22 coder auditor professional jobs found in Houston, TX

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Position is responsible for leading multiple reviews / audits of healthcare coding, billing, documentation, operations, and related risk areas to support compliance with regulatory standards, internal policies and procedures, and other guidelines. Typically reports to Director, Corporate Compliance. Job Description Location : Memorial Hermann, Memorial City Status :...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data integrity and validation of the coded information for external and internal affairs. This position typically reports to the Coding Compliance Manager. Job Description Minimum Qualifications Education :  High school diploma or GED,...

HIM/Medical Records Analyst/Coding Specialist Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility is fully accredited and included a 16-bed residential treatment center for adult chemical dependency. We offer a broad range of behavioral health programs for children, adolescents and adults. Treatment is offered at multiple levels of care including inpatient, partial hospitalization and intensive outpatient. The hospital is easily accessible off the Southwest Freeway near the Galleria. West Oaks Hospital is seeking a dynamic and talented HIM/Medical Records Coding Specialist to join our team of compassionate, dedicated professionals. The HIM/Medical Records Coding Specialist will be responsible for assigning diagnostic and procedures codes and abstracts data to outpatient and/or inpatient encounters based upon documentation within the medical record while maintaining...

HIM/Medical Records Coding Specialist Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility is fully accredited and included a 16-bed residential treatment center for adult chemical dependency. We offer a broad range of behavioral health programs for children, adolescents and adults. Treatment is offered at multiple levels of care including inpatient, partial hospitalization and intensive outpatient. The hospital is easily accessible off the Southwest Freeway near the Galleria. West Oaks Hospital is seeking a dynamic and talented HIM/Medical Records Coding Specialist to join our team of compassionate, dedicated professionals. The HIM/Medical Records Coding Specialist will be responsible for assigning diagnostic and procedures codes and abstracts data to outpatient and/or inpatient encounters based upon documentation within the medical record while maintaining compliance...

Risk Adjustment Coder II The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization. Job Specifications and Core Competencies: Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions, utilizing ICD-10 coding guidelines for Commercial and Medicare risk...

Medical Coder Multi-Specialty (Hospital & Clinic) Location: Kingwood or Remote Employment Type: Full-Time Reports To: Revenue Cycle Manager Position Summary We are seeking a highly skilled, detail-driven, and high-producing certified medical coder with multi-specialty experience to join our growing healthcare organization. This role requires strong proficiency in both hospital and outpatient clinic coding, with specialty expertise in: Cardiology Urology Dermatology General Surgery Pulmonology The ideal candidate has 2+ years of coding experience, maintains current certification (AAPC or equivalent), and consistently demonstrates accuracy, productivity, and strong clinical understanding across multiple service lines. This is a high-impact role within a performance-driven, collaborative organization focused on compliance, precision, and revenue integrity. Core Responsibilities Coding & Documentation Review Accurately assign ICD-10-CM, CPT, and HCPCS Level...

Direct Jobs is seeking a Risk Adjustment Coder II in Houston, Texas. This role involves advanced support for medical record reviews, ensuring correct capture of chronic conditions and compliance with CMS guidelines. The Coder II acts as a subject matter expert, facilitating team training and audits. The ideal candidate will have a Bachelor's degree or equivalent experience in risk adjustment, along with relevant coding certifications. Experience in Commercial and Medicare coding is required alongside strong analytical and communication skills. #J-18808-Ljbffr

Job Number: 180041, Job Title: Risk Adjustment Coder II, Salary: $27.69 - $34.62 JOB SUMMARY The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization. JOB SPECIFICATIONS AND CORE COMPETENCIES Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions,...

Community Health Choice is a nonprofit managed care organization serving Texas. The Risk Adjustment Coder II will review complex medical records, code chronic conditions, and map to HCCs under CMS guidelines. The role supports Commercial and Medicare risk adjustment programs and helps ensure accurate documentation and coding. The coder will contribute to trainings, audits, and collaboration across departments to improve documentation quality and compliance. #J-18808-Ljbffr

Are you ready to make a real difference in people's lives? Join the Harris Center for Mental Health and IDD as a Regulatory Compliance Auditor. The Regulatory Compliance Auditor provides coordination between the Authority and contracted services programs by technical review of the medical records, billing service codes, contracts and other documents. The Regulatory Compliance Auditor is responsible for carrying out programmatic and departmental goals and objectives as stipulated by Texas Administrative Code (TAC), Medicaid Guidelines, Texas Resiliency and Recovery Guidelines, and Quality Practices of the Agency. This position provides center-wider oversight to the Intellectual Disability Division (IDD) and Mental Health Division (MH), Forensics and CPEP, related to compliance standards, state and federal guidelines, and contract requirements. This position is responsible for planning and scheduling ongoing audits, collaborating with managers, supervisors and additional staff...

Compliance Auditor needed! Join our growing organization! Onco360 has an immediate need for a Compliance Auditor. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Remote opportunity! Some Travel required - see details below Starting Salary at $60,000 and up, depending on experience Summary: The Compliance Auditor will assist the Onco360/CareMed/ConnectMed360 Compliance Team through the completion of routine and random pharmacy compliance audits at Onco360/CareMed/ConnectMed360 pharmacy locations to ensure all pharmacy activities and operations are executed in compliance with state and/or federal regulations and laws governing pharmacy operations. This individual provides support to Onco360/CareMed/ConnectMed360 pharmacy operations teams in answering compliance and regulatory questions based around their needs. The Compliance Auditor shall develop and...

