17 coder auditor jobs found in Boston

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process.    Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes.    Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection. Analyzes data to identify deficiencies, prepare...

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process.    Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes.    Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection. Analyzes data to identify deficiencies, prepare...

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process.    Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes.    Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection. Analyzes data to identify deficiencies, prepare...

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process.    Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes.    Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection. Analyzes data to identify deficiencies, prepare...

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process.    Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes.    Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection. Analyzes data to identify deficiencies, prepare...

Senior Medical Coding Analyst CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix's autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. Reporting to the Senior Manager, Medical Coding & Audit, as a Senior Medical Coding Analyst, this role will be a key member of the team responsible for ensuring that CodaMetrix meetsand exceedsour customers' coding quality expectations. They will leverage their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency of coding...

Program Integrity Clinical Compliance Auditor This position is remote in Massachusetts. You will have the flexibility to work remotely as you take on some tough challenges. Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The Program Integrity Clinical Compliance Auditor will be responsible for performing compliance reviews of medical and administrative documentation to identify instances of healthcare fraud and/or wasteful and abusive conduct by health care providers who submit claims for payment. This position will utilize information from claims data...

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...

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 the...

Title: Certified Risk Coder Reports to: Manager, Risk Coding Classification: Individual Contributor Location: Boston (Remote) Job description revision number and date: 2.0, 01.06.2025 Organization Summary Community Care Cooperative (C3) is a 501(c)(3) non‑profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast‑growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary The Certified Risk Coder will be a part of an emerging coding team and coding service that performs...

Datavant is seeking an Inpatient Auditing Specialist who will address consulting and educational needs related to coding quality and compliance. This role is crucial for shaping the future of healthcare from a fully remote workspace. Responsibilities include conducting audits, providing coder education, and maintaining high accuracy rates. Candidates should have at least 5 years of experience and relevant certifications, with attractive benefits available to support your professional development. #J-18808-Ljbffr

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 you to help shape the future of healthcare from your own workspace! What You Will Do Assign diagnostic and procedural codes using ICD-9-CM, ICD-10-CM, and ICD-10-PCS codes Accurately sequence and abstract medical codes from patient records, ensuring precision and adherence to documentation Oversee and audit the work of Level 1 & 2 Coders, where applicable Champion documentation improvement opportunities and coding issues, facilitating resolution with relevant stakeholders Uphold an overall 95% coding accuracy rate and a 95% accuracy rate for MS-DRG assignments Maintain a minimum production of 1 chart per hour or site-specific productivity benchmarks Foster professional...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. 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. Job Description: Essential Duties & Responsibilities including but not limited to: Hospital Coding: Review the complete electronic...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. 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. Job Description: Essential Duties & Responsibilities including but not limited to: Hospital Coding: Review the complete electronic...

Senior Medical Coding Analyst CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix's autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. Reporting to the Senior Manager, Medical Coding & Audit, as a Senior Medical Coding Analyst, this role will be a key member of the team responsible for ensuring that CodaMetrix meets—and exceeds—our customers' coding quality expectations. They will leverage their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency of coding...

Title: Certified Risk Coder Reports to: Manager, Risk Coding Classification: Individual Contributor Location: Boston (Remote) Job description revision number and date: 2.0, 01.06.2025 Organization Summary: Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Quality Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary: The Certified Risk Coder will be a part of an emerging coding team and coding service that...