50 internal coding auditor jobs found

Compliance Auditor - RemoteThe Revenue Cycle Compliance Hospital Auditor conducts audits to evaluate compliance with a wide variety of Federal and State laws, regulatory rules & regulations, PSJH policies and procedures.Areas of audit focus for this position may involve clinical and non-clinical services, including but not limited to revenue cycle:Rev Cycle departments, Rev Cycle Billing Offices, External Vendor; HIM Coding, Revenue Integrity RI, Chargemaster CDM, EPIC, and Clinical Documentation CDT.This position works collaboratively with Case Management, Utilization Review, Revenue Integrity, our PB Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs and Finance under the supervision of the Rev Cycle Compliance Senior Manager.The Revenue Cycle Compliance Hospital auditor navigates and analyzes data across both the Clinical EMR and Epic Billing systems.This includes reviewing line-item charges, Revenue Codes, CPT descriptions, status, orders,...

Billing and Coding AuditorBanyan Treatment Centers is seeking a detail-oriented and experienced Billing and Coding Auditor to support the accuracy and compliance of our billing practices across our behavioral health services. This critical role ensures the integrity of our claims processes and supports continuous quality improvement, staff education, and adherence to payer regulations.As a nationally recognized provider of addiction and mental health care accredited by The Joint Commissionwith 18 locations, robust Telehealth services, and backed by TPG's Rise Fund since 2023our 1,600employees are dedicated to delivering compassionate, high-quality care that transforms lives.Positions DetailsLocation:Flexible On-site (Pompano Beach, FL), Hybrid or Remote (USA)Reports to:Auditing Manager & Director of RCMSchedule:Full-timeKey ResponsibilitiesConduct regular audits of behavioral health billing and claims for accuracy and compliance.Review coding of all services (ICD-10, CPT,...

Coding Auditor & EducatorThe Coding Auditor-Educator is an advanced level position utilizing ICD-10-CM, ICD-10 PCS, and CPT-4 Coding Classification systems who supports the facility and Coding Service Center. Responsible for answering coding and billing questions, onboarding and training new staff, performing coding audits, and development and deployment of coding education. Works in conjunction with the Coding Service Center leadership team in planning and performing coding education and training across the system. Responsible for performing internal audits and follow up education. Facilitates and promotes standardization of coding practices, monitors and communicates regulatory coding and billing changes for timely and accurate implementation. Participates in short-term and long-term strategic planning with regard to compliant coding and regulatory billing practices.Along with CO, KS and NM, this position is open to remote/out of state candidates residing in only these...

Medical Coder Educator - USFTGP RCOServes 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.QualificationsRequired:High School Diploma or...

Coding Auditor (ICD-10)A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas:Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.Job DescriptionPosition:Coding Auditor (ICD-10)Duration:Full-TimeLocation:Newark/Wall NJJob Summary:This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on ICD9-...

Department Description:The Critical Care Auditor/ Coder position will be working directly with the Department of Anesthesia, Critical Care and Pain Medicine and will have the opportunity to work remotely following an initial onsite training period. The incumbent will be required from time-to-time to attend billing onsite staff meetings and meetings with the physicians they support. AFS, LLC is located in Needham Heights, Massachusetts. Job Location:Virtual Job Summary:Performs professional certified coding and provides administrative and project support to the department. Analyzes surgical-medical documentation, provides the individual surgeon/physician with the application of appropriate ICD-10/CPT/HCPCS descriptor codes including the appropriate use of modifiers to ensure compliance for reimbursement. Essential Responsibilities:Analyzes evaluation and management, including critical care, procedures and other notes and documents to determine the scope and complexity of the...

Physician Coding AuditorThe Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding.Orlando Health is committed to providing benefits that go beyond the expected, with career-growing free education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions.Orlando Health proudly embraces and honors the individuality of our team members. By sharing different ideas and perspectives and working together as a team, we are better able to relate to, care for and authentically serve our patients and families who make up the collective populations in our community....

About UsAt Cooper University Health Care , our commitment to providing extraordinary health care begins with our team.Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols.We have a commitment to our employees to provide competitive rates and compensation programs.Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement.We also provide attractive working conditions and opportunities for career growth through professional development.Discover why Cooper University Health Care is the employer of choice in South Jersey.Short DescriptionThe auditor reviews professional fee billing, coding and documentation.Reviews to be performed are identified based on the then-current OIG Workplan and compliance risk analyses.Customers include employed providers, senior leadership,...

Professional Coding Auditor And Educator - Remote This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing.In addition, this role focuses on performing the following Health Information Management duties:Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information.An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a hands on environment.The majority of time is spent in the delivery of support services or activities, typically under supervision.An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education.Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation or...

