13 coding auditor educator jobs found

Job Description Job Description The Medical Coder / Coder PAR at Apex Spine and Neurosurgery is responsible for reviewing clinical documentation and assigning accurate CPT, ICD-10, and HCPCS codes for spine, neurosurgical, and interventional pain management services. This role ensures compliant, complete, and timely coding to support revenue integrity, authorization accuracy, and efficient claims processing in accordance with CMS and payer guidelines. Key Responsibilities Review operative reports, clinic notes, imaging, and diagnostic studies to accurately assign CPT, ICD-10, and HCPCS codes for spine and neurosurgical procedures. Code surgical and procedural services including (but not limited to): spine surgeries, decompressions, fusions, discectomies, laminectomies, injections, nerve blocks, ablations, and other interventional pain procedures. Ensure compliance with CMS guidelines, NCCI edits, payer-specific policies, and internal coding standards. Communicate directly...

Job Description Job Description Position Summary The Certified Medical Coder and Biller is responsible for accurate medical coding, charge capture, and timely billing of services provided within a Federally Qualified Health Center (FQHC). This role ensures compliance with federal, state, and payer-specific regulations, including HRSA, CMS, Medicare, Medicaid, and managed care requirements. The position plays a key role in maintaining revenue integrity while supporting the organization’s mission to provide high-quality, affordable care to underserved populations. Responsibilities and Duties Coding Responsibilities Assign accurate CPT, HCPCS, and ICD-10-CM codes in accordance with official coding guidelines and FQHC requirements Review clinical documentation to ensure coding accuracy, completeness, and medical necessity Apply appropriate modifiers, revenue codes, and PPS/encounter billing methodologies (e.g., T1015 where applicable) Identify documentation...

Job Description Job Description Description: The Certified Professional Coder (CPC) – Primary Care (with Risk Code Review) is responsible for accurate and compliant coding of professional services, verification of demographic and insurance information, and timely resolution of front-end claim edits prior to submission. This role also includes reviewing encounters for accuracy of risk-related diagnosis codes to ensure proper documentation support in compliance with payer and CMS guidelines. The coder supports Southeast Medical Group’s goals for revenue integrity, compliance, and operational efficiency through close collaboration with providers, front-end staff, and billing teams. Requirements: Essential Duties and Responsibilities Coding and Charge Review Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes for all primary care encounters, including preventive, chronic, and acute visits. Ensure all codes are supported by clinical documentation and...

You will be able to work from your home location within the United States PURPOSE AND SCOPE: Conducts data quality audits of outpatient encounters to validate coding assignment is in compliance with the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. Provides feedback and education to coders. Escalates compliance, risk-related issues to expedite mitigation. PRINCIPAL DUTIES AND RESPONSIBILITIES: Consults facility leaders and staff on best practices, methodology, and tools for accurately coding. Chart Analysis, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA/AAPC). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to...

E&M Coder - Physician Overview: Reviews, analyzes, and codes medical record documentation to include, but not limited to, medical, diagnostic, and procedural information for the correct ICD-10, CPT and/or HCPCS codes to the greatest specificity. Abstracts demographic and coding information into the information system accurately and completely. Reviews documentation for medical necessity. Audits orders and claims before submission for accuracy and to minimize claim denials. Assesses records and prepares reports. Provides technical guidance to physicians and other departmental staff in identifying and resolving issues or errors. Develops effective working relationships with physicians and other stakeholders. Primary coding responsibility is all Evaluation and Management (E/M) leveling along with additional ancillary services done in an office setting. Responsibilities: Reviews, analyzes, and codes medical record documentation to include, but not limited to, medical,...

divh2Coder Quality Auditor/h2pThe Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties./ppJob Responsibilities:/pulliQuality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess...

Overview The Staff Pad has partnered with Blue Ridge Medical Center in Blue Ridge, Georgia. Blue Ridge Medical Center is seeking an experienced Health Information Management (HIM) Coder to join our team in a fully remote capacity. This individual will be responsible for reviewing, analyzing, and assigning diagnostic and procedural codes for inpatient, outpatient, and/or emergency department medical records using ICD-10-CM, CPT, and HCPCS coding systems in accordance with official coding guidelines and facility standards. Key Responsibilities Review and abstract clinical documentation from patient records to assign accurate codes for diagnoses and procedures Ensure compliance with federal regulations and hospital policies related to coding and billing Maintain productivity and quality standards established by the HIM department Query physicians when appropriate to ensure accurate and complete documentation Assist in resolving coding-related billing issues or discrepancies...

Specialty Coder II - Anesthesia BayCare is currently in search of our newest team member who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area. Position details: Location: Remote (must reside in the state of Florida, Georgia, North Carolina, or South Carolina) Status: Full time (non-exempt) Shift: 8:00am - 4:30pm Days: Monday through Friday This Specialty Coder II opportunity is a full-time remote position. This team member must reside in the state of Florida, Georgia, North Carolina, or South Carolina. Sign on bonuses available! Responsibilities: The Specialty Coder II is a Certified Professional Coder who assigns diagnosis and procedural codes using ICD-10 CM and CPT-4 coding systems. The Specialty Coder audits physician documentation to assign appropriate CPT codes, diagnosis codes, and modifiers related to anesthesia...

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...

We are seeking a detail-oriented Medical Coding Specialist to join our team and play a critical role in our revenue cycle management. In this position, you will be responsible for the precise assignment of CPT, ICD-10, and modifier codes for complex surgical procedures, ensuring every entry is supported by a thorough review of operative notes and clinical documentation. Beyond technical coding, you will act as a bridge between departments, partnering with the billing team to resolve denials and discrepancies while maintaining strict compliance with CMS and payer regulations. Your expertise will support our financial health through timely claim processing and organized record-keeping for internal audits. This position is a fully on-site position located in Alpharetta, GA. salary: $25 - $28 per hour shift: First work hours: 8:30 AM - 4:30 PM education: High School Responsibilities Precision Coding: Assign accurate CPT, ICD-10-CM, and HCPCS codes, along with...

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...

Join to apply for the Coder-Certified I role at Southeast Medical Group . Position Summary: Southeast Primary Care Partners is seeking a dedicated and detail‑oriented Certified Coder to join our dynamic team. The successful candidate will play a crucial role in accurately coding healthcare claims for reimbursements, ensuring compliance with federal regulations, and contributing to the efficiency and effectiveness of our healthcare services. The Certified Coder reviews medical records to assure proper billing, participates in audits, and develops methodologies to improve coding issues identified. Codes must meet QA standards following Official Coding Guidelines and Risk Adjustment Guidelines. Key Responsibilities Review patients’ medical records to extract relevant information needed for billing and coding. Apply appropriate ICD‑10, CPT, and HCPCS Level II code assignments to ensure accurate and timely billing. Work closely with healthcare providers and billing teams to...

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 team meetings and company events. Pay Transparency The base pay for this role is: $67,813 - $89,004 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities Responsible for daily operations pertaining to Risk...