24 coding auditor jobs found

Medical Coder Trajectory RCS joined the MedHQ family in 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing healthcare cash flow through integration of both business office processes and clinical documentation. MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and above all excellent...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

A leading health network in Arizona is seeking a detail-oriented professional for a medical coding role. Responsibilities include ensuring the accurate assignment of codes, complying with medical coding guidelines, and conducting audits for adherence to regulations. The ideal candidate will possess strong analytical skills and be knowledgeable about insurance regulations. This role includes travel between network sites and may require evening or weekend hours as needed. #J-18808-Ljbffr

Professional Services Certified Coding Reviewer Position Code: Coder-8125 Department: Health Information Management Safety Sensitive: YES Reports To: HIM Director/Manager Exempt Status: NO Position Purpose: All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHIs vision to be among the kindest highest quality health systems in the country. Key Responsibilities Ensures data quality in compliance with State Federal and regulatory requirements. Evaluates medical record documentation and charge reports to ensure completeness accuracy and compliance with the Correct Coding Initiative Edits. Codes all professional charges to ensure accurate and timely billing. Performs coding reviews and/or surgical coding for practices and providers. Evaluates and reports audit findings or reviews and reports on results to physicians and/or operations directors. Provides technical guidance training and on-going coding education when...

Medix - 3003 North Central [Medical Records Clerk] As a Coder at Medix, you'll: Analyze medical records to assign appropriate codes for billing and insurance purposes; Ensure accuracy and compliance with coding guidelines and regulations; Collaborate with healthcare professionals to clarify diagnoses and procedures; Maintain confidentiality of patient information; Update coding knowledge through continuous education and training; Assist in audits and reviews to improve coding processes and accuracy...Hiring Immediately >>

Datavant Inpatient Coder Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team....

Abstractor/Coder The University of Chicago Physicians Group (UCPG) team is responsible for the overall management of clinical revenue for physician billing. This includes frontend revenue capture, working of edits and conducting audits for physician education. Ensuring the workflow of charge capture through invoice creation. UCPG is seeking an Abstractor/Coder to work with providers and staff on professional billing and compliance activities. Strong knowledge of evaluation and management coding guidelines and requirements is strongly preferred. This position is eligible for a flexible work arrangement. Responsibilities: Obtain appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses, and physician visits. Analyze denial and rejection reports, and appeal wherever appropriate. Submit charges in a timely manner. Work in collaboration with the Clinical Revenue Supervisor and others, provide guidance to faculty and staff on...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from...

Risk Adjustment Coder Specialist Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for...

Job Opportunity: Inpatient Coder Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of...

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate...

Navajo Preference Employment Act TCRHCC is located within the Navajo Nation and, in accordance with Navajo Nation law and applicable federal law, has implemented a Navajo/Indian Preference in Employment Policy. Pursuant to this Policy, applicants who are enrolled members of the Navajo Nation, Hopi Tribe, and San Juan Southern Paiute Tribe and who meet the necessary qualifications for this position will be given preference in hiring and employment for this position. Applicants who are legally married to an enrolled member of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe, who have resided within the territorial jurisdiction of the Navajo Nation or other federally-recognized American Indian Tribe for at least one continuous year immediately preceding the date of application, and who meet the necessary qualifications for this position will be given secondary preference. Applicants who are enrolled members of any other federally-recognized American Indian Tribe and...

Job Description Staff Position Description Position Title: Professional Services Certified Coding Reviewer Position Code: Coder-8125 Department: Health Information Management Safety Sensitive: YES Reports to: HIM Director/Manager Exempt Status: NO Position Purpose: All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI's vision to be among the kindest, highest quality health systems in the country. Key Responsibilities Ensures data quality in compliance with State, Federal and regulatory requirements. • Evaluates medical record documentation and charge reports to ensure completeness, accuracy and compliance with the Correct Coding Initiative Edits. • Codes all professional charges to ensure accurate and timely billing • Perform coding reviews and/or surgical coding for practices and providers. • Evaluates and report audit findings or reviews and reports on results to physicians and/or...

PLEASE NOTE - This position may require temporarily relocation to other TONHC Facilities: Sells Hospital, Santa Rosa Health Center, San Simon Health Center, and San Xavier Health Center. Position Summary: Under general supervision, this position serves as a certified professional coder; performs the full range of coding, assigns ICD, CPT, HCPCS, and medical inpatient codes; abstracts data from the record; perform chart analysis; peer review; and serves as a medical documentation and coding technical expert to TONHC providers. Scope of Work: This position is located within Tohono O'odham Nation Health Care (TONHC). The work involves performing specialized medical record tasks and resolving problems using established processes, coding conventions, and guidelines. Performance of duties reflects directly on patient care by recording services performed on the patient. The incumbent works independently under the general supervision of the Supervisor or designee....

ESSENTIAL FUNCTIONS FOR THIS POSITION • Ensures that codes are assigned correctly and sequenced appropriately as per government and insurance regulations • Complies with all medical coding guidelines • Follows up and clarifies any information that is not clear with the rendering provider • Conducts ad-hoc audits to ensure fidelity to coding guidelines • Relevant expert for Southwest Network on accurate and efficient coding practices • Analyze medical records and identify documentation deficiencies NONESSENTIAL FUNCTIONS • Follows policies and procedures and adheres to the requirements of the Corporate Compliance Program. • Ensures confidentiality of verbal and written information in accordance with HIPAA standards and Southwest Network policy, and adheres to the legal, ethical, and professional guidelines adopted by Southwest Network. • Other duties as assigned. EDUCATION and/or EXPERIENCE, LICENSURE and CERTIFICATION • Associate degree in medical coding or...

