37 coder auditor jobs found

Overview At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions. The Outpatient Payment Integrity Coder Auditor is responsible for reviewing outpatient medical claims to ensure coding accuracy, compliance, and appropriate payment in accordance with CMS and payer-specific guidelines. This role supports the development and implementation of payment integrity initiatives by identifying coding and billing inaccuracies, trends, and potential cost savings opportunities across outpatient facility claims. The ideal candidate has advanced knowledge of outpatient coding, APC and EAPG payment methodologies, and clinical documentation requirements, with strong analytical and auditing skills. Salary Range: $100,000 - $102,500 Responsibilities Perform detailed coding audits on outpatient facility claims to validate appropriate CPT/HCPCS, revenue codes, modifiers, and ICD-10 coding...

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for a Certified Coding Auditor to work in its New York office or remotely. Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers....

Outpatient Coder The Outpatient Coder works under general supervision to complete charge documents for outpatient services. The Certified Professional Coder, LPN, or RN is responsible for reviewing a patient's medical records after a visit and translating the information into codes that payors use to process claims from patients. The coder will work under general supervision to complete charge sessions for outpatient services within the primary care setting. The coder must have a strong work ethic as there is a productivity requirement with the completion of a minimum of 240 charge sessions daily. The outpatient coder will be responsible for complying with medical coding guidelines and policies regarding appropriate CPT/ICD-10/HCPCS codes. Education & Experience: Certified Professional Coder (CPC) certification, or, graduate from a school of nursing (LPN or RN), required If candidate is a graduate from a school of nursing without coding certification, then AAPC (CPC and...

POSITION SUMMARY: The Outpatient Coder works under general supervision to complete charge documents for outpatient services. The Certified Professional Coder, LPN, or RN is responsible for reviewing a patient's medical records after a visit and translating the information into codes that payors use to process claims from patients. The coder will work under general supervision to complete charge sessions for outpatient services within the primary care setting. The coder must have a strong work ethic as there is a productivity requirement with the completion of a minimum of 240 charge sessions daily. The outpatient coder will be responsible for complying with medical coding guidelines and policies regarding appropriate CPT/ICD-10/HCPCS codes. EDUCATION & EXPERIENCE: Certified Professional Coder (CPC) certification, or, graduate from a school of nursing (LPN or RN), required If candidate is a graduate from a school of nursing without coding certification, then AAPC...

Job Title Individual responsible for coding all hospital ED, RCR, CLI, REF records for purposes of reimbursement, research, and compliance with federal regulations. Responsibilities Reviews patient's entire current medical record and assigns appropriate ICD-10 diagnosis and CPT procedure codes according to accepted coding guidelines and hospital's policies and procedures. Assigns accurate APC and E-APG's to patient's record utilizing hospital encoding system. Corrects any edits flagged by encoder and financial system. Understands and applies modifiers appropriately. Charge entry. Accurately abstracts statistical data from records using hospital abstracting system. Attends hospital sponsored coding educational programs and department coding meetings. Participates in and practices lean management principles and processes. DCH Standards: Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation....

Job Description Job Description Description: Role Summary Responsible for reviewing medical records and assigning accurate CPT, HCPCS, ICD-10-CM, and appropriate modifiers for outpatient services. This role supports compliant coding and consistent performance across a variety of outpatient encounter types. Core Responsibilities Review medical records and assign accurate CPT/HCPCS, ICD-10-CM, and modifiers. Ensure documentation supports coded services and identify/escalate discrepancies or gaps. Ensure compliance with CMS, payer-specific rules, and official coding guidelines (including NCCI edits). Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards. Requirements: Minimum Qualifications Credentials: CPC, CCS, RHIA, or RHIT (active). Experience: Minimum 3+ years outpatient coding experience across multiple outpatient service types. Skills & Knowledge: Strong knowledge of CPT, HCPCS, ICD-10-CM,...

Coding Educator It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Coding Educator with at least 3 years of experience and expertise in coding across various specialties, excellent communication and presentation skills. Remote work: This position is eligible for remote work in accordance with SSM policies. Note that remote work is not permissible in some states; Human Resources should be consulted for additional information and guidance. Job Summary: Develops and coordinates the delivery of coding educational programs. Promotes consistency and accuracy of coding and documentation practices. Acts as a liaison for coding questions and concerns between providers, coding, corporate responsibilities, and educational departments. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Drives optimal clinical and financial outcomes through thorough assessment of provider documentation and coding competency, identification of...

Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. Interprets a wide variety of clinical and diagnostic documentation in order to process hospital and / or pro-fee charges for episodes of outpatient care. Assigns appropriate ICD-CM (current edition) and CPT codes as well as modifiers. Based on account type, may assign ICD-PCS codes, as appropriate adhering to official coding guidelines. Major Responsibilities: Upon review of the medical record, performs analysis on documentation,...

Certified Coder Professional Reporting to the Manager Physician Coding Services, the Certified Coder Professional will be responsible for reviewing and evaluating clinical documentation within medical records to ensure high quality and compliant coding. The Certified Coder Professional will provide training, consultation, and feedback to clinicians on their documentation and coding to ensure Emanate Health Medical Group receives appropriate reimbursement and conforms to applicable guidelines and regulations. Collaborates with Emanate Health's Compliance team and with all third party billing and reimbursement requirements including, but not limited to, the requirements of Medicare and Medicaid programs. Serves as the coding subject matter expert for the physicians. Minimum Education Requirement: Associate degree preferred; college degree preferred, knowledge of Medical Terminology, Anatomy & Physiology and Computer experience. Minimum Experience Requirement: Minimum of 2+...

Outpatient Coder 3 The University of Miami/UHealth Department Health Information Management has an exciting opportunity for a full-time Outpatient Coder 3 to work in Miami, FL. Under the general direction of the Outpatient Coding Manager, the Outpatient Coder 3 reviews documentation in the electronic medical record (EMR) and assigns and sequences ICD-10-CM diagnosis codes and CPT procedure codes in accordance with national coding guidelines. The primary focus of this role is to capture all encounter specific diagnoses and procedure codes for accurate reimbursement, data collection, and research purposes. Core Job Functions Review, analyze, and interpret the entire electronic medical record (EMR) to identify all diagnoses and procedures documented during a patient's admission. Guidelines and knowledge of anatomy and physiology, medical terminology, and disease processes. Reviews documentation and reaches out to physicians for additional information when information for proper...

Outpatient Coder When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Job Description: Under the general supervision of the Outpatient (OP) Coding Manager and OP Coding Supervisor, the OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Essential Duties & Responsibilities including but not limited to: Hospital Coding: Review the complete...

Outpatient Coder When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Job Description Under the general supervision of the Outpatient Coding Manager and OP Coding Supervisor, the OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Essential Duties & Responsibilities including but not limited to: Review the complete electronic and scanned...

Job Description Job Description Job Duties: The Outpatient Coder I assesses documentation and verifies the correct ICD and CPT codes to patient medical records, monitors records for timely coding turnaround, maintains coding and documentation quality standards, and performs audits to support data quality and medical necessity. Qualifications: High School Diploma or equivalent; completion of additional post-secondary health-related program preferred. E&M experience preferred, CPC Apprentice preferred. 2-3 years preferred. Shift Schedule: Full-Time; Monday-Friday, 8:00AM - 4:30PM or 8:30AM - 5:00PM Flexible scheduling available. Remote work may be an option following the training period and successful demonstration of coding competencies. Benefits: Medical | Dental | Vision Flexible Spending | Health Savings Basic Life and AD&D Insurance (paid by BCH) Supplemental Life and AD&D Insurance Disability Insurance...

Outpatient Coder - Coding - 338010 US:NM:Alamogordo | Medical Coding | Full Time Summary: Responsible for maintaining current and high-quality ICD-10-CM and CPT coding for all Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. The coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM Guidelines for Coding and Reporting and CPT Guidelines. Outpatient coding is applicable towards clinical, provider office visits, therapeutic, laboratory, recurring, emergency department, outpatient observation, and ambulatory surgery patient encounters. Coder will work collaboratively with various CHRISTUS Health departments (Admitting, Charging, Patient Financial Services, HIM, etc.) to resolve charging issues,...

