567 coding documentation compliance auditor jobs found

To ensure the accuracy and compliance of diagnosis coding in risk adjustment programs, the contract-to-hire Certified Risk Coder Auditor will conduct medical record audits, validate diagnosis codes, and provide coding guidance while working remotely. Key Responsibilities Perform prospective and retrospective medical record reviews and audits Validate diagnosis code accuracy, completeness, specificity, and appropriateness based on provider documentation Identify coding and documentation deficiencies and provide written and verbal feedback Required Qualifications 7+ years of relevant professional experience 5+ years of HCC/Risk Adjustment coding experience utilizing inpatient and outpatient coding guidelines 5+ years of Risk Adjustment auditing experience CRC (Certified Risk Coder) certification in good standing Strong knowledge of Medicare, ACA Commercial, and Medicaid risk adjustment models

To ensure the accuracy and compliance of diagnosis coding in risk adjustment programs, the contract-to-hire Certified Risk Coder Auditor will conduct medical record audits, validate diagnosis codes, and provide coding guidance while working remotely. Key Responsibilities Perform prospective and retrospective medical record reviews and audits Validate diagnosis code accuracy, completeness, specificity, and appropriateness based on provider documentation Identify coding and documentation deficiencies and provide written and verbal feedback Required Qualifications 7+ years of relevant professional experience 5+ years of HCC/Risk Adjustment coding experience utilizing inpatient and outpatient coding guidelines 5+ years of Risk Adjustment auditing experience CRC (Certified Risk Coder) certification in good standing Strong knowledge of Medicare, ACA Commercial, and Medicaid risk adjustment models

The Revenue Cycle Management CPC Auditor is responsible for conducting comprehensive audits across all phases of the revenue cycle to ensure accuracy, compliance, and optimal reimbursement. This role is critical in identifying revenue leakage, reducing denials and strengthening internal controls and staff productivity requirements. The Auditor will evaluate charge capture, coding accuracy, documentation integrity, billing workflows, payment posting, denial follow-up, Appeals, and AR follow-up for RCM, clinical, and provider teams to drive continuous process improvement. *This is a remote role. We are only hiring in the following states: AZ, CA, NM, NV, OR, TX and WA. What you will do: Audit execution & oversight by performing routine and ad hoc audits across the full revenue cycle process, including: Charge entry and charge capture accuracy CPT, HCPCS, and ICD-10 coding compliance Modifier usage Workers' compensation billing rules and state-specific...

Job Description Job Description Location: Miami, FL (On-site preferred; Hybrid/Remote may be considered) Employment Type: Part-Time (25–35 hours per week) About the Position We are seeking an experienced Senior Medical Coding Auditor (CPC) to join our growing multi-specialty medical practice specializing in Primary Care and Gynecology . The ideal candidate will be responsible for reviewing clinical documentation before claims are submitted to ensure accurate coding, appropriate E/M level selection, documentation compliance, and optimal reimbursement while maintaining full regulatory compliance. This position works closely with providers, clinical staff, and the billing department to improve documentation quality, reduce claim denials, maximize appropriate reimbursement, and ensure coding accuracy. Primary Responsibilities Review approximately 300 provider notes per week for coding accuracy and documentation compliance prior to claim submission. Validate...

Senior Risk Adjustment Coder The Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare Advantage Risk Adjustment. What you will do: Risk Adjustment Review May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing Reviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses. Evaluating medical records to verify that M.E.A.T criteria support the submitted diagnosis codes. Inquire with clinicians the recommended HCC diagnosis for chart addendum. Collaborating with other departments to address coding updates and support risk adjustment...

Job Description Job Description The Revenue Cycle Management CPC Auditor is responsible for conducting comprehensive audits across all phases of the revenue cycle to ensure accuracy, compliance, and optimal reimbursement. This role is critical in identifying revenue leakage, reducing denials and strengthening internal controls and staff productivity requirements. The Auditor will evaluate charge capture, coding accuracy, documentation integrity, billing workflows, payment posting, denial follow-up, Appeals, and AR follow-up for RCM, clinical, and provider teams to drive continuous process improvement. *This is a remote role. We are only hiring in the following states: AZ, CA, NM, NV, OR, TX and WA. What you will do: Audit execution & oversight by performing routine and ad hoc audits across the full revenue cycle process, including:  Charge entry and charge capture accuracy  CPT, HCPCS, and ICD-10 coding compliance  Modifier usage  Workers’...