Position Summary TheMedical Coder/Audit Specialist position is an exempt salaried position thatensures that AAAI's coding, documentation, and billing practices are accurate,compliant, and aligned with payer regulations. This role reduces risk exposure,strengthens revenue capture, manages payer portals, and supports providersthrough education and proactive auditing. This position supports timelysubmission of insurance claims to a wide variety of payers and functions as anintermediary between healthcare providers, clients, patients and healthinsurance companies. Must be certified from an accredited organization such as AAPC (CPC) (CCS) is required in coding and / or billing. Reports To: Medical PracticeAdministrator Principal Duties andResponsibilities 1.Revenue Protection & Growth Accurate Coding = Correct Reimbursement: Ensures all CPT/ICD-10 codes and HCPCS are properly supported, reducing underpayments. Audit-Driven Optimization: Identifies missed...

Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be...

Medical Coder Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting. We are seeking an experienced Medical Coder to join our healthcare consulting practice. The role is fully remote within the US, with infrequent travel to client locations for onboarding and training. We are proud of our national presence, and excited to offer great career opportunities within the organization. What you'll do: Accurately assign ICD-10 CM, E/M, ICD-10 PCS, CPT, HCPCS, modifiers and units based on documentation. Adhere to systems and standards required in multi-specialty medical coding encounters, including Outpatient, Emergency Room, Surgery, Inpatient facilities, Inpatient Professional Rounds, and others. Process encounters within required SLA on contract with deficiencies identified escalated as necessary. Review and respond to each audit within...

Position Title and Code Professional Services Certified Coding Reviewer Position Code: Coder-8125 Department and Reporting Department: Health Information Management Reports to: HIM Director/Manager Safety Sensitive: YES Exempt Status: NO Position Purpose All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI’s vision to be among the kindest, highest quality health systems in the country. Key Responsibilities Ensures data quality in compliance with State, Federal and regulatory requirements Evaluates medical record documentation and charge reports to ensure completeness, accuracy and compliance with the Correct Coding Initiative Edits Coded all professional charges to ensure accurate and timely billing Perform coding reviews and/or surgical coding for practices and providers Evaluates and report audit findings or reviews and reports on results to physicians and/or operations directors Provides technical guidance, training,...

Healthcare Coder – Southwest Network This position requires a candidate who can accurately code healthcare services in compliance with government and insurance regulations, maintain confidentiality, and work efficiently with electronic medical record systems. Essential Functions Assigns codes correctly and sequences them according to regulatory guidelines. Complies with all medical coding guidelines. Follows up and clarifies any unclear information with providers. Conducts ad‑hoc audits to ensure fidelity to coding guidelines. Serves as a subject‑matter expert for accurate and efficient coding practices. Analyzes medical records and identifies documentation deficiencies. Nonessential Functions Follows policies and procedures and adheres to the Corporate Compliance Program. Maintains confidentiality of verbal and written information per HIPAA standards and Southwest Network policy. Performs other duties as assigned. Education, Experience & Certifications Associate degree...

Join to apply for the Professional Billing Coder II role at Onvida Health 2 days ago Be among the first 25 applicants Join to apply for the Professional Billing Coder II role at Onvida Health Get AI-powered advice on this job and more exclusive features. Job Description Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Job Description Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Days Pay Rate Type: Hourly Location: Remote Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $22.62 Mid = $28.28 Max = $33.93 Summary The Professional Billing Coder II is an intermediate-level coding professional responsible for independently reviewing medical documentation and assigning accurate diagnostic and...

Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Days Pay Rate Type: Hourly Location: Remote Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $22.62 Mid = $28.28 Max = $33.93 Summary The Professional Billing Coder II is an intermediate-level coding professional responsible for independently reviewing medical documentation and assigning accurate diagnostic and procedural codes for outpatient and professional services. This role requires advanced knowledge of coding guidelines and payer‑specific requirements to support correct billing, compliance, and optimal reimbursement. The PB Coder II works with minimal supervision and may assist with training or mentoring entry‑level coders. Responsibilities Review and interpret...

As a member of the care team, the Certified Coder is responsible for working collaboratively with other team members to assure the safe, timely and accurate delivery of patient care. The Certified Coder is responsible for accurate and timely coding of surgeries, consults and E&M visits. Customer Service Operates within the concept of patient focused care Delivers caring, timely service with positive body language Presents good telephone skills Greets patients at every stage of the visit Responds promptly to patient needs requests Responds promptly to Physician and team member requests and inquiries Participates as an active, positive member of the TOI team Certified CoderDuties Reviews all surgery charge slips Works with physicians on procedures and charges Knows how to use ICD-10, CPT, CCI and coding companion books to assign appropriate codes and modifiers Assigns appropriate codes using ICD-10 and CPT Requests details from clinical staff when information is not recorded...

Essential Functions Ensures that codes are assigned correctly and sequenced appropriately as per government and insurance regulations Complies with all medical coding guidelines Follows up and clarifies any information that is not clear with the rendering provider Conducts ad-hoc audits to ensure fidelity to coding guidelines Serves as a relevant expert for Southwest Network on accurate and efficient coding practices Analyzes medical records and identifies documentation deficiencies Nonessential Functions Follows policies and procedures and adheres to the requirements of the Corporate Compliance Program Ensures confidentiality of verbal and written information in accordance with HIPAA standards and Southwest Network policy, and adheres to the legal, ethical, and professional guidelines adopted by Southwest Network Other duties as assigned Working Conditions and Driving Travel between Southwest Network sites as well as in the community is required; must have a registered...