Coding Compliance Auditor I: Drive Accurate Reimbursement

Jackson Health System; Miami (FL); On-site; USD 55,000 - 75,000; Full time

Job summary

Jackson Health System in Miami, FL is seeking an HIM Coding Compliance Auditor 1 to analyze abstracted and coded data for accurate DNFB management, AHCA data submissions and PFS communication.

The role requires 5–7 years of related experience, strong analytical skills and the ability to collaborate with PFS and clinical staff to ensure coding compliance across ICD-9-CM, CPT-4 and related guidelines, while maintaining high professional standards.

Qualifications

• High school diploma required; bachelor's degree preferred.
• Strong analytical and organizational skills.
• Ability to communicate effectively in writing and verbally.
• Knowledge of healthcare coding concepts and relevant regulations.

Responsibilities

• Reviews quality of coded and abstracted data assuring coding compliance within the Jackson Health System.
• Performs target and focused MS-DRG, APC, CPT, Case mix and Medical Necessity reviews.
• Identifies monitors and corrects rejected claims due to HIM coding.
• Works as a liaison with PFS and other internal departments to facilitate reimbursement.
• Develops training protocols for coders on ICD-9-CM, CPT-4, APCs and coding guidelines.
• Collaborates with Coding Manager to achieve departmental goals.
• Assists in preparation of policies related to coding and abstracting.
• Communicates effectively with supervisors, managers, peers, hospital personnel and physicians.

Skills

Data analysis

Prioritization

Communication

Critical thinking

Independent judgment

Problem solving

Education

High school diploma

Bachelor's degree in related field

Job description

Jackson Health System in Miami, FL is seeking an HIM Coding Compliance Auditor 1 to analyze abstracted and coded data for accurate DNFB management, AHCA data submissions and PFS communication.

The role requires 5–7 years of related experience, strong analytical skills and the ability to collaborate with PFS and clinical staff to ensure coding compliance across ICD-9-CM, CPT-4 and related guidelines, while maintaining high professional standards.