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Physician Practice E&M Auditor Educator, Medical Group Auditing & Coding

đŸ”„ 0 minutes ago

🐊 Florida – Remote

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đŸ’” $26 - $33 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

đŸ‘» Ghost score 0%

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Logo of Baptist Health

Baptist Health

10,000+ employees

đŸ„ Healthcare

đŸ€ 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, and issues related to medical necessity of services billed. ‱ Evaluate documentation accuracy, including E/M and other payer codes, medical necessity, reimbursement overpayments and underpayments, and compliance with documentation standards. ‱ Research and apply federal guidelines and compliance requirements to audit delivery. ‱ Develop and execute provider educational opportunities and curricula, including coding resources, materials, tools, webinars, and campaigns, based on audit results, trends, and regulatory changes. ‱ Lead provider education events to discuss audit results, identify trends, and establish action plans. ‱ Provide support or project management for related audit and coding initiatives and other responsibilities assigned by executive leadership. ‱ Serve as a subject matter expert and establish positive working relationships with stakeholders to provide risk input and sustain understanding of federal coding compliance requirements.

🎯 Requirements

‱ High School, Cert, GED, Trn, Exper. ‱ 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. ‱ Prior Physician Coding & Auditing, Revenue Cycle or billing related to Coding. ‱ Strong knowledge of E&M regulations and CMS Documentation Guidelines. ‱ Successful experience with data abstraction and analyzing 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 proficiency in Microsoft Office and generating reports. ‱ Minimum Required Experience: 4 Years

đŸ–ïž 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

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