15 documentation coding auditor jobs found in Boston

Sr. Recovery Resolution Analyst 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 Sr. Recovery Resolution Analyst 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 analysis, plan members, the...

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

This is a remote based position. Applicants can be located nationwide Back 1d Outpatient Coding Auditor #2814 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced...

Who We Are SouthNewHampshireHealth has been a cornerstone of the region since 1893, delivering high‑quality, compassionate care close to home. Anchored by SouthernNewHampshireMedicalCenter—a 188‑bed, DNV‑accredited hospital in downtown Nashua with a LevelIII‑N trauma center, LevelII Special Care Nursery, and Magnet® designation for nursing excellence—we offer a full spectrum of services from primary care to advanced diagnostics and specialized treatments. Our medical staff includes over 500 providers from Foundation Medical Partners and local practices. Foundation Medical Partners, our multi‑specialty group, spans 70+ practices across southern New Hampshire and northern Massachusetts, providing coordinated, patient‑centered care to thousands each year. About The Job The Coding Specialist – Professional Based (PB) is responsible for analyzing professional (physician and advanced practice provider) encounters and related documentation to assign accurate ICD‑10‑CM, CPT, and HCPCS...

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...

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...

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...

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...

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...

Ambulatory Surgery Outpatient Coder - On-Site (Boston, MA) Experienced Ambulatory Surgery Outpatient Coder needed in Boston, MA - on-site role for certified medical coders (CPC/CCS) with Epic and 3M experience. Join a dynamic healthcare team in the heart of Boston, Massachusetts (zip code 02215). This on-site outpatient coder opportunity is ideal for medical coders focused on ambulatory surgery, outpatient surgical coding, and revenue cycle integrity at a leading Boston medical facility. Job Details Position Type: Full-Time, On-Site (Ambulatory Surgery Coder / Outpatient Coder) Number of Openings: 3 Contract Duration: 13 weeks Start Date: June 1, 2026 Shifts Per Week: 5 Shift Duration: 8 hours Weekly Estimated Pay: $1,310 - $1,560 Location: 330 Brookline Boston Ave, Boston, MA 02215 (Boston medical coding jobs) Required Qualifications Minimum 3+ years of ambulatory surgery / outpatient coding experience Strong...

Dana-Farber Cancer Institute in Boston, MA is seeking a Billing Compliance Reviewer to manage audits and ensure compliance with billing regulations. The role involves analyzing documentation, educating staff, and collaborating with various teams. Ideal candidates should have 5 years of healthcare coding experience and required certifications. The position offers a salary range of $93,800 to $106,000 and is a full-time opportunity. #J-18808-Ljbffr

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...

Medical Billing Specialist job at Entyre Inc. Boston, MA. Our Mission Serve Families. Our Method: Relentless Speed. Entyre Care radically supports family caregivers with financial, emotional, and expert resources. We operate with urgency, focus, and a commitment to delivering “insanely great” outcomes for families. Position Overview We are seeking a highly organized and detail-oriented Billing Specialist to join our accounting team. The Billing Specialist will be responsible for supporting the daily operations of the accounting department, ensuring the accuracy of the medical billing. This role requires a strong understanding of billing, excellent problem-solving skills, and the ability to work collaboratively across departments. Key Responsibilities Prepare and post journal entries, ensuring accuracy and compliance with company policies. Maintain and reconcile general ledger accounts. Assist with month-end, quarter-end, and year-end closing processes. Review and process...

Community Behavioral Health Center Clinical Supervisor (Adult) job at Boston Medical Center. Boston, MA. Position Summary The Clinical Supervisor oversees and supervises master's level clinicians who are responsible for evaluating, treating, and providing behavioral health services for patients of BMC Department of Psychiatry. Responsibilities will include: overseeing daily onsite clinical activities, providing regular clinical and programmatic supervision to clinicians, providing clinical back-up and support to the teams as needed; performance management of Master’s level clinicians; payroll and timekeeping for program staff; and reviewing cases and documentation to ensure staff are compliant with approved protocols and procedures. In addition, the Clinical Supervisor also provides direct clinical care through individual, group, couples, and family psychotherapy using an anti-oppression and health equity lens. The position consults with, collaborates, and communicates with a wide...

Billing Compliance Curriculum Development Specialist Dana-Farber Cancer Institute Boston, MA Full Time The Billing Compliance Curriculum Development Specialist is responsible for the design, development, implementation, and evaluation of enterprise-wide billing compliance education programs at Dana-Farber Cancer Institute (DFCI). This role serves as a subject-matter expert in professional and technical billing compliance, with a strong emphasis on oncology services, regulatory requirements, and risk-based education strategies. The position partners closely with Billing Compliance leadership, Revenue Cycle, HIM, Clinical Operations, and Compliance to ensure education is standardized, scalable, evidence-based, and aligned with CMS, OIG, NCCI, payer guidance, and institutional risk priorities. Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united...