13 coding auditor facility jobs found

Newport News, Virginia Hiring Range $27.30 - $37.58/HourlyActual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs. FOR APPLICATION REVIEW - PROVIDE YOUR CODER CERTIFICATION NUMBER ON YOUR APPLICATION OR RESUME This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA. Overview The Inpatient Coder II is responsible for analyzing the medical record to assign International Classification of Diseases (ICD) Clinical Modification (CM) diagnoses and Procedure Coding System (PCS) procedure codes to ensure correct code assignment and optimal reimbursement in compliance with state and federal guidelines. Works in collaboration with the Clinical Documentation Improvement (CDI) team to ensure accurate Diagnosis Related Group (DRG) assignment and works closely with management to resolve problems and meet...

Certified CoderAt Commence, we're the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient processes to program and patient health. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care.With human-centered, healthcare-relevant, and value-based solutions, we create new possibilities with data. We provide proof beyond the concept and performance beyond the scope with a focus on efficiencies that transform the lives of those we serve. With a culture driven by purpose, straightforward communication and clinical domain expertise, Commence cuts straight to better care.Requirements3+ years of direct experience in medical coding, medical billing, and/or coding quality assurance/auditing in a healthcare environment, including ICD-10-CM/PCS, CPT/HCPCS, and DRG/APR-DRG coding systemsActive coding...

Corporate Coding and Compliance - Newport News, VA 23606 Overview Level Entry Position Type Full Time High School Travel Percentage None Category Coding and Compliance Description Position Summary A Coder I performs coding audits for quality checks and provider education. Major Duties and Responsibilities Maintains working knowledge of coding and compliance. Provides coding training and support to all TPMG locations. Participates in coding-related denial meetings. Performs coding and auditing of medical record documentation to ensure accurate coding. Reviews and submits documentation for all Recovery Audit Contractors (RAC) requests; timely follow-up of RAC audit. Reviews and submits documentation for all Error Rate Testing (CERT) requests with timely follow up of CERT response. Reviews and submits documentation for Targeted Probe and Educate (TPE) requests. Reviews and submits documentation for medical record requests for all insurance carriers. Follows HIPPA guidelines. Works...

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...

Sentara Health Plans in Virginia Beach, VA is seeking a Risk Adjustment Coder to perform compliance activities related to CMS/HHS risk adjustment and RADV audits. You will review professional and facility coding to ensure accurate HCC capture and support vendor and internal audits. The role requires an Associate degree or 4 years of coding experience, knowledge of ICD-10-CM guidelines, and CRC certification within two years. #J-18808-Ljbffr

Req ID: RQ226381 Type of Requisition: Regular Clearance Level Must Be Able to Obtain: None Public Trust/Other Required: None Job Family: Ancillary Health Skills: Claims Data,Data Analysis,Microsoft Excel,Policy Analysis,Strategic Objectives Certifications: Certified Fraud Examiner (CFE) | Association of Certified Fraud Examiners (ACFE) - Association of Certified Fraud Examiners (ACFE) Experience: 8 + years of related experience Job Description: GDIT's Federal Health Division is hiring a Healthcare Coding Expert to support the Centers for Medicare and Medicaid (CMS), you will be trusted to identify trends in the data and create leads and referrals for the Healthcare Fraud Prevention Partnership (HFPP) members (Partner) and the Trusted Third Party (TTP). You will be part of a 50-person team supporting the TTP which was established in 2012 to reduce fraud, waste and abuse in healthcare data. Work expected to begin in October 2026 Work...

Inpatient Coder II Newport News, Virginia Hiring Range: $27.30 - $37.58/Hourly. Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs. This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA. Overview: The Inpatient Coder II is responsible for analyzing the medical record to assign International Classification of Diseases (ICD) Clinical Modification (CM) diagnoses and Procedure Coding System (PCS) procedure codes to ensure correct code assignment and optimal reimbursement in compliance with state and federal guidelines. Works in collaboration with the Clinical Documentation Improvement (CDI) team to ensure accurate Diagnosis Related Group (DRG) assignment and works closely with management to resolve problems and meet deadlines. What You Will Do: Assigns International Classification of Diseases...

Medical Coding Professional 2The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS leaders and champions to identify STARS gaps and deficiencies.The...

Medical Coding Professional 2 The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS leaders and champions to identify STARS gaps and deficiencies....

IPA Consultative Coding ProfessionalBecome a part of our caring community and help us put health first. The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with...

Become a part of our caring community We are looking for a consultative coding professional to provide medical coding expertise and support to IPA affiliates nationwide. The IPA Consultative Coding Professional will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value‑based care initiatives. They will analyze trends, triage, answer questions in real‑time, research and interpret coding guidelines, and respond to inquiries and issues. Assignment will include a panel of up to 30 providers within a defined market or region. The professional will deliver ongoing education, support coding workflows, and ensure agreement on documentation and coding standards, while collaborating with STARS leaders and champions to identify gaps and deficiencies. They will support IPA‑affiliated clinicians—physicians and advanced practice providers—to ensure documentation supports accurate diagnostic coding...

Coding Specialist (Part-Time)At Commence, we're the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient processes to program and patient health. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care.With human-centered, healthcare-relevant, and value-based solutions, we create new possibilities with data. We provide proof beyond the concept and performance beyond the scope with a focus on efficiencies that transform the lives of those we serve. With a culture driven by purpose, straightforward communication and clinical domain expertise, Commence cuts straight to better care.Primary DutiesPerforming audit functions for the identified encounters in a timely and accurate manner.Generating well-written deliverables and audit work papers.Outstanding verbal communication skills.Outstanding...

General Position Summary: The Medical Coding Specialist works as part of the Billing & Coding Department to review clinical documentation, abstract data from patient medical records, and accurately assign diagnosis and procedure codes in accordance with applicable coding guidelines and regulatory requirements.   Essential Duties and Responsibilities:   1.      Reviews patient medical records and assigns diagnosis and procedure codes in accordance with ICD-10-CM, CPT, HCPCS, and applicable coding guidelines. 2.      Ensure compliance with federal, state, payer, and organizational coding regulations and policies. 3.      Assigns and sequences diagnosis and procedure codes accurately for all services rendered. 4.      Ensures documentation and coding accurately reflect services provided and support quality reporting metrics. 5.      Identifies missed diagnoses, chronic conditions, and documentation deficiencies that may...