Florida Licensed Clinical Audit Manager

Job Summary

To lead and oversee clinical and coding operations, the full-time remote Senior Manager, Clinical & Coding will manage end-to-end audit activities, ensure regulatory compliance, and optimize financial outcomes while mentoring multidisciplinary teams.

Key Responsibilities

• Lead and oversee clinical and coding audits, ensuring compliance with CMS regulations and coding guidelines
• Provide subject matter expertise in clinical documentation and coding accuracy, supporting audit findings and rebuttals
• Manage and develop audit teams, assigning workloads and monitoring productivity to ensure timely completion of audits

Required Qualifications

• Bachelor's degree in Nursing
• 7+ years of experience in healthcare auditing, focusing on clinical and coding post-pay audits
• 1+ years of people leadership experience, including training and performance feedback
• Strong knowledge of CMS regulations and official coding guidelines
• Professional credentials such as RHIA, RHIT, CCS, CPC, or equivalent