21 professional coding auditor and educator jobs found

Job Title: Lead Inpatient Coder How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. The Lead Inpatient Coder serves as a key expert in ICD-10-CM, ICD-10-PCS, and DRG assignment, providing specialized knowledge and guidance to the Inpatient Coding team. This role is responsible for addressing complex coding questions, reviewing, and resolving external audit findings, and contributing to coding improvement initiatives. Additionally, the Lead Inpatient Coder plays a critical role in delivering ongoing education and training to the coding team, helping to minimize...

Payment Integrity Nurse Coder RN III The Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding expertise in the application of medical and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management projects. The position serves as a subject matter expert (SME), performing medical records reviews to include quality audits as well as validation of accuracy and completeness of all coding elements. The position is also responsible for guidance related to Payment Integrity initiatives to include concept and cost avoidance development. This position trains and mentors Payment Integrity Nurse Coder, RN staff. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff. Duties: Performs Quality Audits to include validation of accuracy and completeness of ICD, Rev Code, CPT, HCPCs, APR, DRG, POA, and all relevant coding...

Medical Record Coder At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments. For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding. Submits daily productivity report to HIM manager by defined deadline. Meets and maintains HIM coding quality and...

Job Description Job Description South Los Angeles based FQHC looking for onsite Certified HCC coder . *This is not a remote position Conduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare Risk Adjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding. Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records audit HEDIS coding and record collection...

Medical Billing Coder - Dermatology The dermatology medical billing coder works under direct supervision, acquires skills and knowledge in revenue cycle practices and concepts. Learns to work on projects of limited scope and complexity. Coding all E/M and procedural coding for outpatient service for 45+ attending at UCSF Health Dermatology Department, as well as ensuring teaching physician guidelines are correct, including all minor and major procedure coding. The final salary and offer components are subject to additional approvals based on UC policy. Your placement within the salary range is dependent on a number of factors, including your work experience and internal equity within this position classification at UCSF. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement. The current hourly rate range for this position is $26.11-$55.32, with the entry point at $31.64, d.o.e.,...

Job Description Job Description Education and/or Experience :   Must have these requirements under the umbrella of the HCC industry: Requires knowledge in HCC Coding documentation guidelines. Requires technical expertise in ICD-9-CM or ICD-10-CM. Strong skills in medical record audit and review. Regulatory requirements for coded data. Medical record documentation requirements. Understanding of healthcare data systems. Proficiency in MS Outlook and Word. Strong proficiency with Excel--must have ability to prepare spreadsheets. Excellent written and verbal communication skills. Certification is a plus with HCC. AHA coding clinic is a plus. Certification required in CPC and/or CCS, and CRC is a plus. Hybrid Schedule Requirements Part A Monday - Wednesday onsite / Thursday - Friday Remote Part B Wednesday - Friday Onsite / Monday - Tuesday Remote   We are looking for HCC Risk Adjustment Auditors/Coders to join our team!   Position...

Coding Educator (Temp-to-Hire, 13 Weeks) Location: Within the Company Footprint (Hybrid - Mostly Remote with Local Travel) Type: Contingent / Temp-to-Hire Shift: Day 5x8-Hour (08:00 - 17:00) Note: MUST be legally authorized to work in the United States. OVERVIEW: The company is seeking experienced Professional Fee (Pro Fee)-focused Coding Educators to support large-scale chart review, coding accuracy validation, physician education, and documentation improvement initiatives. These roles are high-visibility and require strong communication and presentation skills to engage directly with clinicians and support the company's revenue cycle, audit, and education functions Candidates must live within the company's geographic footprint and be available for occasional on-site work and local travel. Positions are structured as 13-week temp-to-hire with conversion opportunities KEY RESPONSIBILITIES: Coding Education & Training Deliver physician and coder...

