13 coding auditor jobs found in Houston

DRG Coding Auditor Principal This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2675 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 knowledge...

Are you ready to make a real difference in people's lives? Join the Harris Center for Mental Health and IDD as a Medical Coding Auditor . Under the direction of the Compliance Manager, the Medical Coding Auditor conducts medical record audits to ensure that documentation meets required standards and regulations. Maintains up-to-date information on all the standards set by JCAHO, Medicare, Medicaid, and other entities relating to medical records. Reviews medical records for coding accuracy and completeness. Prepares audit reports that highlight deficiencies and suggest solutions. Your Role in Action Analyzes medical records and identifies documentation deficiencies. Reviews and verifies documentation supports diagnoses, procedures and treatment results. Identifies diagnostic and procedural information. Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes. Ensures compliance...

DRG Coding Auditor Principal Virtual:? ?? This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group...

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,...

Medical Coder Lead Revenue Cycle Management is looking for a Medical Coder Lead to join our team! Remote opportunity after 30-90 day in-person training SUMMARY The Medical Coder Lead is responsible for serving as a subject matter expert in coding processes providing advanced technical guidance and ensuring coding accuracy compliance and productivity standards are met. The position supports coders and auditors through consultation mentoring and expertise on complex coding scenarios. ESSENTIAL FUNCTIONS: Serve as a resource and consultant for coders on complex or specialty coding scenarios. Review and provide guidance on challenging cases to ensure coding accuracy and compliance. Partner with auditors to resolve discrepancies and identify trends in coding errors. Provide mentoring and technical support to coders promoting knowledge sharing and best practices. Assist in developing and updating coding procedures guidelines and reference materials. Collaborate with clinical...

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 The Health Insurance Portability and Accountability Act (HIPAA) Auditor is responsible for performing HIPAA/ Information Privacy and Security compliance activities across all aspects of Memorial Herman Health System and its affiliates and subsidiaries. Job Description Minimum Qualifications Education: Bachelors Degree (Nursing, Health Information Management,...

Overview At Houston Methodist, the Lead Inpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to inpatient encounters based upon documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. Houston Methodist Standard...

A healthcare provider organization in Houston seeks a Risk Adjustment Coding Specialist II to ensure compliance with Medicare documentation requirements, conduct audits, and mentor staff. Candidates must have 3-5 years of experience in risk adjustment coding, relevant certification, and reliable transportation for travel. This position follows a hybrid model requiring travel to provider offices, offering a competitive salary between $70,000 and $85,000 per year. #J-18808-Ljbffr

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 Part D prescription...

Job description: Employment type: Contract (initial 3 months; likely extension) Schedule: Full-time, Monday–Friday (flexible daytime hours) Location: Remote (U.S. only) About the Role We’re hiring an experienced Inpatient Medical Coder to support acute-care facility coding for a Level I Trauma Hospital. The ideal candidate is AHIMA-credentialed, highly accurate with ICD-10-CM/PCS and MS-DRG/APR-DRG assignment. Key Responsibilities Review inpatient medical records and assign  ICD-10-CM/PCS  codes with appropriate  DRG  assignment (MS-DRG/APR-DRG as applicable). Ensure compliance with  AHIMA ,  AHA Coding Clinic ,  CMS , and facility guidelines. Query providers per policy to clarify documentation and support compliant code/DRG selection. Meet or exceed productivity and  95–98%+ quality  standards. Collaborate with HIM/CDI teams to resolve discrepancies and optimize documentation integrity. Maintain HIPAA compliance and safeguard PHI in a remote work setting....

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 • 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,...

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...