25 coding auditor jobs found in Columbia

Compliance Coding Auditor Hours: Variable Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $48.140 - $62.110 - $76.080 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit...

Become a part of our caring community and help us put health first The Inpatient 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 Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the...

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g., ICD‑10‑CM, CPT, HCPCS). The role requires interpretation and independent determination of the appropriate courses of action, contributing to overall cost reduction by increasing the accuracy of provider contract payments in our payer systems and ensuring correct claims payment for appropriate CPT/HCPCS code assignments. The Auditor analyzes, enters and manipulates database data, responds to or clarifies internal requests for medical information, understands departmental, segment and organizational strategy and operating objectives, and follows established guidelines and procedures while making decisions in ambiguous situations. Where you come in The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g.,...

A leading health services company is seeking a Medical Coding Auditor to ensure the accuracy and correctness of coding guidelines for medical claims. This role involves reviewing medical records, conducting peer reviews, and maintaining compliance with federal and state guidelines. Candidates should have strong knowledge of CPT/HCPCS coding, certification with CPC, and a minimum of 3 years of experience. The position allows for remote work with typical hours from Monday to Friday. #J-18808-Ljbffr

A prominent health services provider in Columbia, SC is seeking a Lead Certified Coding Specialist - Auditor to join their team. This role involves providing data and reports related to coding and claims, as well as educating staff on coding requirements. The ideal candidate will possess a Medical Coding Certification and have experience with insurance filing and coding policies. A supportive work environment with competitive wages and benefits awaits the successful applicant. #J-18808-Ljbffr

A leading healthcare provider in Columbia, SC, is seeking a Quality Medical Auditor - Coding Specialist. This role involves conducting validation reviews of medical records, coordinating rate adjustments, and managing HIPAA compliance. Candidates should have at least 3 years of relevant experience and an associate's degree in a related field. The position offers a comprehensive benefits package and potential for remote work. #J-18808-Ljbffr

Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for leading coding teams, coder training, work que management, performing prebill and second-level coding reviews utilizing auditing software and documents findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. Reviews and responds to inpatient denials as needed. Performs Inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference....

A leading health data platform company is seeking an Inpatient Auditing Specialist to perform coding audits and provide consultancy related to coding quality. The role requires a strong focus on customer service and adherence to coding standards. Candidates should have 5+ years of inpatient coding experience and hold relevant certifications. This fully remote position offers flexible scheduling and competitive hourly pay ranging from $35 to $45. #J-18808-Ljbffr

A global staffing firm is seeking a Medical Review Auditor in Columbia, SC. The role involves performing validation reviews of Diagnosis Related Groups and managing records retrieval and compliance. Candidates must have at least 3 years of experience in medical record management and hold an Associate Degree in Nursing or Health Information Management. Join a dynamic team dedicated to quality healthcare outcomes and enjoy a structured work schedule of Monday to Friday, 8am to 4:30pm. #J-18808-Ljbffr

Job Title Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary...

Title: Certified Coding Specialist - Auditor Location: Novant Health Urgent Cares (Columbia, SC) Status: Full-Time Who Are We? Part of the Novant Health family based in North Carolina, Novant Health Urgent Care (formerly Doctors Care) provides exceptional healthcare through our network of more than 50 urgent care centers and 20 physical therapy facilities across South Carolina. Our Columbia-based headquarters delivers non-medical management and administrative services to support these locations. For decades, we have been committed to delivering exceptional, convenient, and affordable healthcare experiences to families and communities throughout the Palmetto State. What Do We Offer? Competitive wages with annual market data review Incentive Pay Program Continuing Education Reimbursement Eligible employer under the Public Service Loan Forgiveness (PSLF) Program UpToDate Subscription Generous PTO 403(b) with 100% vested match Health, dental,...

Quality Medical Auditor - Coding Specialist life insurance, paid time off, 401(k), remote work United States, South Carolina, Columbia Jan 01, 2026 Internal Reference Number: R1048322 Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Description Position Purpose : Performs validation reviews of Diagnosis Related Groups...

Quality Medical Auditor - Coding Specialist Join to apply for the Quality Medical Auditor - Coding Specialist role at BlueCross BlueShield of South Carolina . Summary Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate...

Title: Certified Coding Specialist - Auditor Location: Novant Health Urgent Care (Columbia, SC) Status: Full-Time Part of the Novant Health family based in North Carolina, Novant Health Urgent Care (formerly Doctors Care) provides exceptional healthcare through our network of more than 50 urgent care centers and 20 physical therapy facilities across South Carolina. Our Columbia‑based headquarters delivers non‑medical management and administrative services to support these locations, and for decades we have been committed to delivering convenient, affordable healthcare experiences to families and communities throughout the Palmetto State. What We Offer Competitive wages with annual market data review Incentive Pay Program Continuing Education Reimbursement Eligible employer under the Public Service Loan Forgiveness (PSLF) Program UpToDate Subscription Generous PTO 403(b) with 100% vested match Health, dental, vision insurance Health Reimbursement Account Flexible...

