer codes, medical necessity, and compliance with documentation standards. • Research and apply federal guidelines and compliance requirements to audit delivery. • Develop and execute provider education opportunities and curricula, including coding resources, materials, tools, webinars, and campaigns. • Base education on audit results, identified trends, and changes in coding compliance and regulatory guidelines. • Lead provider education events covering audit results, trends, and action plans. • Provide support or project management for related audit and coding initiatives. • Establish positive working relationships as the subject matter expert and provide input on risk and federal coding compliance requirements.

🎯 Requirements

• High School, Cert, GED, Trn, Exper. • AAPC Certified Professional Medical Auditor. • AHIMA Certified Coding Specialist-Physician-based. • AAPC Certified Professional Coder. • Prior Physician Coding & Auditing, Revenue Cycle or billing related to Coding. • Upon Hire, CPC-Certified Professional Coder and/or CCS-P-Certified Coding Specialist-Physician required. • CPMA-Certified Professional Medical Auditor upon hire or must be completed within 1 year. • Overall experience to include at least 2 years of professional E&M coding experience and 2 years of E&M provider education experience. • Strong knowledge of E&M regulations and CMS Documentation Guidelines. • Successful experience with data abstraction and analyze patient encounters for a focused review sample and development of comprehensive coding education materials and resources. • Proficient in ICD10CM, CPT and HCPCS coding, policy and procedures based on physician practices. • Strong organizational skills and attention to detail. • Ability to prioritize provider medical record reviews/projects and provider coding education opportunities with alignment with audits and overall trends. • Work independently with little or no supervision. • Ability to provide excellent customer service. • Excellent computer skills and proficient in Microsoft Office and generating reports. • Minimum Required Experience: 4 Years

🏖️ 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