Location: Miami, FL (On-site preferred; Hybrid/Remote may be considered) Employment Type: Part-Time (25–35 hours per week) About the Position We are seeking an experienced Senior Medical Coding Auditor (CPC) to join our growing multi-specialty medical practice specializing in Primary Care and Gynecology. The ideal candidate will be responsible for reviewing clinical documentation before claims are submitted to ensure accurate coding, appropriate E/M level selection, documentation compliance, and optimal reimbursement while maintaining full regulatory compliance. This position works closely with providers, clinical staff, and the billing department to improve documentation quality, reduce claim denials, maximize appropriate reimbursement, and ensure coding accuracy. Primary Responsibilities Review approximately 300 provider notes per week for coding accuracy and documentation compliance prior to claim submission. Validate appropriate Evaluation & Management (E/M)...

Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future – we provide the venue for individuals who have the desire and...

Posting Details Posting Summary Working Title Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Role Title Role Code FLSA Exempt Pay Band UG Position Number 295A0003 Agency Tidewater Community College Division Tidewater Community College (Div) Work Location Suffolk - 800 Hiring Range $30-$100 per hour, commensurate with qualifications and experience. Emergency/Essential Personnel No EEO Category I-Faculty Full Time or Part Time Part Time Does this position have telework options? -Telework options are subject to change based on business needs- No Does this position have a bilingual or multilingual skill requirement or preference? Work Schedule Varies Sensitive Position No Job Description Tidewater Community College has served South Hampton Roads - both students and employers - for 50 years. It has grown from 1 campus into a regional educational and...

Abstracts clinical information from a variety of medical records, charts and documents and assigns appropriate ICD-10 and/or CPT-4 codes to patient records according to established procedures. Works with coding databases and confirms DRG assignments. Responsibilities: Codes data from patient records utilizing coding systems to ensure optimal reimbursement of the office visits and hospital surgery for all surgeons and mid-levels of the practice. Translates diagnostic and procedural information using the International Classification of Diseases codes and sequences these codes in a manner which legitimately optimizes office and hospital reimbursement through the use of proper coding and modifiers. Skilled in accurate assignment and auditing of ICD-10-CM, CPT, HCPCS, and E/M services for inpatient, outpatient and office-based encounters. Abstracts data from patients’ medical records in order to compile accurate and timely statistical data. Reviews and analyzes all patient types to...

Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Tidewater Community College has served South Hampton Roads – both students and employers – for 50 years. It has grown from 1 campus into a regional educational and economic force. TCC is the largest provider of higher education and workforce services in Hampton Roads, enrolling nearly 25,000 students in 2024-25. Founded in 1968 as a part of the Virginia Community College System, Tidewater Community College (TCC) services South Hampton Roads with 4 campuses in Chesapeake, Norfolk, Portsmouth, and Virginia Beach, 7 regional centers and 2 important cultural institutions. The college had 3,399 graduates in 2024-2025, 40 percent of whom pursued degrees that would let them transfer to 4-year institutions. Of South Hampton Roads residents enrolled in higher education 33% enrolled at TCC. TCC's institutional accreditation is affirmed through 2027 by the Southern Association of Colleges and...

Position Summary The RCS Medical Coding Auditor is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback. The ideal candidate brings strong hands-on experience with professional fee coding , deep knowledge of E/M, surgical, and modifier use , and the ability to translate audit findings into actionable insights. Key Responsibilities Perform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedback Validate ICD-10-CM, CPT®, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelines Conduct medical chart audits of professional services across multiple specialties...

Title: Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Agency: Tidewater Community College Location: Suffolk - 800 FLSA: Exempt Hiring Range: $30-$100 per hour, commensurate with qualifications and experience. Full Time or Part Time: Part Time Additional Detail Job Description: Tidewater Community College has served South Hampton Roads - both students and employers - for 50 years. It has grown from 1 campus into a regional educational and economic force. TCC is the largest provider of higher education and workforce services in Hampton Roads, enrolling nearly 25,000 students in 2024-25. Founded in 1968 as a part of the Virginia Community College System, Tidewater Community College (TCC) services South Hampton Roads with 4 campuses in Chesapeake, Norfolk, Portsmouth, and Virginia Beach, 7 regional centers and 2 important cultural institutions. The college had 3,399 graduates in 2024-2025, 40 percent of...

