23 coding auditor jobs found

A leading medical coding firm is seeking an experienced CPC certified medical coder in Texas to conduct coding audits and provide litigation support. Candidates should have a minimum of 5 years of coding experience, with at least 3 years in Texas. The role includes performing audits, conducting reviews for medical necessity, and preparing documentation. The firm offers a comprehensive benefits package, including medical, dental, vision coverage and a 401k plan with company match. #J-18808-Ljbffr

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Medical Coder II Red Lodge, MT, US 6 days ago Requisition ID: 1064 Salary Range: $20.83 To $28.63 Hourly Medical Coder II Status: Part Time (20 hours/week) | Non-Exempt Reports to: Health Information and Technology Manager Purpose and Scope of Position Responsible for reviewing and interpreting medical records, documents, and other patient data to assign appropriate codes for healthcare procedures, diagnoses, and services provided. These codes are used for insurance reimbursement, statistical purposes, and maintaining accurate patient records. Medical coders work closely with healthcare providers, insurance companies, and billing departments. Job Requirements Required Qualifications Education: High school diploma or equivalent. Certification: Certification from a recognized body such as the American Academy of...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The key challenge of this role centers around your ability to work quickly, accurately, and independently. You'll be challenged with daily production goals as well as maintaining a high accuracy rate to achieve your quality goals. Extensive use of electronic medical records in an ICD-10 environment is also required. Hours : This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 5am - 5pm. We offer 2-3 weeks of paid training. The hours during training will be 7am...

Job TitleAt UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.The key challenge of this role centers around your ability to work quickly, accurately, and independently. You'll be challenged with daily production goals as well as maintaining a high accuracy rate to achieve your quality goals. Extensive use of electronic medical records in an ICD-10 environment is also required.Hours: This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 5am - 5pm.We offer 2-3 weeks of paid training. The hours during training will be 7am...

Note: Please only apply to the specific job posting for which you have experience in the specialty. Duplicate applications will not be considered. Job Summary We are seeking a detail-oriented and knowledgeable Medical Biller and Coder for Podiatry Department to join our healthcare team. The ideal candidate will be responsible for managing the billing process, ensure accuracy in medical coding, and facilitating timely payments from insurance companies and patients. A strong understanding of podiatry-specific medical terminology, coding systems, and collections is essential for success in this role. Responsibilities Process medical billing claims accurately and efficiently using appropriate coding systems such as ICD-10 and ICD-9, CPT, and HCPCS specific to podiatric procedures. Review patient records to ensure all necessary information is included for billing purposes. Verify insurance coverage and benefits prior to submitting claims to ensure proper reimbursement. Follow up...

Where compassion meets innovation and technology and our employees are family. Thank you for your interest in joining our team! Please review the job information below. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or hospital administration as required. Always maintains utmost level of confidentiality. Adheres to hospital policies and procedures. Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines. Reviews the medical record and assigns the appropriate ICD and CPT codes....

Hours This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 5am - 5pm. We offer 2-3 weeks of paid training. The hours during training will be 7am to 3:30 pm CST, Monday - Friday. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities Receive assigned provider inquiries and perform a code review on both professional and facility claims Make determinations on cases after a coding review is complete Review various edits on cases and complete audit of medical records received to ensure proper editing is applied Review medical charts electronically Abstract and code diagnosis and procedures from the medical record Review and supply procedure and diagnosis codes for benefit coding requests Document requested information from the medical record Perform ongoing analysis of medical...

Contract duration: 3 months + Possibility of Extension Schedule: 8am to 5pm (M-F) Key Responsibilities: Review and accurately code provider, facility, and inpatient claims . Analyze itemized bills and medical records to validate coding accuracy. Audit claims for compliance with CMS and Official ICD-10 Coding Guidelines . Identify coding discrepancies and recommend appropriate corrections. Perform medical record abstraction and coding research as needed. Required Qualifications: Associate Degree OR 2+ years of health insurance industry experience. 2+ years of medical coding through medical record abstraction . Active CPC, CCS-P, RHIA, or RHIT certification. Knowledge of CMS and ICD-10 coding guidelines . Proficiency with Microsoft Word, Excel, and Outlook . Strong analytical, verbal, and written communication skills. Preferred: Associate or Bachelor’s degree in a healthcare-related field. #J-18808-Ljbffr

Join UnitedHealthcareAt UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.The key challenge of this role centers around your ability to work quickly, accurately, and independently. You'll be challenged with daily production goals as well as maintaining a high accuracy rate to achieve your quality goals. Extensive use of electronic medical records in an ICD-10 environment is also required.Hours: This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 5am - 5pm.We offer 2-3 weeks of paid training. The hours during training...

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world. At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you're interested in joining a health care system that is changing the face of care and well-being in our community, we...

