28 compliance coding auditor jobs found in Houston

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 **If you are located outside of the state of Texas -- you must be located in KANSAS, OKLAHOMA, TENNESSEE, LOUISIANA, GEORGIA, SOUTH CAROLINA, NORTH CAROLINA, or be willing to relocate to one of the eligible states (including Texas). ** Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data...

Signature Performance, Inc. is seeking an Outpatient Coding Auditor for a remote nationwide position. You will perform quality reviews, coordinate with managers, and deliver clear audit findings to educate staff. Strong coding credentials and experience in ICD-10-CM/PCS, CPT-4/HCPCS and reimbursement systems are required to guide improvement initiatives. You will mentor coders, identify documentation gaps, and provide continuing education on changes in coding and reimbursement. #J-18808-Ljbffr

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2972 United States Apply X Facebook LinkedIn Email Copy Work Schedule 8 hours daily between 6:00a - 6:00p Eastern Time Monday - Friday Compensation Range $28.00 - $30.00/Hour Position Type Full Time Description About You You are a person who enjoys ensuring coding accuracy and solving documentation and compliance challenges. We need someone who demonstrates skills in organization, prioritization, professionalism, and coaching others. In the role of Outpatient Coding Auditor, you will be responsible for quality reviews and audits and coordinating with department managers to ensure standards are met in accordance with department and organization policies. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? What is your experience with conducting business in a way that is credit to a company? We are counting on you...

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,...

Professional Fee Coder II Division: Patient Business Services Work Arrangement: Hybrid Location: Houston, TX Salary Range: $57,320 to $67,435 FLSA Status: Nonexempt Work Schedule: Monday - Friday, 8 a.m. - 5 p.m. Summary The Patient Business Services (PBS) Coding department is looking for an experienced mid-level coder to review and abstract CPT, ICD-10 and HCPCS coding for physician services. Our coders assist in maximizing the revenue by completely capturing and accurately documenting physician, professional, and departmental charges to ensure submission of clean insurance claims, as well as accurate patient statements. They apply correct coding guidelines to patient charge encounter, while assuring timely turnaround of charges. The PBS Coding department is responsible for accurately capturing the revenue for all physician specialties at Baylor College of Medicine as well as outpatient facility charges at McNair Cancer Center. We focus on providing...

MUST ALREADY HAVE EXPERIENCE DOING BILL AUDIT REVIEWS FOR DIFFERENT STATES. We are seeking an experienced CPC-certified medical coder with multi-state experience to perform coding audits, utilization reviews, demand package reviews, and provide litigation support including deposition and testimony services as needed. The ideal candidate must have experience reviewing medical records and billing across multiple states and payer environments. Responsibilities: • Perform comprehensive medical coding audits (ICD-10-CM, CPT, HCPCS) • Conduct utilization reviews to assess medical necessity and documentation compliance • Review the medical portion and prepare the billing and coding review portion of demand package reviews for personal injury and insurance cases • Analyze medical records for payer disputes, recoupments, and appeals • Prepare detailed, defensible written audit reports • Provide expert review, affidavit support, deposition preparation, and testimony when...

Job Title Experienced CPC-Certified Medical Coder Job Description MUST ALREADY HAVE EXPERIENCE DOING BILL AUDIT REVIEWS FOR DIFFERENT STATES. We are seeking an experienced CPC-certified medical coder with multi-state experience to perform coding audits, utilization reviews, demand package reviews, and provide litigation support including deposition and testimony services as needed. The ideal candidate must have experience reviewing medical records and billing across multiple states and payer environments. Responsibilities Perform comprehensive medical coding audits (ICD-10-CM, CPT, HCPCS) Conduct utilization reviews to assess medical necessity and documentation compliance Review the medical portion and prepare the billing and coding review portion of demand package reviews for personal injury and insurance cases Analyze medical records for payer disputes, recoupments, and appeals Prepare detailed, defensible written audit reports Provide expert review, affidavit...

Medical Coder Revenue Cycle Management is looking for a full-time Medical Coder to join our team! Remote opportunity after in-person training. SUMMARY: 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...

Professional Fee Coder II Division: Patient Business Services Work Arrangement: Hybrid Location: Houston, TX Salary Range: $57,320 to $67,435 FLSA Status: Nonexempt Work Schedule: Monday Friday, 8 a.m. 5 p.m. Summary The Patient Business Services (PBS) Coding department is looking for an experienced mid-level coder to review and abstract CPT, ICD-10 and HCPCS coding for physician services. Our coders assist in maximizing the revenue by completely capturing and accurately documenting physician, professional, and departmental charges to ensure submission of clean insurance claims, as well as accurate patient statements. They apply correct coding guidelines to patient charge encounter, while assuring timely turnaround of charges. The PBS Coding department is responsible for accurately capturing the revenue for all physician specialties at Baylor College of Medicine as well as outpatient facility charges at McNair Cancer Center. We focus on providing accurate and compliant...

