12 coder auditor jobs found in Phoenix

Job Title: Quality Assurance Coder/Auditor Location: Phoenix, AZ (Hybrid, Required to Travel into the office 1 x per week) Duration: 6 Months (possibility of extension or conversion) Department: Medicare/ Medicaid Purpose The Quality Assurance Coder/Auditor will develop a risk mitigation and provider education program. On a regular basis, the Coder/Auditor will educate primary care providers and their staff on their historical diagnoses/coding error trends, accurate completion of medical record documentation, and at‑risk code identification and risk mitigation. This includes the review, analysis, and recommended coding based on medical and clinical diagnoses, procedures, injuries, or illnesses contained in medical records and supporting documentation. The Quality Assurance Coder/Auditor will perform risk mitigation analysis using available vendor tools to identify at‑risk single occurrences of HCCs and OIG targets. Deletions will be submitted for unsupported/invalid diagnoses....

Spectraforce Technologies seeks a Quality Assurance Coder/Auditor to lead risk adjustment coding quality within Medicare/Medicaid programs. You will review records, perform audits, and educate providers on accurate diagnoses and documentation to improve coding accuracy. This hybrid Phoenix role requires travel to physician offices weekly, a minimum of 5 years of medical coding with HCC experience, and CCS-P/CRC/CPC/COC credentials. The position is 6 months with potential extension. #J-18808-Ljbffr

A healthcare data collaboration platform is seeking experienced inpatient coders to join their remote team. The role requires attention to detail, proficiency in medical coding, and strong communication skills. Candidates should have at least 3 years of inpatient coding experience and preferred certifications (CCS, RHIT, RHIA). The position offers a flexible schedule and includes benefits such as a 401k savings plan and comprehensive training. Pay ranges from $32 to $42 per hour based on experience and qualifications. #J-18808-Ljbffr

Risk Adjustment Coding AuditorOverview We are seeking a detail-oriented Risk Adjustment Coding Auditor to support the accuracy, integrity, and compliance of clinical coding data across risk adjustment programs. In this role, you will conduct audits, review medical record documentation, identify coding opportunities, and provide guidance on coding accuracy to help support compliant reporting and appropriate reimbursement. The ideal candidate will bring extensive HCC coding and risk adjustment auditing experience, strong analytical skills, and a thorough understanding of Medicare, Medicaid, and ACA risk adjustment models. Key Responsibilities Perform retrospective and prospective chart reviews to evaluate risk adjustment diagnosis coding accuracy. Audit medical records to verify the completeness, specificity, and appropriateness of reported diagnoses. Review clinical documentation to ensure accurate HCC capture and risk adjustment reporting. Evaluate...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Job # 25231 Ortho Coder Acclivity Healthcare - Your personable, proven partner! Since 1999, Acclivity Healthcare has served the specialized recruiting and staffing needs of leading healthcare employers nationwide. Our clients range from independent physician practices to national healthcare systems and insurance providers. We are proud of our 18,000+ successful placements with quality-oriented organizations that recognize the value of better talent. Compensation and Schedule for the Ortho Coder Ortho Coder - Full-time, remote, $26-$31 per hour, Monday to Friday, 7:00am to 3:30pm within Arizona time zone during training. Year-end and quarterly incentive bonuses available! Required Qualifications of the Ortho Coder - 5+ years of recent E/M coding experience required - 2+ years of recent ortho coding experience required - Must provide equipment during training - Certified Professional Coder (CPC) certification required - High school diploma or GED required -...

Datavant is seeking a Profee Auditing Specialist to perform coding audits and enhance educational support related to coding quality and compliance. Candidates should have over 5 years of Professional Fee coding experience and hold a CPC certification. This fully remote role offers a competitive salary of $35—$45 per hour, alongside comprehensive benefits including medical, dental, and retirement plans. Join Datavant to contribute to transformative healthcare data solutions. #J-18808-Ljbffr

A health data exchange leader is seeking an Inpatient Auditing Specialist to perform coding audits, provide coder education, and ensure regulatory compliance. This fully remote position allows for flexible scheduling, catering to professionals with over 5 years of inpatient coding experience. Candidates should hold certifications like CCS, RHIA, or RHIT and have experience with software such as Epic and Cerner. #J-18808-Ljbffr

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Contract to Hire Job # 25233 Coding Auditor/Educator Acclivity Healthcare - Your personable, proven partner! Since 1999, Acclivity Healthcare has served the specialized recruiting and staffing needs of leading healthcare employers nationwide. Our clients range from independent physician practices to national healthcare systems and insurance providers. We are proud of our 18,000+ successful placements with quality-oriented organizations that recognize the value of better talent. Compensation and Schedule for the Coding Auditor/Educator Coding Auditor/Educator – Full-time, work-from-home, $28-$35 per hour, Monday to Friday, 7:00am to 3:30pm within Arizona time zone during training. Join a a remote team dedicated to employee growth! Required Qualifications of the Coding Auditor/Educator 3+ years of recent E/M coding experience required 2+ years of recent auditing and provider education experience required Surgical coding experience preferred...

Become a part of our caring community 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. Where you Come In 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 accuracy of...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...