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.This comprehensive approach to treatment, the gold standard in care for opioid use disorder, has been shown to prevent more deaths from overdose and lead to long-term recovery.We are committed to bringing critical services to communities across the U.S.to improve access to treatment for over 26,500 patients.Our clinics are all outpatient and office-based, with clinics in Georgia, Kentucky, New Jersey, North and South Carolina, Pennsylvania, Tennessee, Texas, and...

Job DescriptionJob DescriptionJob Summary / PurposeThe Senior Clinical Coding Auditor & Trainer will conduct audits of inpatient coding processes for Fidelis Care and assist in development of training and audit tools.Location :The Senior Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis.Candidates must be willing to travel to New York twice a year to be considered for the position.Pay Range :$68,700.00 - $123,700.00 per yearResponsibilities :Develop and maintain complex audit processes and audit tools related to inpatient codingDevelop and conduct clinical education courses for existing and new employeesAudit established guidelines for medical necessityAnalyze training needs and identify, select, or develop appropriate training programs including training aids and materialsAudit staff in accordance with established auditing processes, work with staff to identify and resolve errors, and present findings and...

Quadris Team, LLC - A Revenue Cycle Management Group, is searching for a dynamic person to join us, working with our highly skilled Medical Coding Team to fill the role of Medical Coding Auditor & Educator.We are a 100% remote team supporting our clients across the United States! See us at.The ideal applicant will be a subject matter expert in both Facility and Profee medical coding auditing.Job Focus :The Senior Coding Auditor may be responsible for a variety of duties and obligations, depending on the client and assignment.These responsibilities may include inpatient / outpatient / professional fee facility auditing, denial management, coding, implementation specialist, job aid creation, training, and specialty coding.The position may also be responsible for management of the audit team and project management.All coding and auditing are performed within the scope of regulatory and compliance law expectations.Auditing Responsibilities :May include conducting inpatient,...

Job DescriptionJob DescriptionMedical Coding Compliance SpecialistCompensation :Up to $85,000 annually, determined by your experience and qualifications.Job Location :Remote (US)Job Highlights :Work-Life Balance :Monday to Friday schedule for a fulfilling personal and professional life.Competitive Compensation :Be rewarded with a generous salary and benefits package.Career Growth Opportunities :Unlock your potential and advance in your career with our support.Supportive Work Environment :Join a team that values and appreciates your contributions.Comprehensive Training :Enhance your skills and knowledge through our extensive training programs.Compliance and Peace of Mind :Work with confidence knowing that we prioritize compliance with employment laws and regulations.Paid Time Off and Holidays :Enjoy well-deserved time off to relax and recharge.Life Insurance Coverage :Protect your loved ones with our employer-paid life insurance policy.Collaborative Team Environment :Thrive in a...

Job DescriptionJob DescriptionDescription :Facility Outpatient Coding AuditorJob Type :Full-Time or Part-Time Remote Medical Coding Audit Outpatient Coding Facility CodingGrow Your Career with a National Leader in Outpatient Medical Coding & Auditing - Work from Home!Are you a certified outpatient medical coding auditor with experience in surgical coding, emergency department (ED) coding, interventional radiology , or facility outpatient services ? Join GeBBS Healthcare Solutions , an award-winning provider of HIM (Health Information Management) and RCM (Revenue Cycle Management) services.We are expanding and seeking experienced Remote Outpatient Facility Coding Auditors to support our national client base.Position Summary :As a Remote Outpatient Coding Auditor , you'll conduct quality assurance audits on coded outpatient medical records.Your audits will focus on multiple service areas including :Outpatient SurgeriesObservationsInterventional RadiologyCardiac...

Summary: Selected by CHRISTUS Health Coding Leadership, to focus coding skills and expertise on designated Inpatient or Outpatient high dollar or specialty account types. Specialty Coder is responsible for maintaining current and high-quality ICD-10-CM, ICD-10-PCS and/or CPT coding for the Inpatient and or/ Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Specialty 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 and ICD-10-PCS Guidelines for Coding and Reporting and AMA CPT Guidelines. Coder will work collaboratively with various CHRISTUS Health departments, including but not limited to the HIM and Clinical Documentation Specialists, to ensure accurate and complete physician documentation to support...

Job DescriptionDepartment / Unit :Health Information ManagementWork Shift :Day (United States of America)Salary Range :$60,367.47 - $90,551.20Professional Coding Auditor will apply an advanced professional coding skill set to act as a service line coding team lead expert, working collaboratively to support all workflows related to professional fee coding / charging / denials follow-up.Coordinates with others as needed to ensure comprehensive and timely completion of professional coding processes.Audit CPT and ICD-10 diagnosis coding applied by providers and coding staff to assure compliance with federal and state regulations and insurance carrier guidelines.Provide education, instruction and training to providers and coding staff.This position is remote but does require onsite education to providers as needed.This position has remote opportunityThis position requires a CPC Certification - Upon HireTwo years or more prior experience in professional fee coding - requiredEssential...

