Healthcare Coding Quality Auditor & Educator (CPC/CCS-P)

Jobtailor; Gainesville (FL); On-site; USD 70,000 - 90,000; Full time

Job summary

Jobtailor in Gainesville, FL is seeking a healthcare coding auditor to conduct comprehensive audits of provider documentation and coding accuracy. You will evaluate ICD-9/ICD-10, CPT, and HCPCS codes, ensure medical necessity, and communicate findings to physicians and leadership.

The role includes educator duties, corrective actions, and ongoing education programs. Ideal candidates have CPC/CCS-P/CPMA/CEMC certifications, 3+ years in CPT/ICD-10 coding audits, and strong analytical,

Qualifications

• CPC and/or CCS-P Coding Certification.
• CPMA, CEMC, or other healthcare auditing certification within 6 months of hire.
• High School Diploma or GED.
• 3+ years of healthcare CPT/ICD-10 coding experience in auditing or documentation review.
• Ability to apply coding guidelines to complex, multi-specialty documentation.

Responsibilities

• Conduct coding, billing, and documentation audits.
• Evaluate documentation adequacy supporting billed services (ICD-9/ICD-10, CPT, HCPCS).
• Ensure medical necessity and compliance with documentation, coding, and billing standards.
• Apply standardized audit scoring and findings methodologies.
• Communicate audit results to physicians, leadership, Compliance, and staff.
• Provide physician and coder education and recommend corrective actions.
• Serve as SME on documentation and coding rules and regulations.
• Coordinate and perform professional services documentation and coding audits for outpatient records.
• Review clinical documentation for completeness, accuracy, and data integrity.
• Conduct daily audits for new, PRN, locum, and flagged providers until standards are met.
• Review findings with providers and recommend improvements.
• Train and orient new providers on coding and documentation expectations.
• Prepare and deliver audit reports by provider and practice.
• Track provider improvement and compliance.
• Develop and deliver coding education, training programs, and updates.
• Support denial management by reviewing CPT denials and implementing corrective actions.
• Support operational needs including claims, queues, and escalations.

Skills

Communication Skills

Analytical Skills

Presentation Skills

Collaboration Skills

Education and Training Skills

Education

CPC Certification

CCS-P Certification

CPMA Certification

CEMC Certification

Tools

Microsoft Office

Excel

PowerPoint

Job description

Jobtailor in Gainesville, FL is seeking a healthcare coding auditor to conduct comprehensive audits of provider documentation and coding accuracy. You will evaluate ICD-9/ICD-10, CPT, and HCPCS codes, ensure medical necessity, and communicate findings to physicians and leadership.

The role includes educator duties, corrective actions, and ongoing education programs. Ideal candidates have CPC/CCS-P/CPMA/CEMC certifications, 3+ years in CPT/ICD-10 coding audits, and strong analytical,