Medical Coding Auditor

Location: Miami, FL (On-site preferred; Hybrid/Remote may be considered) Employment Type: Part-Time (25-35 hours per week) About the Position We are seeking an experienced Senior Medical Coding Auditor (CPC) to join our growing multi-specialty medical practice specializing in Primary Care and Gynecology. The ideal candidate will be responsible for reviewing clinical documentation before claims are submitted to ensure accurate coding, appropriate E/M level selection, documentation compliance, and optimal reimbursement while maintaining full regulatory compliance. This position works closely with providers, clinical staff, and the billing department to improve documentation quality, reduce claim denials, maximize appropriate reimbursement, and ensure coding accuracy. Primary Responsibilities Review approximately 300 provider notes per week for coding accuracy and documentation compliance prior to claim submission. Validate appropriate Evaluation & Management (E/M) level selection according to current AMA and CMS guidelines. Review and validate CPT, ICD-10-CM, HCPCS codes, and appropriate modifiers. Review coding for Primary Care and Gynecology services to ensure documentation supports all billed services. Ensure documentation fully supports the services billed. Identify coding discrepancies, documentation deficiencies, and compliance concerns. Return encounters to providers when documentation clarification or corrections are required. Collaborate with providers and the billing department to minimize denials and coding-related claim rejections. Assist providers in improving clinical documentation to accurately support medical necessity and coding. Monitor coding trends and identify opportunities to improve reimbursement while maintaining compliance. Participate in provider education, internal coding audits, and documentation improvement initiatives. Stay current with CPT, ICD-10, CMS regulations, payer policies, and coding updates. Qualifications Required Minimum 3 years of physician coding experience in Primary Care, Family Medicine, Internal Medicine, and/or Gynecology. Thorough knowledge of 2021+ E/M Documentation Guidelines. Advanced knowledge of CPT, ICD-10-CM, HCPCS Level II, and modifier usage. Experience performing pre-bill coding reviews and documentation audits. Strong analytical skills and exceptional attention to detail. Excellent communication skills and ability to work collaboratively with providers. Preferred Experience coding Gynecology services (well-woman exams, preventive visits, office procedures, and gynecologic evaluations). Experience using eClinicalWorks (eCW). Experience working with Medicare, Medicaid, and commercial insurance plans (Oscar, Aetna, Cigna, UnitedHealthcare, and other commercial payers). Experience providing provider education and documentation improvement feedback. Schedule Part-Time (25-35 hours per week) Monday-Friday Flexible schedule Compensation Competitive hourly pay based on experience and certifications. Performance Expectations Review approximately 300-400 provider encounters per week. Maintain a turnaround time of 24 hours or less for coding reviews. Ensure coding accuracy, documentation integrity, and compliance with payer guidelines. Work collaboratively with providers to improve documentation quality and coding consistency. Help reduce coding-related denials while supporting appropriate reimbursement. Ideal Candidate The ideal candidate is detail-oriented, proactive, and highly experienced in physician coding. This individual enjoys working directly with providers, has extensive knowledge of Primary Care and Gynecology documentation requirements, and is committed to maintaining the highest standards of coding accuracy, compliance, and revenue integrity. Flexible work from home options available. #J-18808-Ljbffr