Physician Billing Auditing Manager -Hybrid work setting, Florida residency required
Position Summary:The PB Audit Manager is responsible for leading and managing the auditing functions of Physician Practices across multiple specialties with a focus on Physician & Coder Education. This role ensures coding accuracy, compliance with regulatory guidelines, and optimal reimbursement through proactive audit strategies, education and collaboration with clinical, coding and financial teams
Key Responsibilities:- Audit Oversight & Execution
- Develop and implement a comprehensive auditing program for professional fee coding.
- Conduct routine and targeted audits to assess coding accuracy, documentation quality, and compliance with CMS, CPT, ICD-10, and payer-specific guidelines.
- Analyze audit findings and identify trends, risks, and opportunities for improvement in documentation and coding accuracy.
- Team Leadership & Development
- Provide mentorship, performance feedback, and ongoing training.
- Identify organizational opportunities to partner with Providers, improve coding quality and prevent unnecessary corrective actions
- Plan Provider education with Physician Practices as warranted
- Compliance & Risk Management
- Collaborate with Compliance and Legal departments to ensure adherence to federal and state regulations.
- Support internal and external audit processes, including RAC, MAC, and payer audits.
- Maintain documentation of audit results and corrective actions for compliance reporting.
- Reporting & Analytics
- Prepare detailed audit reports and dashboards for leadership, highlighting key metrics and trends.
- Roll-out targeted education for improvement based on findings
- Stakeholder Collaboration
- Work closely with physicians, Physician Practice Administration, Clinical Information Systems, and revenue cycle leadership to resolve coding discrepancies and improve documentation practices.
- Serve as a subject matter expert on coding guidelines and reimbursement policies.
Qualifications:- Education & Certification
- Bachelor's Degree in Health Information Management, Healthcare Administration, or related field (preferred).
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent credential required.
- Certified Professional Medical Auditor (CPMA) preferred.
- Experience
- Minimum 5 years of experience in coding, with at least 2 years in a leadership or auditing role.
- Experience providing coder mentorship and physician education in PB coding matters.
- Strong knowledge of CPT, ICD-10, HCPCS, and E/M coding guidelines.
- Experience with electronic health records, coding software, and audit tools.
- Skills
- Excellent analytical, organizational, and communication skills.
- Proficiency in Microsoft Office Suite and data reporting tools.
BenefitsWe believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs. Our robust employee benefits package includes:
• Health benefits
• Life insurance
• Long-term disability coverage
• Healthcare spending accounts
• Retirement plan
• Paid time off
• Pet Insurance
• Tuition reimbursement
• Employee assistance program
• Wellness program
• On-site housing for select positions and more!
