Coding Auditor

1103 Team Member Services; Orlando (FL); On-site; USD 55,000 - 103,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

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

Job summary

AdventHealth is seeking a skilled Medical Coder Auditor to conduct post-bill coding audits across inpatient and outpatient services. The role requires deep knowledge of ICD-10-CM/PCS, CPT/HCPCS and DRG/IPPS/OPPS rules, with strong analytical and communication skills for actionable feedback.

Ideal candidates have 5+ years in acute care coding, CCS/RHIA/RHIT/CPC/CIRCC, and experience with Epic/Optum EMR systems. This is a full-time on-site position in Orlando, FL with competitive benefits.

Qualifications

• 5+ years of acute care inpatient or outpatient hospital coding.
• Experience with high complexity cases.
• Experience in coding audits or quality review.
• Certifications in CCS, RHIA, RHIT, CPC or CIRCC are required.

Responsibilities

• Conducts post-bill coding audits to assess coding accuracy and reimbursement integrity.
• Performs coding validation including DRG, MCC/CC, modifier, and APC assignments.
• Applies IPPS/OPPS rules and CPT/HCPCS guidelines during audits.
• Identifies trends in coding accuracy and reimbursement outcomes.
• Provides detailed audit findings and education to support improvements.
• Collaborates to translate audit results into training materials.
• Supports onboarding audits and competency validation for new coders.
• Reinforces adherence to coding guidelines and CMS requirements.
• Tracks audit outcomes and quality trends for performance improvement.

Skills

EMR CAC systems

Epic Optum

ICD-10-CM/PCS CPT/HCPCS

DRG IPPS OPPS APC

Coding audits

Audit feedback

CMS regulations

Analytical skills

Communication

Time management

Education

High School Grad or Equiv

Associates degree

Healthcare related discipline

Job description

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.

Benefits

• Medical Insurance
• Dental Insurance
• 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 & Location

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.
• Collaborates 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

• [Required] 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.

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

Physical Requirements - https://tinyurl.com/23km2677

Pay Range: $26.55 - $49.39

Background Screening Requirement

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.

Every day, our fellow team members show up to work, unified by one shared mission: Extending the Healing Ministry of Jesus Christ. As a faith-based health care organization, our story is one of hope as we strive to heal and restore the body, mind and spirit. Though our facilities are spread across the country, this unwavering belief binds us together. Across every office, exam and patient room, we’re committed to providing individualized, holistic care. This is our Christian mission, and it inspires us to help make communities healthier and happier.