Medical Coding & Risk Adjustment Auditor (Remote Contract) Location: Remote Duration: 6+ Month Contract Client: New Jersey-Based Healthcare Organization Position Summary We are seeking an experienced Medical Coding & Risk Adjustment Auditor to support a healthcare client's Risk Adjustment and Data Validation initiatives. This role is responsible for reviewing, interpreting, auditing, coding, and analyzing medical record documentation to ensure diagnosis accuracy, proper documentation, and Hierarchical Condition Category (HCC) abstraction. The position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation (RADV) audits, as well as ongoing Risk Adjustment activities across Medicare, Medicaid, and Commercial lines of business. Key Responsibilities Review, interpret, and translate CPT, HCPCS, ICD-9, and ICD-10 codes for HCC abstraction. Audit medical records for completeness, accuracy, and compliance with applicable...

Medical Coder Educator - USFTGP Revenue Cycle Operations Serves as the coding reviewer and documentation educator for USFTGP Revenue Cycle Operations. Collaborate extensively with compliance; utilizing approved coding industry tools and approved internal documentation. This position is responsible for providing coding literacy and awareness using adult methodologies to revenue cycle, coding professionals, department managers, medical staff and others, ensuring proficiency is accurate and within compliant coding practices for billing. Analyze and report review findings indicating documentation gaps reimbursement and data internation, inpatient, outpatient and professional service coded. Report to compliance focused areas of improvements, recommendations and actions taken to improve medical staff knowledge and coding accuracy. Conduct individual and group coding and documentation support instructions as assigned and acts as an internal coding expert resource. Qualifications...

Pediatric Coding Auditor Ann & Robert H. Lurie Children's Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children's Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report. Job Description Summary: Conducts retrospective audit of ambulatory and inpatient physician documentation to ensure billing accuracy and compliance. Accounts for concurrent inpatient billing accuracy and compliance for selected Divisions. Provides physician education on coding and documentation guidelines. Essential Job Functions: Reviews and audits physicians' documentation in the medical record and the level of CPT code selection to verify accuracy through a concurrent coding...

COMPANY OVERVIEW Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG currently bidding on a contract with the Federal Government for several coding positions. You would be a W-2 employee for HPMG and NOT a government employee. SUMMARY Responsible for assignment of accurate ICD codes for diagnoses and procedures. Medical Severity - Diagnostic Related Group (MS-DRG) is automatically assigned by the grouper software for inpatient stays. Inpatient coders may also be responsible for the assignment of accurate ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities from medical record documentation (paper or electronic) for inpatient professional services (a.k.a., rounds or IBWA encounters). Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities. MANDATORY KNOWLEDGE AND SKILLS Position requires...

Overview Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We help clients maximize their reimbursement and educate them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Our billing specialists receive ongoing training specific to medical specialty, and we continually update knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future – we provide the venue for individuals who have the desire and drive to grow. Career paths are supported with career development, leadership opportunities, and a productive integration of personal and professional life. With over 200 professionals across our family of Yeo & Yeo companies, you join a diverse team working to positively impact our clients and communities. Position Summary...

The University of Vermont Health Network is seeking a qualified RN Clinical Coder/Auditor for a hybrid position based in Colchester, VT. This role involves auditing clinical documentation to ensure compliance with regulatory standards and enhancing clinical outcomes through accurate coding. Candidates must possess a current Vermont RN Licensure and relevant prior experience in home health or hospice. Strong skills in ICD-10 coding, attention to detail, and project management are essential for success in this position. #J-18808-Ljbffr

Certified Medical Coding Auditor (CPC or CCS-P) Join to apply for the Certified Medical Coding Auditor (CPC or CCS-P) role at Accelerated Urgent Care Certified Medical Coding Auditor (CPC or CCS-P) 2 weeks ago Be among the first 25 applicants Join to apply for the Certified Medical Coding Auditor (CPC or CCS-P) role at Accelerated Urgent Care About Us Simply put, our purpose at Accelerated Urgent Care is to get you quality care when you need it. We aim to foster a supportive environment where our team members can develop their careers. To promote this goal, we’ve built a diverse and driven team of employees who are all eager to learn from one another and reach Accelerated Urgent Care’s mission of delivering exceptional healthcare to the patients and communities that we are privileged to serve. We are ... a fast-growing company that doubles in size year after year since 2012! Recognized as Kern County’s Top Urgent Care center 6 years in a row! Dedicated to our employees’ career...

Remote Medical Coding Auditor (CPC, CCS-P, or CPMA) Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder. Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted treatment (MAT) options to combat the growing opioid epidemic and helping people with opioid use disorder start their path to recovery. Day in the Life of a Medical Coding Auditor Conducting audits of claims and patient records to identify incorrect coding. Audits will be performed for both provider and coder coding accuracy with required documentation in accordance with current coding guidelines. Developing, implementing, and coordinating corrective action proposals and plans. Tracking completion of internal and external Plans of Correction....