Coding Auditor

Reposted 2 Hours Ago
Be an Early Applicant
South Orland, ME, USA
In-Office
27K-49K Hourly
Senior level
Healthtech
The Role
Conducts post-bill inpatient and outpatient coding audits, validating DRGs, MCC/CCs, modifiers, APCs, documentation, compliance, and reimbursement accuracy. Identifies trends, reports audit outcomes, provides actionable feedback, supports coder onboarding and competency validation, and collaborates on education and training materials. Requires hospital coding expertise, knowledge of CMS guidelines and reimbursement systems, strong analytical and communication skills, and an accepted coding certification.
Summary Generated by Built In

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

  • Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

  • Paid Time Off from Day One

  • 403-B Retirement Plan

  • 4 Weeks 100% Paid Parental Leave

  • Career Development

  • Whole Person Well-being Resources

  • Mental Health Resources and Support

  • Pet Benefits

Schedule:

Full time

Shift:

Day (United States of America)

Address:

601 E Rollins St

City:

Orlando

State:

Florida

Postal Code:

32803

Job Description:

  • Conducts post-bill coding audits to assess coding accuracy, documentation alignment, and reimbursement integrity across inpatient and/or outpatient service lines.
  • Performs coding validation activities, including DRG assignment, MCC/CC integrity review, modifier validation, and APC assignment review.
  • Applies knowledge of IPPS, OPPS, DRG, APC, ICD-10CM/PCS, CPT/HCPCS, modifier usage, and coding guidelines during audit reviews.
  • Identifies trends related to coding accuracy, documentation quality, service capture, and reimbursement outcomes.
  • Provides detailed audit findings and feedback to support accuracy improvement and standardization of coding practices
  • Collaborate with the education team to translate audit results into targeted education and training initiatives
  • Supports onboarding audits and competency validation for new coders
  • Reinforces adherence to coding guidelines, regulatory requirements, and enterprise standards
  • Participates in development of coding education materials, guidance, and training content based on audit trends
  • Tracks and reports on audit outcomes, accuracy rates, and quality trends and performance improvement trends
  • Performs other duties as assigned

Knowledge, Skills, and Abilities:

  • Proficient experience with EMR and CAC systems (Epic and Optum preferred). [Required]
  • Strong knowledge of ICD-10-CM/PCS, and/or CPT/HCPCS coding, modifier usage and reimbursement methodologies [Required]
  • Understanding of DRG/IPPS and/or OPPS/APC reimbursement systems and coding requirements [Required]
  • Ability to perform coding audits and identify accuracy, compliance, and reimbursement trends [Required]
  • Ability to translate audit findings into clear, actionable feedback and education [Required]
  • Knowledge of coding guidelines and CMS regulatory requirements [Required]
  • Strong analytical and problem-solving skills [Required]
  • Effective communication and collaboration skills [Required]
  • Ability to manage time and meet deadlines [Required]

Education:

  • High School Grad or Equiv [Required]
  • Associates degree [Preferred]

Field of Study:

  • Healthcare related discipline 

Work Experience:

  • 5+ years of acute care inpatient or outpatient hospital coding[Required]
  • Experience with high complexity cases [Required]
  • Experience in coding audits or quality review [Preferred]

Licenses and Certifications:

  • Certified Coding Specialist (CCS) [Required] OR Registered Health Information Administrator (RHIA) [Required] OR Registered Health Information Technician (RHIT) [Required] OR Certified Professional Coder (CPC) [Required] OR Certified Interventional Radiology Cardiovascular Coder (CIRCC) [Required]

Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

$26.55 - $49.39

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.


Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:
https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Skills Required

  • Proficient experience with EMR and CAC systems; Epic and Optum preferred
  • Strong knowledge of ICD-10-CM/PCS and/or CPT/HCPCS coding, modifier usage, and reimbursement methodologies
  • Understanding of DRG/IPPS and/or OPPS/APC reimbursement systems and coding requirements
  • Ability to perform coding audits and identify accuracy, compliance, and reimbursement trends
  • Ability to translate audit findings into clear, actionable feedback and education
  • Knowledge of coding guidelines and CMS regulatory requirements
  • Strong analytical and problem-solving skills
  • Effective communication and collaboration skills
  • Ability to manage time and meet deadlines
  • High school graduation or equivalent
  • Associate degree
  • Healthcare-related field of study
  • 5+ years of acute care inpatient or outpatient hospital coding experience
  • Experience with high-complexity cases
  • Experience in coding audits or quality review
  • One required certification: CCS, RHIA, RHIT, CPC, or CIRCC

AdventHealth Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about AdventHealth and has not been reviewed or approved by AdventHealth.

  • Healthcare Strength — Comprehensive medical, dental, vision, and pharmacy coverage is offered with multiple plan options and 100% coverage for preventive care. Wellness programs and mental health resources are included to support whole-person well-being.
  • Retirement Support — Retirement programs include the Adventist HealthCare Retirement Plan with employer cash contributions and matching for employee contributions. Additional financial protections include disability and life/AD&D insurance and tax-advantaged accounts.
  • Wellbeing & Lifestyle Benefits — Whole-person resources feature mental-health support (e.g., Lyra), wellness initiatives, and an Employee Assistance Program. Tuition assistance, education pathways via AdventHealth University, and employee discounts add lifestyle and career value.

AdventHealth Insights

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The Company
HQ: Altamonte Springs, FL
80,000 Employees
Year Founded: 1973

What We Do

At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. More than 80,000 skilled and compassionate caregivers in physician practices, hospitals, outpatient clinics, skilled nursing facilities, home health agencies and hospice centers provide individualized, wholistic care. Our Christian mission, shared vision, common values and focus on whole-person health is our commitment to making communities healthier with a unified system: 50 hospital campuses and hundreds of care sites in diverse markets throughout nine states.

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