Overview Individual responsible for coding all hospital ED, RCR, CLI, REF records for purposes of reimbursement, research, and compliance with federal regulations. Applies ICD-10 diagnosis and CPT procedure codes and appropriate APC or E- APG. Coder must abstract statistical data from records into hospital abstracting system in accordance with hospital policies and procedures. Individual must have knowledge of CPT, APCs, E-APG's, federal and state coding guidelines. Responsibilities Reviews patient's entire current medical record and assigns appropriate ICD-10 diagnosis and CPT procedure codes according to accepted coding guidelines and hospital's policies and procedures. Assigns accurate APC and E-APG's to patient's record utilizing hospital encoding system. Corrects any edits flagged by encoder and financial system. Understands and applies modifiers appropriately. Charge entry. Accurately abstracts statistical data from records using hospital abstracting...

Outpatient Coder - Coding - 368951 US:TX:Tyler | Medical Coding | Full Time Description Summary: Responsible for maintaining current and high-quality ICD-10-CM and CPT coding for all Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. The coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM Guidelines for Coding and Reporting and CPT Guidelines. Outpatient coding is applicable towards clinical, provider office visits, therapeutic, laboratory, recurring, emergency department, outpatient observation, and ambulatory surgery patient encounters. Coder will work collaboratively with various CHRISTUS Health departments (Admitting, Charging, Patient Financial Services, HIM, etc.) to resolve charging...

Description Summary: Responsible for maintaining current and high-quality ICD-10-CM and CPT coding for all Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. The coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM Guidelines for Coding and Reporting and CPT Guidelines. Outpatient coding is applicable towards clinical, provider office visits, therapeutic, laboratory, recurring, emergency department, outpatient observation, and ambulatory surgery patient encounters. Coder will work collaboratively with various CHRISTUS Health departments (Admitting, Charging, Patient Financial Services, HIM, etc.) to resolve charging issues, denials, and physician documentation clarifications, to ensure accurate billing...

Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Non-Exempt Hiring Range: $0.00 - $0.00 Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations . Schedule Details: Monday through Friday Scheduled Hours: 7a-3:30p Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5470 ED Coding and Revenue Capture This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a...

Senior Outpatient Coder Position Details: Full-Time Remote Reports to Coding Operations Manager You must reside in one of these states to be eligible for this position: Arkansas California Kentucky Massachusetts Nevada New Mexico Oregon Utah Tennessee Texas Wyoming Job Summary: The Senior Coder supports assigned inpatient and/or outpatient coding operations through day-to-day workflow leadership and may provide oversight of coding quality, coding edits, auditing, and staff education. Assigned functions may include inpatient, observation, emergency department, ambulatory surgery, ancillary, clinic, and other hospital-based coding services. The position supports Revenue Cycle Operations with special projects, including denial review, appeals, discharge-not-final-billed management, regulatory and payer edit review, and process improvement efforts designed to meet organizational goals while promoting accurate, complete, and compliant coding and billing....

Outpatient Coder - Coding - 331187 US:TX:Irving | Medical Coding | Full Time Summary: Responsible for maintaining current and high-quality ICD-10-CM and CPT coding for all Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. The coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM Guidelines for Coding and Reporting and CPT Guidelines. Outpatient coding is applicable towards clinical, provider office visits, therapeutic, laboratory, recurring, emergency department, outpatient observation, and ambulatory surgery patient encounters. Coder will work collaboratively with various CHRISTUS Health departments (Admitting, Charging, Patient Financial Services, HIM, etc.) to resolve charging issues, denials,...

Facility Op Coder When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Job Description: Under the general supervision of the Facility Outpatient (OP) Coding Manager and OP Coding Supervisor, the Facility OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The facility OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Essential Duties & Responsibilities including but not limited to: Review...

Miami, FL | Full-Time Health Information Management Department: Health Information Management Address: 1611 NW 12 Ave, Miami, FL 33136 Shift Details: Monday to Friday, 7.30 AM to 4 PM [Remote but open to applicants who reside in the state of Florida] Summary HIM Outpatient Coder 1 is responsible for coding and abstracting outpatient medical records, including Emergency Room visits, Clinic visits and Recurrent visits. The Coder 1 is responsible for reviewing the clinical documentation contained in the patient health record to accurately assign and sequence ICD-9 and CPT codes for use in reimbursement and data collection. Able to transition to ICD-10-CM. Responsibilities Codes outpatient diagnostics/outpatient clinics/recurring visits/emergency room visits using ICD-9 or CPT codes as appropriate. Maintains a yearly average accuracy rate of 94% during internal and/or external Coding audits. Verifies patient information to identify any discrepancies...