Description Providence is calling for Compliance Auditor - Remote The 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...

Company Overview Community Health Choice, Inc. (Community) is a non‑profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women Children's Health Insurance Program (CHIP) for the children of low‑income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions. Community Health Choice (HMO D‑SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare...

Brief Description Are you ready to make a real difference in people's lives? Join the Harris Center for Mental Health and IDD as a Regulatory Compliance Auditor. The Regulatory Compliance Auditor provides coordination between the Authority and contracted services programs by technical review of the medical records, billing service codes, contracts and other documents. The Regulatory Compliance Auditor is responsible for carrying out programmatic and departmental goals and objectives as stipulated by Texas Administrative Code (TAC), Medicaid Guidelines, Texas Resiliency and Recovery Guidelines, and Quality Practices of the Agency. This position provides center‑wider oversight to the Intellectual Disability Division (IDD) and Mental Health Division (MH), Forensics and CPEP, related to compliance standards, state and federal guidelines, and contract requirements. This position is responsible for planning and scheduling ongoing audits, collaborating with managers, supervisors and...

About Us Community Health Choice, Inc. (Community) is a non‑profit managed care organization licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 members with programs including the Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women; the Children’s Health Insurance Program (CHIP) for the children of low‑income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR; Health Insurance Marketplace Plans offering individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions; and the Community Health Choice HMO D‑SNP, a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid. Improving members’ experiences is at the heart of every Community...

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients. Job Summary Our client is seeking a dedicated Coding Auditor. The position is responsible for ensuring accuracy in code assignment of diagnosis and procedure to outpatient and/or inpatient encounters based on documentation within the electronic medical record while maintaining compliance with established rules and regulatory body guidelines. The role includes performing data quality reviews to ensure data integrity, coding accuracy, and revenue preservation. Additional duties involve participating in quality review and performance improvement projects throughout the department and/or facility. Key Responsibilities Ensure accuracy in code assignment of diagnosis and procedure for outpatient and inpatient encounters. Maintain compliance with established rules and regulatory body guidelines. Conduct data quality reviews to ensure data...

About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women Childrens Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions. Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits,...

This is a remote based position. Applicants can be located nationwide Back 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...

Medical Coder – Multi-Specialty (Hospital & Clinic) Location: Kingwood or Remote Employment Type: Full-Time Reports To: Revenue Cycle Manager Position Summary We are seeking a highly skilled, detail-driven, and high-producing certified medical coder with multi-specialty experience to join our growing healthcare organization. This role requires strong proficiency in both hospital and outpatient clinic coding, with specialty expertise in: Cardiology Urology Dermatology General Surgery Pulmonology The ideal candidate has 2+ years of coding experience, maintains current certification (AAPC or equivalent), and consistently demonstrates accuracy, productivity, and strong clinical understanding across multiple service lines. This is a high-impact role within a performance-driven, collaborative organization focused on compliance, precision, and revenue integrity. Core Responsibilities Coding & Documentation Review Accurately assign ICD-10-CM,...

Medical Coder - Multi-Specialty (Hospital & Clinic) Location: Kingwood or Remote Employment Type: Full-Time Reports To: Revenue Cycle Manager Position Summary We are seeking a highly skilled, detail-driven, and high-producing Certified Medical Coder with multi-specialty experience to join our growing healthcare organization. This role requires strong proficiency in both hospital and outpatient clinic coding, with specialty expertise in: • Cardiology • Urology • Dermatology • General Surgery • Pulmonology The ideal candidate has 2+ years of coding experience, maintains current certification (AAPC or equivalent), and consistently demonstrates accuracy, productivity, and strong clinical understanding across multiple service lines. This is a high-impact role within a performance-driven, collaborative organization focused on compliance, precision, and revenue integrity. Core Responsibilities Coding & Documentation Review • Accurately assign...

Responsibilities HIM/Medical Records Analyst/Coding Specialist Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility is fully accredited and included a 16-bed residential treatment center for adult chemical dependency. We offer a broad range of behavioral health programs for children, adolescents and adults. Treatment is offered at multiple levels of care including inpatient, partial hospitalization and intensive outpatient. We are available 24 hours a day, seven days a week to assist you and answer your questions about treatment options and insurance coverage. The hospital is easily accessible off the Southwest Freeway near the Galleria. Visit us online at: https://westoakshospital.com/ West Oaks Hospital is seeking a dynamic and talented HIM/Medical Records Coding Specialist to join our team of compassionate, dedicated professionals. The HIM/Medical...

HIM/Medical Records Coding Specialist Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility is fully accredited and includes a 16-bed residential treatment center for adult chemical dependency. We offer a broad range of behavioral health programs for children, adolescents, and adults. Treatment is offered at multiple levels of care including inpatient, partial hospitalization, and intensive outpatient. We are available 24 hours a day, seven days a week to assist you and answer your questions about treatment options and insurance coverage. The hospital is easily accessible off the Southwest Freeway near the Galleria. West Oaks Hospital is seeking a dynamic and talented HIM/Medical Records Coding Specialist to join our team of compassionate, dedicated professionals. The HIM/Medical Records Coding Specialist will be responsible for assigning diagnostic and procedures codes...