Medical Data Coder Lead GeoControl Systems, Inc. as a HUBZone company, is required to maintain a Federally mandated level of employees that reside (home residence) in a qualified HUBZone. ONLY applicants whose home address lies in a qualified HUBZone will be considered for this position. You can verify whether you reside in a HUBZone by using the following website: https://maps.certify.sba.gov/hubzone/map Medical Data Coder Lead Belong. Connect. Grow. with the Human Health and Performance Contract 2 (HHPC2). We are a team of innovators, thinkers, creators, explorers, volunteers and dreamers and we all share one goal: to improve the world responsibly and safely. On HHPC2 we are at the forefront of safeguarding astronaut health, ensuring human performance, and advancing technologies for human space exploration. We are seeking a Medical Data Coder Lead to support the Lifetime Surveillance of Astronaut Health (LSAH) at the Johnson Space Center (JSC). What You'll Do: You will be a...

Job Description The Invoice Coder (Project Invoice Processor/Coder) is responsible for high-volume invoice processing and accurate invoice coding in support of large capital projects in the midstream, industrial gases, and carbon sequestration space. This role ensures invoices are routed timely for approval, coded correctly to the appropriate project/cost structure, and processed in compliance with company policies and controls. The Invoice Coder will work with various internal and external service providers including, but not limited to, Project Engineers, Planning Engineers, Operations Engineers, and Environmental Engineers. Responsibilities Essential duties and responsibilities: Review and route approximately 100 invoices weekly for approval, ensuring accurate coding and compliance with company policies and procedures. Manage a high volume of invoice coding with a strong focus on accuracy, timeliness, and completeness of documentation. Perform detailed data...

Medical Coder Revenue Cycle Management is looking for a full-time Medical Coder to join our team! Remote opportunity after in-person training. SUMMARY: 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...

Summary About the Position: This is an open continuous announcement. Multiple vacancies exist and may be filled from this announcement at any of the locations listed. We accept applications on an ongoing basis; qualified applicants will be considered as vacancies become available. 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 retrospective audits of diagnoses, E/M levels, procedures, and documentation to identify inaccurately coded services and ensure regulatory compliance. Review medical records, analyze coding accuracy trends, prepare finding reports, and coordinate results with leadership to drive performance improvement. Use encounter audits to identify operational and regulatory issues, ensures complete data capture, and support development of compliance plans. Develop and deliver one-on-one and group training on...

Medical Data Coder Lead Join the Human Health and Performance Contract 2 (HHPC2), where a team of innovators, thinkers, creators, explorers, volunteers, and dreamers shares one goal: to improve the world responsibly and safely. On HHPC2, we are at the forefront of safeguarding astronaut health, ensuring human performance, and advancing technologies for human space exploration. We are seeking a Medical Data Coder Lead to support the Lifetime Surveillance of Astronaut Health (LSAH) at NASA's Johnson Space Center. What You'll Do As a member of the LSAH team, you will help enhance astronaut medical records by incorporating records from outside providers into the internal medical record. The Medical Data Coder Lead is responsible for managing the LSAH medical coding program, applying coding expertise to perform health information management and medical coding functions, and developing quality assurance procedures. This position also provides leadership oversight for the work...

Coder Assistant (SAP) Location: Houston, TX (Hybrid) Duration: 12 Month Contract Overview: We are seeking a highly motivated AP Coder Assistant who excels in a fast-paced, collaborative environment to join the Accounts Payable Team under the Procurement and Supply Chain Team. This role works under the direct supervision of the Accounts Payable Lead. To perform this job successfully, an individual must be able to perform each essential duty. The expectations listed below are representative of the knowledge, skill, and/or ability required. Key Responsibilities: Actively enforce and maintain strict adherence to all accounts payable policies and procedures in OpenInvoice and SAP. Capable of following a standard processing matrix and adhering to established Standard Operating Procedures. Review and confirm all electronic field tickets and invoices have appropriate supporting documentation and in compliance with submission requirements in OpenInvoice portal....

