Medical Coding Auditor
Employment type
Full-time
Work setting
On-site
Location
Fort Lauderdale, FL
Schedule
Day shift
Posted
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Job overview
The Medical Coding Auditor role follows a hybrid work schedule in Fort Lauderdale, FL. Compensation is not specified. South Florida Community Care Network’s audit work addresses potential fraud, waste, abuse, and overpayment in healthcare claims. The auditor reviews medical records, claims, and appeals to assess coding and billing against guidelines, coverage policies, and regulatory and contract requirements. The role documents findings, prepares reports and appeal summaries, and supports compliance and potential fraud investigations.
What you'll do
- Conduct pre- and post-payment medical record audits and appeal reviews
- document coding guidelines, coverage policies, decisions, and discrepancies
- prepare appeal summaries and present reviews to the appeals committee
- notify providers of findings
- identify potential fraud, waste, and abuse
- analyze billing practices and calculate overpayments or underpayments
- prepare reports and compile data.
What we're looking for
- Skills & competencies
- medical coding auditorfort lauderdale flsouth florida community care networkmedical codingclaims auditingappeals reviewmedicaidcompliancefraud waste and abusehybrid work
- Work arrangement
- Weekend coverage required
About the employer
South Florida Community Care Network LLC is hiring for this role. Industry: HMO Medical Centers. Sector: 62.
Additional details
- Industry sector
- 62
- Industry
- HMO Medical Centers
- Occupation code
- 29-2072.00
You'll be redirected to the employer's application page.
Listing ID: c0869166-aba5-41a0-9c6d-4d6e117d4a06