12 coding auditor jobs found in Houston

A leading healthcare staffing company is seeking a Medical Coding Auditor in Houston, TX. This role involves reviewing surgical cases to verify the accuracy of coding and providing educational support to coders. Ideal candidates will have 2-5+ years of cardiology coding experience, be CPC or CCS certified, and possess a strong background in various surgical specialties. The position promotes a diverse and inclusive environment where all candidates are considered regardless of their background. #J-18808-Ljbffr

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,...

Summary About the Position: This position is located at Brooke Army Medical Center, Fort Sam Houston, Texas. A recruitment or relocation incentive may be authorized. Salary negotiation may be available for those candidates who are new to Federal service. This is a Direct Hire Solicitation Learn more about this agency Duties Help Perform internal audits of inpatient, outpatient, and ambulatory encounters to ensure coding accuracy and compliance. Trains coders, providers, and other staff on documentation, coding guidelines, and regulatory updates. Identify coding issues, reports non-compliance, and creates corrective action plans to resolve documentation or coding problems. Maintains and updates program templates based on ICD-10, CPT, and HCPCS changes or clinic practice updates. Direct and evaluate coding auditors, assign workload, provide training, and manage performance. Requirements Help Conditions of employment Appointment may be...

Medical Compliance Auditor We are searching for a Medical Compliance Auditor - someone who works well in a fast-paced setting. In this position, you will review and approve or deny medical claim appeals and perform clinical audits of medical records submitted in support of services billed by providers. This process includes clinical judgment, utilization review, application of product benefits, understanding of regulatory requirements for Medicaid managed care and fraud and abuse, and verification of medical necessity utilizing nationally recognized criteria. Job Duties & Responsibilities Assess the treatment plan, clinical information, and medical necessity of all requested services Utilizes established criteria to appropriately review billed services within established timeframe required. Consults with medical directors and clinical staff regarding patient's history and current care needs and whether services billed were appropriate. Refers case failing medical...

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 :...

Medical Compliance Auditor We are searching for a Medical Compliance Auditor - someone who works well in a fast-paced setting. In this position, you will review and approve or deny medical claim appeals and perform clinical audits of medical records submitted in support of services billed by providers. This process includes clinical judgment, utilization review, application of product benefits, understanding of regulatory requirements for Medicaid managed care and fraud and abuse, and verification of medical necessity utilizing nationally recognized criteria. Job Duties & Responsibilities Assess the treatment plan, clinical information, and medical necessity of all requested services Utilizes established criteria to appropriately review billed services within established timeframe required. Consults with medical directors and clinical staff regarding patient's history and current care needs and whether services billed were appropriate. Refers case failing medical...

Medical Coder Revenue Cycle Management is looking for a Medical Coder to join our team. Remote opportunity after in-person training. The Medical Coder is responsible for reviewing medical documentation and accurately assigning CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS codes depending on the encounter type. The position ensures accurate billing, compliance, and optimized reimbursement across outpatient and/or facility (inpatient) settings. Essential Functions: Assign accurate diagnosis and procedure codes based on medical record documentation using CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS. Review provider documentation to ensure coding is supported and complete for billing submission. Apply proper modifiers, sequencing, and coding conventions appropriate to the setting (inpatient or outpatient). Ensure compliance with coding regulations, organizational policies, and HIPAA standards. Meet coding productivity and quality benchmarks. Collaborate with clinical, billing, and...

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. 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...

At Houston Methodist, the Lead Outpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to outpatient 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. FLSA STATUS Non-exempt...

Requisition number: 2360324 Job category: Medical & Clinical Operations Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Senior Medical Coder performs concurrent review of FFS coding rules, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. This position will support coding functions within charge review, claim edits, and denials and play a critical role in 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 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...

The Senior Medical Coder performs concurrent review of FFS coding rules, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. This position supports coding functions within charge review, claim edits, and denials and plays a critical role in maintaining coding accuracy and supporting revenue cycle integrity. Schedule: Monday to Friday, 8 AM - 5 PM Location: Remote - Nationwide You will enjoy the flexibility to telecommute from anywhere within the U.S. while taking on challenging assignments. Primary Responsibilities Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes Identify unclear or incomplete documentation and generate queries to obtain additional information Follow...