Coding Auditor

AdventHealth; Orlando (FL); On-site; USD 36,000 - 68,000; Full time

Benefits offered by this job

Benefits from Day One

Paid Time Off from Day One

403-B Retirement Plan

Parental Leave

Career Development

Whole Person Well-being Resources

Mental Health Resources and Support

Pet Benefits

Job summary

AdventHealth in Orlando, FL is seeking a coding audit specialist to evaluate post-bill coding accuracy across inpatient and outpatient services. You will validate DRG assignments, MCC/CC integrity, modifiers, and APC mapping, ensuring compliant reimbursement and standardization of practices.

The role emphasizes translating audit results into targeted education, supporting onboarding, and maintaining CMS regulatory compliance while meeting deadlines in a fast-paced healthcare environment.

Qualifications

• Proficient experience with EMR and CAC systems.
• Strong knowledge of ICD-10-CM/PCS, CPT/HCPCS coding and modifiers.
• Understanding of DRG/IPPS and OPPS/APC reimbursement systems.
• Ability to perform coding audits and identify trends.
• Translate audit findings into actionable feedback and education.
• Knowledge of CMS regulatory requirements.
• Strong analytical and problem-solving skills.
• Effective communication and collaboration skills.
• Ability to manage time and meet deadlines.

Responsibilities

• Conducts post-bill coding audits to assess accuracy and reimbursement integrity.
• Performs coding validation including DRG, MCC/CC integrity, and APC assignment.
• Applies IPPS, OPPS, DRG, APC, ICD-10-CM/PCS, CPT/HCPCS guidelines during audits.
• Identifies trends related to accuracy, documentation quality, and reimbursement outcomes.
• Provides detailed audit findings and feedback to improve coding practices.
• Collaborate with education team to translate audits into training.
• Supports onboarding audits and competency validation for new coders.
• Reinforces adherence to coding guidelines and enterprise standards.
• Tracks and reports audit outcomes and quality trends.

Skills

EMR/CAC systems

ICD-10-CM/PCS and CPT/HCPCS

DRG/IPPS & OPPS/APC knowledge

Coding audits & quality review

Audit feedback & education translation

CMS regulatory requirements

Analytical & problem-solving

Communication & collaboration

Time management & deadlines

Education

High School Diploma or Equivalent

Associate's degree

Tools

Epic

Optum

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.

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:

$26.29 - $48.91

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.