Role Name: Quality Medical Auditor Location: Columbia, SC 29223 Work Environment: Remote (Preferred Onsite) Schedule: Mon - Fri, 8AM-4:30PM Contract length: 4 months assignment with possible conversion Job Summary: Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Day to Day: 75% Determines methodology to identify cases for validation review. Conducts validation reviews/coordinates rate adjustments with appropriate claims area. Creates monthly/quarterly reports to present to each line of business providing information on records review, outcomes, trends, and...

Datavant is a leading data platform company dedicated to health data exchange, with a vision that every healthcare decision is powered by accurate data at the right time. Our network is one of the largest and most diverse in the U.S., ensuring that data remains secure and accessible to enhance health decisions. Our clients include prominent life sciences firms, government agencies, and healthcare providers. Joining Datavant means becoming part of a high-performing, values-driven team that is committed to solving the intricate challenges of healthcare through technological innovations. Our diverse team members bring a rich array of professional, educational, and personal experiences to support our ambitious vision for the future of healthcare. Your Role: We are seeking credentialed inpatient coders who possess meticulous attention to detail and a solid understanding of medical terminology to join our dynamic team. This position offers the flexibility of fully remote work,...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 58427 - MCS - University Physicians, and the department will be hiring for two positions. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them...

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 58429-MCS-C- University Physicians, and the department will be hiring for two positions Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of...

Overview Duration: 5 months (Possible contract to hire) Work Schedule: Monday-Friday, 8am-4:30pm. Job Description: A typical day would like in this role: We are opening these positions due to increased volume of DRG review. We currently have 2 Medical Review Auditors on our team already. The normal day is DRG reviews and audits. Responsibilities Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Determines methodology to identify cases for validation review. Conducts validation reviews/coordinates rates adjustments with appropriate claims area. Creates monthly/quarterly reports to...

BayCare is currently in search of our newest Team Member who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area. Position Details Location: Remote (must reside in the state of Florida, Georgia, North Carolina, or South Carolina) Status: Full time (non-exempt) Shift: 8:00am - 4:30pm Days: Monday through Friday Sign on bonuses available! Responsibilities The Specialty Coder II is a Certified Professional Coder who assigns diagnosis and procedural codes using ICD-10 CM and CPT-4 coding systems. The Specialty Coder audits physician documentation to assign appropriate CPT codes, diagnosis codes, and modifiers. Mentors and training of other Specialty Coders. Serves as a resource for the department. Performs other duties as assigned. Preferred Coding Specialties Anesthesia General Surgery Cardiothoracic Surgery Neurosurgery...

Overview The Coder III, under the direct supervision of the Hospital Coding Supervisor, serves a dual role focusing on coding accuracy and team education. This position is responsible for abstracting medical record documentation across various settings (inpatient, outpatient, clinic, and emergency department) to select and sequence appropriate ICD-10-CM/PCS, HCPCS, and CPT4 codes. The Coder III ensures adherence to coding compliance guidelines for accurate and timely assignment of codes, including final DRG assignment. A key aspect of the position is providing ongoing education and training to care team members to enhance coding proficiency and compliance with regulatory requirements. Entity Entity: Medical University Hospital Authority (MUHA) Worker Type Worker Type: Employee Worker Sub-Type Worker Sub-Type: Regular Cost Center Cost Center: CC002307 SYS - Hospital Coding Pay Rate Type Pay Rate Type: Hourly Pay Grade Pay Grade: Health-26 Scheduled Weekly Hours...

Join to apply for the Specialty Coder II role at BayCare Health System . BayCare is currently searching for a new team member who is passionate about providing outstanding customer service to our community and seeking a career opportunity with one of the largest employers within the Tampa Bay area. Position Details Location: Remote (must reside in the state of Florida, Georgia, North Carolina, or South Carolina) Status: Full time (non‑exempt) Shift: 8:00am – 4:30pm Days: Monday through Friday Sign on bonuses available! Responsibilities The Specialty Coder II is a Certified Professional Coder who assigns diagnosis and procedural codes using ICD‑10 CM and CPT‑4 coding systems. The Specialty Coder audits physician documentation to assign appropriate CPT codes, diagnosis codes, and modifiers. Mentors and trains other Specialty Coders. Serves as a resource for the department. Performs other duties as assigned. Preferred Coding Specialties Anesthesia General Surgery...

Job Description Job Description Medical Coder W2 Contract – This will convert to a full-time role. Pay rate: $36 Location: Columbia South Carolina (on-site) - Hybrid Hours: Monday-Friday 8:00am - 4:30pm Do you have any of these certifications on your resume: RHIT, RHIA, CIC, CPMA, or CPC? If so… we want to talk to you! About the Role: Step into a key role within our healthcare organization, where you’ll help safeguard the accuracy and reliability of medical coding and billing operations. In this position, you’ll oversee detailed validation reviews across multiple business areas, drive initiatives that support cost efficiency, and uphold critical regulatory requirements including HIPAA compliance. This is an excellent opportunity to strengthen healthcare quality, support financial integrity, and expand your expertise in medical auditing and coding oversight. Responsibilities In this role, you will take the lead in performing detailed reviews of medical coding accuracy,...