Virtua Health Coding SpecialistAt Virtua Health, we exist for one reason to better serve you.That means being here for you in all the moments that matter, striving each day to connect you to the care you need.Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between we are your partner in health devoted to building a healthier community.If you live or work in South Jersey, exceptional care is all around.Our medical and surgical experts are among the best in the country.We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home.A Magnet-recognized health system ranked by U.S.News and World Report, we've received multiple awards for quality, safety, and outstanding work environment.In addition to five hospitals, seven emergency departments,...

Company Overview :Read on to fully understand what this job requires in terms of skills and experience If you are a good match, make an application.Upward Health is an in-home, multidisciplinary medical group providing 24 / 7 whole-person care.Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help.Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients.We are able to treat a wide range of needs - everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals - because we know that health requires care for the whole person.It's no wonder 98% of patients report being fully satisfied with Upward Health!Job Title & Role Description :The Certified Medical Coder is responsible for analyzing provider documentation to accurately select ICD-10 and CPT / HCPCS...

About Us: At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact—whether we’re supporting data-driven decisions, modernizing systems or safeguarding critical programs. Job Overview We are seeking an experienced and detail-oriented Senior Medical Coder to support our Medicare Part C Risk Adjustment Data Validation (RADV) initiatives. The ideal candidate will have strong experience in ICD-9-CM/ICD-10-CM coding across various care settings, including inpatient, outpatient, and physician office encounters. The candidate will perform diagnosis coding, support intake reviews, conduct appeal responses, and contribute to quality...

Claims Billing SpecialistThe Specialist is responsible for resolving inquiries related to claims, eligibility, and authorization and working with multiple parties to ensure records are up to date. The Specialist will ensure first-call-resolution standards are followed and will refer and follow-up as per Hoag guidelines. Ensure accuracy, reports issues, and works to resolve. Ensure compliance and regulatory guidelines and health plan requirements are met. Documents actions taken following HIPAA guidelines. May assist in providing customer service, member services, and others in working with providers/billing offices when needed. Assist in identifying and reporting issues working with the management team to help minimize re-work and address front-end process issues. Performs other duties as assigned.May also maintains databases, audit information and works with patients to process patient payment. May follow up with insurance companies on outstanding or unpaid claims, create/send...

About Us: At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact-whether we're supporting data-driven decisions, modernizing systems or safeguarding critical programs. We are seeking an experienced and detail-oriented Senior Medical Coder to support our Medicare Part C Risk Adjustment Data Validation (RADV) initiatives. The ideal candidate will have strong experience in ICD‑9‑CM/ICD‑10‑CM coding across various care settings, including inpatient, outpatient, and physician office encounters. The candidate will perform diagnosis coding, support intake reviews, conduct appeal responses, and contribute to quality assurance efforts....

Day Kimball Health is hiring a Certified Professional Coder for the Central Business Office . Location: Putnam, CT. Shift: Days Shift, 40 Hours. Why Choose Day Kimball Health? For nearly 130 years, Day Kimball Health has been the trusted healthcare provider for the Northeastern Connecticut community, offering accessible and compassionate care close to home. As a non‑profit, integrated healthcare provider, we are committed to delivering high‑quality services while maintaining a strong connection with our patients and their families. We value both personal and professional growth and offer a supportive, collaborative environment where you can thrive. Certified Professional Coder Job Summary Under the general supervision of the Director of Professional Revenue Cycle, the Certified Professional Coder performs all phases of abstracting, diagnosis coding, charge capture, and posting through record analysis. The coder conducts quarterly chart audits to ensure documentation meets...

Summary/Objective:  The Revenue Cycle Manager is responsible for all duties listed below. The position requires coordination with clients, executive staff and RCM staff for the revenue cycle management performance reporting. Essential Functions: Core duties and responsibilities include the following. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.  1.  LEAD AND SUPERVISE REVENUE CYCLE STAFF Provide day‑to‑day leadership, coaching, and performance oversight for billing, coding, collections, and reimbursement teams. Ensure staff adhere to organizational policies, regulatory requirements, and best practices across the full revenue cycle. 2.   Monitor and Report Staff Productivity Develop, track, and analyze productivity metrics for all revenue cycle functions. Prepare regular performance dashboards and present findings AND SUGGESTIONS for...

Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values.These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.Reporting to the Supervisor of Outpatient Coding, The OP Senior Coder is a vital multifaceted role within the Outpatient Coding Department.This position provides support to the Outpatient Coding Department as a OP coding subject matter expert, educator, QA reviewer, and also focuses daily efforts on A/R management and oversight.Additionally, this person works with partner departments to problem solve issues and streamline processes.The OP Senior Coder is also required to mentor other team members and also prepare them for the role of OP Senior Coder.The OP Senior Coder possesses a strong level of OP clinical coding expertise, and has the ability to handle multiple priorities.This position...