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Baptist Health is a not-for-profit healthcare system serving South Florida through 12 hospitals and approximately 200 outpatient centers, urgent care facilities, and physician practices. Its more than 29,000 employees and 4,500 physicians provide care across Miami-Dade, Monroe, Broward, and Palm Beach counties, with specialized programs in cancer, heart and vascular, brain and spine, and orthopedics. Guided by a faith-based, community-oriented mission, Baptist Health focuses on clinical quality, patient safety, staff development, and accessible care.
Physician Practice E/M Auditor Educator - Baptist Health, Florida Remote
Baptist Health seeks a physician coding auditor to review E/M compliance, billing accuracy, and medical necessity. The role also develops provider education and corrective coding resources based on audit findings and regulatory updates.
Description
- Conduct thorough audits of physician and clinical fee coding and billing to assess accuracy and integrity.
- Identify and resolve documentation, coding, billing, and medical-necessity issues affecting billed services.
- Review documentation accuracy across E/M and other payer codes, medical necessity, reimbursement variances, and documentation compliance standards.
- Research applicable federal regulations and compliance guidance, then incorporate them into audit processes.
- Create and deliver provider education programs and curricula, including coding guides, materials, tools, webinars, and campaigns informed by audit findings, trends, and regulatory changes.
- Facilitate provider education sessions covering audit outcomes, emerging trends, and corrective action plans.
- Support or manage related auditing and coding projects, along with additional assignments from executive leadership.
- Act as a coding compliance subject matter expert, build effective stakeholder relationships, provide risk guidance, and reinforce understanding of federal requirements.
Requirements
- High school diploma, certificate, GED, training, or equivalent experience.
- CPC and/or CCS-P certification is required upon hire.
- CPMA certification is required upon hire or must be obtained within one year.
- At least two years of professional E/M coding experience and two years of E/M provider education experience.
- Previous experience in physician coding and auditing, revenue cycle, or coding-related billing.
- Strong understanding of E/M regulations and CMS documentation guidelines.
- Demonstrated ability to abstract data, analyze patient encounters in focused review samples, and create comprehensive coding education materials and resources.
- Proficiency with ICD-10-CM, CPT, and HCPCS coding, as well as physician-practice policies and procedures.
- Strong organization and careful attention to detail.
- Ability to prioritize provider record reviews, projects, and coding education in alignment with audit findings and broader trends.
- Ability to work independently with minimal supervision.
- Ability to deliver excellent customer service.
- Strong computer skills, including Microsoft Office proficiency and report generation; four years of required experience.
- Minimum required experience: 4 years.
Benefits
- Opportunities for career development and advancement supported by defined pathways.
- Broad health and wellness resources extending beyond standard benefits.
- A wellness program that may help eliminate the medical plan deductible and lower out-of-pocket healthcare expenses.
- Tuition reimbursement for continued education and professional growth.
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