53 coding auditor jobs found

Location: Remote (Must reside in TX, GA, LA, MS, AL, FL, WA, or TN) Schedule: Full-time, 40 hours/week Training Schedule: Monday–Friday, 7:00 AM – 3:30 PM CT Post-Training Flexibility: Flexible start times between 5:00 AM – 10:00 AM CT; ability to make up time on weekends Systems Used: Epic, 3M 360, Microsoft Teams Position Overview Are you an experienced Inpatient Hospital Coder looking for a stable, high-quality remote role with long-term growth potential? We are partnering with a large, multi-facility health system to hire Inpatient Coders to support both production-based inpatient coding and pre-bill review/audit functions across multiple hospitals. This team supports several inpatient facilities, offering a diverse and engaging case mix. Depending on experience and team needs, coders may be aligned to production coding, auditing, or a blend over time. The organization is known for strong leadership, low turnover, internal promotions, and a supportive...

We are hiring a part-time Medical Coder to to assign procedure,diagnosis codes for insurance billing, review claims data, research and corresponds with insurance companies in an effort to obtain accurate reimbursement for healthcare claims. . Duties include but are not limited to: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims Adhere to coding policies and procedures consistent with the industry standard guidelines for CPT, ICD-9 and ICD-10. Answer coding questions Review clinical documentation to ensure it meets level of CPT codes and ICD-10 codes Performs related duties, as...

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...

Summary Selected by CHRISTUS Health Coding Leadership, to focus coding skills and expertise on designated Inpatient or Outpatient high dollar or specialty account types. Specialty Coder is responsible for maintaining current and high-quality ICD-10-CM, ICD-10-PCS and/or CPT coding for the Inpatient and or/ Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Specialty Coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding and Reporting and AMA CPT Guidelines. Coder will work collaboratively with various CHRISTUS Health departments, including but not limited to the HIM and Clinical Documentation Specialists, to ensure accurate and complete physician documentation to support...

Job Description Job Description At Broadway Ventures , we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider—we're your trusted partner in innovation. Position Summary We are seeking an experienced Certified Coder to support medical review activities through complex coding validations and quality assurance efforts. This role requires deep expertise in Medicare coding guidelines, DRG validation, and CMS FFS RAC Program requirements. Education High School Diploma required Associate degree or higher preferred Licensure / Certifications Certification from an accredited...

We Are Hiring * Department: Pediatric Surgery Department * Schedule: Monday - Friday 8:00a - 4:30p * Facility: Strictly Peds Medical Office * Location: 1301 Barbara Jordan Blvd Suite 400 Austin, Texas What You Will Do Apply the appropriate diagnostic and procedural code to patient health records for purposes of document retrieval, analysis and claim processing. Responsibilities: * Abstract pertinent information from patient records. Assign the International Classification of Diseases, Clinical Modification (ICD), Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes, creating Ambulatory Patient Classification (APC) orDiagnosis-Related Group (DRG) assignments. * Perform complex coding. * Obtain acceptable productivity/quality rates as defined per coding policy. * Query physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. * Maintain knowledge of,...

Overview Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment team. 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 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...

Medical Coder - Multi-Specialty (Hospital & Clinic) Location: Kingwood-Hybrid Employment Type: Full-Time Reports To: Revenue Cycle Manager Position Summary We are seeking a highly skilled, detail-driven, and high-producing Certified Medical Coder with multi-specialty experience to join our growing healthcare organization. This role requires strong proficiency in both hospital and outpatient clinic coding, with specialty expertise in: • Cardiology • Urology • Dermatology • General Surgery • Pulmonology The ideal candidate has 2+ years of coding experience, maintains current certification (AAPC or equivalent), and consistently demonstrates accuracy, productivity, and strong clinical understanding across multiple service lines. This is a high-impact role within a performance-driven, collaborative organization focused on compliance, precision, and revenue integrity. Core Responsibilities Coding & Documentation Review • Accurately assign...

Registered Nurse Clinical Coder DRG Audit Our client is seeking an experienced Registered Nurse Clinical Coder to support DRG audit activities for one of their major healthcare partners. This role focuses on reviewing inpatient medical records, validating DRG assignments, and ensuring coding accuracy from an insurance and payer-side perspective rather than the provider side. This is an excellent opportunity for an RN with coding experience who enjoys analytical work, documentation review, and collaborating with audit teams. Key Responsibilities: Perform DRG audits on inpatient medical records to validate ICD-10 coding accuracy and DRG assignment. Review clinical documentation to ensure compliance with payer guidelines and audit standards. Identify discrepancies, trends, and opportunities for coding improvement. Communicate audit findings clearly and professionally through written reports and outbound calls as needed. Collaborate with internal teams to support audit...

Revenue Cycle Management Full Time Position Apply the appropriate diagnostic and procedural code to patient health records for purposes of document retrieval, analysis and claim processing. Responsibilities include: Abstracting pertinent information from patient records. Assigning the International Classification of Diseases, Clinical Modification (ICD), Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes, creating Ambulatory Patient Classification (APC) or Diagnosis-Related Group (DRG) assignments. Performing complex coding. Obtaining acceptable productivity/quality rates as defined per coding policy. Querying physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Maintaining knowledge of, complying with and keeping abreast of coding guidelines and reimbursement reporting requirements. Conducting chart audits for physician documentation...

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. The ideal...

Medical Coder Multi-Specialty (Hospital & Clinic) Location: Kingwood-Hybrid Employment Type: Full-Time Reports To: Revenue Cycle Manager Position Summary We are seeking a highly skilled, detail-driven, and high-producing Certified Medical Coder with multi-specialty experience to join our growing healthcare organization. This role requires strong proficiency in both hospital and outpatient clinic coding, with specialty expertise in: Cardiology Urology Dermatology General Surgery Pulmonology The ideal candidate has 2+ years of coding experience, maintains current certification (AAPC or equivalent), and consistently demonstrates accuracy, productivity, and strong clinical understanding across multiple service lines. This is a high-impact role within a performance-driven, collaborative organization focused on compliance, precision, and revenue integrity. Core Responsibilities Coding & Documentation Review Accurately assign ICD-10-CM, CPT, and HCPCS Level...