Senior Coder As a Senior Coder, you will act as the lead coder for your designated team. This position will train staff on department policies, procedures, systems and correct coding requirements. The Sr. Coder additionally will monitor staff workload, audit coders, fill in for out of office coders, and make recommendations to Physician Coding leadership to help improve the efficiency of the team. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time. Responsibilities include: Training all new coders on department policies, procedures and correct coding principles Providing routine education, training and auditing to their designated coding teams Analyzing coder's workload and making recommendations to assigned supervisor to ensure all...

Job Title: Coder (Billing) Salary: $30-$35hr DOE Location: Treehaven Openings: 1 Position Purpose The Jr. Coder is responsible for accurately assigning standardized codes to diagnoses, procedures, and treatments for patient records, insurance claims, and billing processes. This role ensures compliance with applicable coding standards, regulations, and payer policies to facilitate timely and accurate reimbursement. Core Duties and Responsibilities Reviewing patient charts to accurately assign the appropriate billing codes (ICD-10-CM, CPT, HCPCS) for diagnoses, procedures, and services rendered, in accordance with FQHC requirements across all lines of business Assist in the submission of accurate claims to payers after correction Ensuring coding compliance with federal and state regulations as well as insurance requirements Communicate with patients and insurance companies to resolve billing discrepancies Maintain knowledge of the latest coding updates, billing rules, and...

Medical Coder Trajectory RCS joined the MedHQ family in 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing healthcare cash flow through integration of both business office processes and clinical documentation. MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and above all excellent...

Vista Community Clinic (VCC) At Vista Community Clinic (VCC), we believe healthcare is more than medicine, it's about hope, community, and impact. For over 50 years, we've been a leader in the community clinic movement, growing from a small volunteer-driven effort in Vista to a nationally recognized network of state-of-the-art clinics across San Diego, Orange, Los Angeles, and Riverside counties. Today VCC has 14 clinics serving over 70,000 patients annually, we continue our mission of delivering exceptional, patient-centered care where it's needed most. As a private, non-profit, multi-specialty outpatient clinic, VCC provides more than healthcare, we provide opportunity. Here your skills are celebrated, your growth is supported and your work makes a difference. We know that our success is a direct result of the exceptional talents and dedication of our employees. Benefits include: Competitive compensation & benefits Medical, dental, vision Company-paid life insurance...

Sr Coder Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 138 hospital-based locations, in addition to its home-based services and virtual care offerings. The posted compensation range of $32.38 - $48.17 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law. As a Senior Coder, you will act as the lead coder for your designated team. This position will train staff on department policies, procedures, systems and correct coding...

Coder Quality Auditor The 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. Job Responsibilities: Quality 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 coders'...

Job Summary The Health Information Coder III is a senior level inpatient coder with the knowledge and skill set to utilize the ICD-10-CM and ICD-10-PCS classification systems to code acute academic, teaching inpatient cases. The skill set extends to knowledge and comprehension of code sequences into Diagnoses Related Groups on acute academic, teaching inpatient cases. Cases are coded to comply with the official guidelines for coding and reporting, practice standards and code of ethics for HIMS coder. Cases are abstracted according to UCSF Health policies and procedures. The focus of coding and abstracting is on a range of all primary hospital services. There is minimal review of coding for quality. The employee will work eight (8) hours per day, excluding meal periods, on five (5) consecutive days within a workweek. The workweek schedule is set between the employee and the manager and may be scheduled to start any day of the week based on manager approval. Duties and Essential Job...

Billing Medical Coder The Billing Medical Coder is responsible for the day-to-day coding and billing operations for all services billable under grants, federal, state, and county programs including Medicare, Medi-Cal, managed care and private insurances. This role is located in Midtown - Sacramento, CA (95811). This role allows a hybrid schedule requiring 1-2 days per week on site. Training Period: 46 weeks onsite, 5 days per week Essential Functions Review and adjudicate coding of services from documentation in a timely manner. Code physician/provider visit procedure notes to identify appropriate ICD10 and CPT4 codes for charge processing. Ensures that all diagnosis ICD10 codes and procedure CPT, HCPCS codes are identified, sequenced, and coded in an accurate and ethical manner for optimized reimbursement. Assigns Evaluation and Management codes and key concepts/elements documented in the patient note, utilizing defined coding guidelines applicable to professional and...