Avenue360 Health and Wellness in Houston, TX seeks a Hybrid Certified Biller/Coder Specialist to ensure accurate billing across commercial, Medicare, Medicaid, and grant-funded programs. You will validate coding, support audits, and address denials while educating providers and staff. Responsibilities include monitoring trends, collaborating with departments, and driving compliance with payer rules and CMS regulations to optimize reimbursements and documentation quality. #J-18808-Ljbffr

Work Schedule: Monday – Friday, 8 a.m. – 5 p.m. Summary The Patient Business Services (PBS) Coding department is looking for an experienced mid-level coder to review and abstract CPT, ICD-10 and HCPCS coding for physician services. Our coders assist in maximizing the revenue by completely capturing and accurately documenting physician, professional, and departmental charges to ensure submission of clean insurance claims, as well as accurate patient statements. They apply correct coding guidelines to patient charge encounter, while assuring timely turnaround of charges. The PBS Coding department is responsible for accurately capturing the revenue for all physician specialties at Baylor College of Medicine as well as outpatient facility charges at McNair Cancer Center. We focus on providing accurate and compliant coding assistance by coders who are certified and up-to-date on coding rules and regulations. The ideal candidate will have good organizational, communication and...

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,...

Risk Adjustment Coder IIThe 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...

Certified Biller/Coder Specialist Avenue360 Health and Wellness Houston, Texas, United States About this position About Avenue360 Health and Wellness Avenue 360 is a FQHC that strives to provide high quality and caring service to promote healthy people and communities. Our 360-degree approach addresses medical needs and social and environmental challenges, like housing. Our compassionate care extends to those with and without insurance. We believe income must not determine the level of access to quality health care. Providing comprehensive, high quality, and caring service is the core of what we do, whether medical, hospice care, engaging adult activities, and supportive housing programs. We strive to address the many social determinants of healthy living in Greater Houston. Our Values PACT We take PRIDE in our work. We have a positive ATTITUDE. We are CURIOUS. We are COMMITTED. We are CARING and CUSTOMER-SERVICE oriented. We are a TEAM. We LEARN,...

Job TitleExperienced CPC-Certified Medical CoderJob DescriptionMUST ALREADY HAVE EXPERIENCE DOING BILL AUDIT REVIEWS FOR DIFFERENT STATES.We are seeking an experienced CPC-certified medical coder with multi-state experience to perform coding audits, utilization reviews, demand package reviews, and provide litigation support including deposition and testimony services as needed. The ideal candidate must have experience reviewing medical records and billing across multiple states and payer environments.Responsibilities• Perform comprehensive medical coding audits (ICD-10-CM, CPT, HCPCS)• Conduct utilization reviews to assess medical necessity and documentation compliance• Review the medical portion and prepare the billing and coding review portion of demand package reviews for personal injury and insurance cases• Analyze medical records for payer disputes, recoupments, and appeals• Prepare detailed, defensible written audit reports• Provide expert review, affidavit support,...

Title: Medical Coding/ Education Specialist Location: Remote, preferably in Texas Compensation: $65,000 - $75,000 per year Must have Post Acute Care Experience We are seeking an accomplished Medical Coding and Education Specialist to join our healthcare team, focusing on enhancing coding accuracy and compliance within our post-acute care facilities. This role involves reviewing medical records, assessing for accurate provider cpt and ICD-10 codes, and developing educational materials. Additionally, the specialist will collaborate closely with our technology and revenue cycle teams to optimize EMR processes, streamline documentation, and reduce coding denials. Responsibilities: Conduct regular coding audits and reviews to ensure compliance with coding guidelines, regulatory requirements, and reimbursement policies. Develop and deliver educational materials, training modules, and resources on coding guidelines, regulatory updates, and documentation requirements specific to...

The Harris Center for Mental Health and IDD in Houston, TX seeks an experienced Medical Coder to support revenue management. The coder will review records, assign CPT/HCPCS/ICD-10-CM codes, and ensure accurate billing for professional services. Under supervision, responsibilities include coding accuracy, documentation audits, and collaboration with providers to resolve discrepancies while staying compliant with coding guidelines. #J-18808-Ljbffr

Brief Description The Harris Center for Mental Health and IDD, known as \"The HARRIS CENTER,\" is seeking an experienced Medical Coder to join our team. Under the direction of Director of Revenue Management, the Medical Coder utilizes knowledge of insurance regulations, health insurance contracts, and medical coding to perform a variety of revenue cycle support activities. Additionally, the medical coder is responsible for reviewing medical records to assure proper billing of the medical record, comparison of physician selected CPT and ICD-10 codes to the physicians' documentation to substantiate the level of coding, physician services to include identification of professional services and complete review of medical records to accurately optimize all professional services documented for billing. Your Role In Action Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and...