Job Description Job Description Certified Medical Coder Certified coder is responsible for assigning the correct universal medical alphanumeric code to describe the type of service a patient receives in a healthcare facility. Medical coders help ensure the codes are applied correctly and are supported by documentation during the medical billing process. Additionally, the position supports the company’s overall operations and client services by effectively and efficiently driving the Revenue Cycle Management process and delivering successful outcomes. Responsibilities: Assign CPT and ICD-10 codes to billable encounters. Identify trends and issues and communicate to management. Utilize ICD, CPT/HCPCS to investigate coding issues. Understand and communicate Medicare billing rules to staff, management, and physicians. Monitor services to ensure all encounters are coded and billed timely. Conduct billing audits for code accuracy. Stay updated on changes in coding...

Medix - 6621 Fannin Street [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 >>

Description About Us Inform Diagnostics, a Fulgent Genetics Company , is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology, dermatopathology, urologic pathology, hematopathology, and breast pathology. Founded in 2011, our parent entity, Fulgent Genetics, has evolved into a premier, full-service genomic testing company built around a foundational technology platform. Through our diverse testing menu, Fulgent is focused on transforming patient care in oncology, anatomic pathology, infectious and rare diseases, and reproductive health. We believe that by providing a wide range of effective, flexible testing options in conjunction with best-in-class service and support, we can redefine the way medicine is managed for patients and clinicians alike. Since integrating with our therapeutic development business, Fulgent is also developing drug candidates for treating a broad range of cancers using a...

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...

Professional Coder The Professional Coder will review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 DX codes. This position is remote. Essential Duties And Responsibilities Effectively reviews, analyzes, and validates CPT, ICD-10 diagnosis codes, HCPCS, modifiers and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes. Understands National Correct Coding Initiative (NCCI) edits and relative value units as appropriate for the role. Ensure established productivity and quality standards are met. Review denials, research and respond appropriately and timely. Perform audits as determined by management. Assist with all levels of application testing for...

Coder 3 Hours of Work: 8 AM - 4:30 PM Days Of Week: M-F Work Shift: Job Description: Your Job: In this highly technical and fast-paced position, you will collaborate with multidisciplinary team members to provide the very best care for our patients. The Coder 3 performs pre-bill (secondary) audits on inpatient, ambulatory care and observation records to ensure accurate ICD10-CM, ICD10 PCS and/or CPT codes for optimal reimbursement and provide data and clinical information to management, medical staff and various hospital departments. The reviewer also codes and abstracts inpatient, ambulatory and observation records for diagnosis and procedures to determine optimal reimbursement. Your Job Requirements: Associate's degree in Health Information Management or Certification as a Coding Specialist; Bachelor's degree in Health Information Management preferred RHIA, RHIT, or CCS preferred Minimum of 3 years of DRG-based coding experience in an acute care hospital with...

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...

Experienced Multi-Specialty Surgery Coder The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours: Monday - Friday, working 40 hours a week Location: Fully Remote - U.S You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Provide coding and abstraction of physician or professional records Provide communications to Coordinator, Supervisors and Managers Complete RAI's, denials, charge hold reports, and coding edits Assist on special coding projects as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear...

Coding Specialist This position is responsible for accurately coding at least one main outpatient work type accounts (Observation, Same Day Surgery, and/or ER) as well as assisting with the coding of other outpatient work types as needed. All accounts should be completed within 5 days following discharge. Position Requirements Minimum Education Required: Completion of college level course work in Medical Terminology and Anatomy and Physiology. Preferred: Minimum education level of Associates Degree. Minimum Work Experience Required: A minimum of two (2) years coding experience in an acute care hospital. Required Licenses/Certifications Required: CCA credentials (Certified Coding Associate) or CPC credentials (Certified Professional Coder) Required Skills, Knowledge, and Abilities Required: A thorough working knowledge of Medicare billing rules, regulations and local medical review policies as they impact reimbursement under APCs and DRGs. Preferred Qualification Preferred:...

Job Description Job Description About Legent Health At Legent Health , our mission is simple yet profound: “To provide first-class health care that puts YOU first.” Our vision reflects our commitment to excellence: “Through robust physician partnerships, become a nationwide leader in compassionate, quality healthcare focused on the patient and available to everyone.” Our values, also known as our brand pillars, define how we stay true to our identity in the healthcare industry and the communities we serve. These values are central to everything we do: Respect: We honor the time and trust of both patients and physicians by delivering organized, efficient services that ensure a seamless healthcare experience. Service: We are committed to highly personalized care for patients, their families, and the physicians who serve them, driving optimal outcomes for all. Leadership: We strive to be a trusted leader through innovation, clear communication, and unwavering...

Job Description Job Description We are hiring for an Endovascular clinic in need of an experienced Certified Medical Biller & Coder. Experience in Endovascular and outpatient surgery, preferred. Duties include the following: Perform audits of clinical documentation, physician billing and applicable industry standard billing codes by analyzing medical records, coding records and health system bills. Validate clinical documentation in conjunction with the bill; assess the level and accuracy of coding, determine that governmental and third party payer regulations are being complied with; and evaluate appropriateness of billing and coding procedures. Prepare reports and provide individual and/or group education to physicians and others based on results of audit. Working collaboratively with appropriate personnel to identify and recommend strategies for process improvement. Requirements: Must have at least 2 years of recent experience Endovascular...