Job Summary The Health Information Coder III is a senior level inpatient coder with the knowledge and skill set to utilize the ICD‑10‑CM and ICD‑10‑PCS classification systems to code acute academic, teaching inpatient cases. The skill set extends to knowledge and comprehension of code sequences into Diagnoses Related Groups on acute academic, teaching inpatient cases. Cases are coded to comply with the official guidelines for coding and reporting, practice standards and code of ethics for HIMS coder. Cases are abstracted according to UCSF Health policies and procedures. The focus of coding and abstracting is on a range of all primary hospital services. There is minimal review of coding for quality. The employee will work eight (8) hours per day, excluding meal periods, on five (5) consecutive days within a workweek. The workweek schedule is set between the employee and the manager and may be scheduled to start any day of the week based on manager approval. Duties and Essential...

Duration :: 13 Weeks Contract Overview Seeking experienced Professional Fee (Pro Fee)–focused Coding Educators to support large-scale chart review, coding accuracy validation, physician education, and documentation improvement initiatives. These roles are high-visibility and require strong communication and presentation skills to engage directly with clinicians and support client revenue cycle, audit, and education functions. Candidates must live within the client geographic footprint and be available for occasional on-site work and local travel. Positions are structured as 13-week temp-to-hire with conversion opportunities. Key Responsibilities Coding Education & Training Deliver physician and coder education for assigned groups, with emphasis on Pro Fee (ASC, surgery, outpatient) environments. Facilitate individual and group training sessions; must be comfortable presenting to clinicians. Address provider and coder questions related to documentation...

Description San Mateo County Health is seeking experienced individuals for the position of Medical Records Coder II for Correctional Health to provide coding for CalAIM billable services including ancillary services and clinic visits. Medical Records Coder II is the journey level class of this series, fully competent to independently code ICD‑10 and CPT procedural coding, perform coding audits, provide physician education on coding issues or EM levels, and analyze and resolve billing edits. The successful candidate will perform billing functions related to the Department of Health Care Services (DHCS) justice‑involved CalAIM initiative. This initiative allows eligible incarcerated individuals to enroll in Medi‑Cal and receive reimbursement for health care services provided within the 90 days prior to their release, supporting their successful reentry into the community. The vacant position for coding will focus on professional fee (pro‑fee) coding. Majority of work will be...

Medical Billing Coder - Dermatology ADT Dermatology BayF Full Time 86498BR Job Summary The dermatology medical billing coder works under direct supervision, acquires skills and knowledge in revenue cycle practices and concepts. Learns to work on projects of limited scope and complexity. Coding all E/M and procedural coding for outpatient service for 45+ attending at UCSF Health Dermatology Department, as well as ensuring teaching physician guidelines are correct, including all minor and major procedure coding. The final salary and offer components are subject to additional approvals based on UC policy. Your placement within the salary range is dependent on a number of factors, including your work experience and internal equity within this position classification at UCSF. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement. The current hourly rate range for this position is...

Join to apply for the Medical Billing Coder - Dermatology role at UCSF Health Job Summary The dermatology medical billing coder works under direct supervision, acquires skills and knowledge in revenue cycle practices and concepts, and learns to work on projects of limited scope and complexity. The coder will perform coding of all E/M and procedural codes for outpatient services for 45+ attending physicians at UCSF Health Dermatology Department, ensuring that teaching physician guidelines are correct, including all minor and major procedure coding. The final salary and offer components are subject to additional approvals based on UC policy. Placement within the salary range is dependent on experience and internal equity. For union‐represented positions, placement will follow the collective bargaining agreement. The current hourly rate range for this position is $26.11–$55.32, with an entry point at $31.64, d.o.e., and is subject to change based on union requirements. For more...