16 coder auditor professional jobs found in Boston

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 and scanned...

Hospital Inpatient Coder - Revenue Integrity - Full Time### Hospital Inpatient Coder - Revenue Integrity - Full TimeApply: Remote - NH: Full time: Posted Today: JR13086Come work at the best place to give and receive care!**Job Description:****Who We Are:** The Revenue Integrity Department at the Elliot Hospital is responsible for the medical coding of our hospital and professional providers. We take pride in our work and observe best practices to ensure accurate, optimal coding. If you are a credentialed coder with strong coding skills, can work in a dynamic and changing environment, and are seeking a change, please consider Coding with our team. Apply today! **About the Job: Remote Position M - F 8 am - 430 (can be flexible) - must live within the U.S.** The Hospital Inpatient Coder is responsible for accurately assigning ICD-10 and DRG codes to hospital inpatient services in accordance with current coding guidelines, payer requirements, and regulatory requirements....

Elliot Health System is seeking a Hospital Inpatient Coder for Revenue Integrity in a remote, full-time capacity. The role focuses on accurate ICD-10 and DRG coding for hospital inpatient services, ensuring compliance and optimal reimbursement. The position requires at least 2 years of coding experience and current CCS certification, with a strong emphasis on audits, deadlines, and adherence to coding standards. #J-18808-Ljbffr

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...

Outpatient CoderWhen 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 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 electronic and scanned medical...

Job Description Job Description Shift delivers AI agents that transform insurers' most critical work. By combining deep industry expertise and unmatched data resources, Shift provides proven results that have earned the trust of hundreds of the world's leading insurers. Our insurance-grade AI is accurate, explainable, and secure—empowering human experts to move with unmatched speed, total confidence, and a renewed focus on the people they serve.       Your browser does not support the video tag. Our culture is built on innovation, trust, and a drive to transform the insurance industry through our SaaS platform. We come from more than 50 different countries and cultures and together we are creating the future of insurance. Learn more at www.shift-technology.com   As part of our US Healthcare Payment Integrity and Customer Success organization, you will use your technical and clinical coding knowledge to help implement and support solutions that improve claim payment...

Department: 10407 Enterprise Revenue Cycle - Coding Production Operations: Inpatient Coding Operations Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Will support : A mix of inpatient community and academic coding. Includes service lines such as cardiology, neurology, and oncology. Schedule : Full-time, Monday-Friday 40hrs with a standard schedule of Monday through Friday, 8 hours per day, totaling 40 hours each week. Certification required : Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA). Remote opportunity: Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY Pay Range: $33.05 - $49.60 Major...

Shift delivers AI agents that transform insurers' most critical work. By combining deep industry expertise and unmatched data resources, Shift provides proven results that have earned the trust of hundreds of the world's leading insurers. Our insurance-grade AI is accurate, explainable, and secure—empowering human experts to move with unmatched speed, total confidence, and a renewed focus on the people they serve. Our culture is built on innovation, trust, and a drive to transform the insurance industry through our SaaS platform. We come from more than 50 different countries and cultures and together we are creating the future of insurance. As part of our US Healthcare Payment Integrity and Customer Success organization, you will use your technical and clinical coding knowledge to help implement and support solutions that improve claim payment accuracy. Working closely with senior specialists, product, and technical teams, you will help validate edit logic, assist with audits, and...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. 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...

Outpatient CoderWhen 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 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:Professional Coding Coding Responsibilities:· Provides review and/or...

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...

Certified Medical Coding SpecialistShift is the leading AI platform for insurance. Shift combines generative, agentic, and predictive AI to transform underwriting, claims, and fraud and risk - driving operational efficiency, exceptional customer experiences and measurable business impact. Trusted by the world's leading insurers, Shift delivers AI when and where it matters most, at scale and with proven results.Our culture is built on innovation, trust, and a drive to transform the insurance industry through our SaaS platform. We come from more than 50 different countries and cultures and together we are creating the future of insurance.As part of our US Healthcare Payment Integrity and Customer Success organization, you will use your technical and clinical coding knowledge to help implement and support solutions that improve claim payment accuracy. Working closely with senior specialists, product, and technical teams, you will help validate edit logic, assist with audits, and...

Required Skills & Experience • Certified coder (CPC, CCS, CRC, CCA, or equivalent certification) • Strong ICD-10-CM coding experience and medical record review background • Knowledge of Risk Adjustment and HCC coding methodologies • Experience reviewing physician documentation and assigning accurate diagnosis codes • Strong understanding of medical terminology, anatomy, physiology, and disease processes • Ability to interpret complex clinical documentation with high accuracy and productivity • Familiarity with CMS guidelines and Medicare Advantage requirements Nice to Have Skills & Experience • Medicare Advantage Risk Adjustment experience • Experience working with CMS-HCC models • CRC (Certified Risk Adjustment Coder) certification • Experience with EMRs and coding software platforms • Background in a health plan, physician practice, hospital, or revenue cycle environment • Audit and quality assurance experience Job Description Insight Global is seeking Medical Coders...

Billing Compliance Auditor III (Hybrid)Position Summary: Billing Compliance Auditor III (hybrid). Under general supervision performs audits of clinical documentation, physician billing and payment records and applicable industry standard codes by analyzing medical records, coding records and health system bills validating clinical documentation in conjunction with the bill; assessing the level and accuracy of coding, determining that governmental and third party payer regulations are being complied with; and evaluating appropriateness of billing and coding procedures. Evaluates accuracy and risk level of coding and billing performance by individuals and clinical units. Prepare reports and provide individual and/or group instruction to physicians and others based on results of audit. Works collaboratively with appropriate personnel to identify and recommend strategies for process improvement and to develop and draft billing and coding policies for the CHB Foundations in coordination...

Who We Are: The Revenue Integrity Department at the Elliot Hospital is responsible for the medical coding of our hospital and professional providers. We take pride in our work and observe best practices to ensure accurate, optimal coding. If you are a credentialed coder with strong coding skills, can work in a dynamic and changing environment, and are seeking a change, please consider Coding with our team. About the Job: The Hospital Inpatient Coder is responsible for accurately assigning ICD-10 and DRG codes to hospital inpatient services in accordance with current coding guidelines, payer requirements, and regulatory requirements. This role supports the integrity of clinical documentation and ensures timely, compliant coding to facilitate optimal reimbursement and minimize denials. The Hospital Inpatient Coder collaborates with providers and coding leadership to resolve coding discrepancies, contribute to quality improvement efforts, and uphold organizational goals related to...

SolutionHealth's Elliot Hospital in Manchester, NH seeks Hospital Inpatient Coder to assign ICD-10 and DRG codes for inpatient services, ensuring compliance with guidelines and payer requirements while supporting revenue cycle. You will collaborate with providers and coding leadership, maintain high accuracy, participate in audits, and help improve documentation quality; 2+ years' experience and AHIMA/AAPC cert are required. #J-18808-Ljbffr