Why ThedaCare?Living A Life Inspired!Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world.At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you're interested in joining a health care system that is changing the face of care and well-being in our community, we encourage you...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in 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 for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

Major Responsibilities: This role will have all responsibilities of coder I, II and III in addition to: reviews complex inpatient documentation at a highly skilled and proficient level to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software. Adhere to organizational and internal department policies and procedures to ensure efficient work processes. Responsible for coding high dollar and long length of stay cases for all patient types. Expertise in query guidelines, and coding standards. Follow up and obtain clarification of inaccurate documentation as appropriate . Serves as a subject matter expert to Coding department leaders and peers. Recommends modifications to current policies and procedures as...

Major Responsibilities: This role will have all responsibilities of coder I, II and III in addition to: reviews complex inpatient documentation at a highly skilled and proficient level to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software. Adhere to organizational and internal department policies and procedures to ensure efficient work processes. Responsible for coding high dollar and long length of stay cases for all patient types. Expertise in query guidelines, and coding standards. Follow up and obtain clarification of inaccurate documentation as appropriate. Serves as a subject matter expert to Coding department leaders and peers. Recommends modifications to current policies and procedures as needed to coincide with government...

Hudson Physicians Sc in Hudson, WI is seeking an experienced healthcare coder to review procedural and diagnostic coding to ensure accurate billing and compliance. This role is largely remote with occasional in-person meetings; candidates must live within reasonable traveling distance from Hudson, WI. You will collaborate with providers across specialties, perform chart audits, and contribute to ongoing coding education and process improvements. #J-18808-Ljbffr

Contract duration: 3 months + Possibility of Extension Schedule: 8am to 5pm (M-F) Key Responsibilities: Review and accurately code provider, facility, and inpatient claims . Analyze itemized bills and medical records to validate coding accuracy. Audit claims for compliance with CMS and Official ICD-10 Coding Guidelines . Identify coding discrepancies and recommend appropriate corrections. Perform medical record abstraction and coding research as needed. Required Qualifications: Associate Degree OR 2+ years of health insurance industry experience. 2+ years of medical coding through medical record abstraction . Active CPC, CCS-P, RHIA, or RHIT certification. Knowledge of CMS and ICD-10 coding guidelines . Proficiency with Microsoft Word, Excel, and Outlook . Strong analytical, verbal, and written communication skills. Preferred: Associate or Bachelor’s degree in a healthcare-related field. #J-18808-Ljbffr

Where compassion meets innovation and technology and our employees are family. Thank you for your interest in joining our team! Please review the job information below. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or hospital administration as required. Always maintains utmost level of confidentiality. Adheres to hospital policies and procedures. Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines. Reviews the medical record and assigns the appropriate ICD and CPT codes....

Driscoll Children’s Hospital seeks a skilled Medical Coder to review medical records and assign ICD and CPT codes for outpatient services, ensuring accurate billing and compliant documentation. The role requires 3–5 years of physician coding experience, preferably in pediatric multi-specialty coding. You will work with the coding manager and billing staff to resolve denials and support audits. #J-18808-Ljbffr

* This is a hybrid position to be located in WI with travel required. * JOB SUMMARY The Coding and Billing Compliance Analyst plays a critical role in safeguarding the accuracy, integrity, and regulatory compliance of coding and billing operations across all service lines.  This position supports the organization’s revenue cycle and compliance initiatives by conducting detailed coding and billing reviews, identifying areas of risk, and contributing to the development of corrective action plans and educational programs.  The analyst ensures adherence to federal and state billing regulations, including Medicaid/Medicare guidelines, HRSA program requirements, and Office of Inspector General (OIG) guidance specific to Federally Qualified Health Centers (FQHCs).  The Analyst collaborates with providers, billing teams, compliance officers, and revenue cycle leadership, to improve clinical documentation, optimize reimbursement, and maintain full compliance with all applicable...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Job Details Level: Experienced Job Location: Hudson, WI - Hudson, WI 54016 Position Type: Full Time Travel Percentage: None Job Shift: Any Job Summary The primary purpose of the position is to review both procedural and diagnostic (ICD-10) coding to ensure appropriate billing and insurance regulations are met. This position will be staffed during clinic hours and is largely remote. Occasionally in-person meetings with providers will be required. Must live within reasonable traveling distance from Hudson, WI. Core Duties and Responsibilities Have in-depth understanding of coding and compliance rules and regulations. Responsible for reviewing provider documentation, coding and posting charges for healthcare services; including Primary Care, Lab/Pathology, Podiatry and more. Provide coding education and engage with assigned providers. Research and communicate governmental and payer-specific rules and regulations to ensure coding compliance. Identify and communicate best practices...

MUST RESIDE IN TEXAS AND HAVE CODING AND AUDITING EXPERIENCE. Counter Affidavit as well as Testimony experience is preferred. We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong Texas based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. Counter Affidavit experience is preferred. Responsibilities Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS) Conduct utilization reviews to determine medical necessity and documentation compliance Review and prepare demand packages and audit response materials Analyze records for payer disputes and recoupments Prepare written audit findings and defensible reports Provide expert support for depositions and testimony as needed Review...