12 coding auditor 1 jobs found in Springfield

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines Utilize encoders and various coding resources Perform CPT Procedure reviews Maintain strict patient and physician...

A leading U.S. healthcare company is seeking a Medical Coding Auditor to ensure correct coding of medical claims. The role requires a minimum of 3 years of coding experience and appropriate certifications. The position is remote, with responsibilities including reviewing medical documentation and confirming CPT coding assignments. Strong knowledge in ICD-10 and a detail-oriented mindset are essential for success. The compensation ranges from $59,300 to $80,900 per year, plus benefits including medical, dental, and vision coverage. #J-18808-Ljbffr

Salary: $25.89 - $28.48 Hourly Location : Springfield, IL Job Type: Civil Service Job Number: 2401379 Department: SIU HealthCare Coding-SMS Division: Administration Opening Date: 10/02/2025 Closing Date: 4/20/2026 2:00 PM Central FLSA: Non-Exempt Bargaining Unit: Non-Represented Shift: Days ExemptorNon_Exempt: Non-Exempt We recommend using the following browsers to complete the application: Desktop: Google Chrome, Edge with Chromium Mobile: Google Chrome, Safari Description The Revenue Cycle Coding Auditor will perform reviews for employees in the Coding department. Audits will include, but are not limited to; employee productivity and quality based on proper documentation, accuracy and coding guidelines. The Auditor will also provide feedback and support relating to departmental/role specific productivity and quality expectations. The incumbent for this position will utilize a high level of in-depth knowledge of the coding role to perform...

Become a part of our caring community and help us put health first 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. 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...

We recommend using the following browsers to complete the application: Desktop: Google Chrome, Edge with Chromium Mobile: Google Chrome, Safari Description The Revenue Cycle Coding Auditor will perform reviews for employees in the Coding department. Audits will include, but are not limited to; employee productivity and quality based on proper documentation, accuracy and coding guidelines. The Auditor will also provide feedback and support relating to departmental/role specific productivity and quality expectations. The incumbent for this position will utilize a high level of in-depth knowledge of the coding role to perform all audits based on specific departmental need. Examples of Duties PBS Auditor: 100% Conduct quality and productivity reviews of coding staff using structured and consistent review programs and methods. Demonstrate in-depth knowledge and experience with SIU-HC supported applications, including but not limited to Athena IDX, TouchWorks,...

Description The Revenue Cycle Coding Auditor will perform reviews for employees in the Coding department. Audits will include, but are not limited to, employee productivity and quality based on proper documentation, accuracy, and coding guidelines. The Auditor will also provide feedback and support relating to departmental/role‑specific productivity and quality expectations. The incumbent will utilize a high level of in‑depth knowledge of the coding role to perform all audits based on specific departmental need. Duties Conduct quality and productivity reviews of coding staff using structured and consistent review programs and methods. Demonstrate in‑depth knowledge and experience with SIU‑HC supported applications, including but not limited to Athena IDX, TouchWorks, Epic, Cerner and Precision BI. Understand the integration of applications and their impact on business processes and operations. Provide on‑site guidance and assistance to end users as necessary. Review, develop and...

QA Nurse / Coder (RN) As a QA Nurse / Coder, you will ensure the accuracy, completeness, and regulatory compliance of Home Health documentationparticularly OASIS assessments, the Home Health Plan of Care (485), and face-to-face encounter noteswhile properly sequencing diagnoses according to federal/state standards and agency policy. Core responsibilities include: Review OASIS forms and Plans of Care for appropriateness, completeness, and compliance. Assign and sequence ICD?10 codes in line with current home health coding guidelines. Ensure consistency and compliance of face-to-face encounter documentation with OASIS and care plans. Conduct additional clinical record audits and OASIS reviews as assigned. Stay current on Medicare reimbursement policies, home health regulations, and compliance requirements. Maintain relevant certifications (HCS?D, HCS?O or COS?C). Participate in quality assurance and performance-improvement efforts. Coordinate with physicians, facilities,...

Essential Duties and Responsibilities: - Abstract and code clinical data. - Audit medical records to ensure compliance with the organization's coding procedures and standards. - Accurately enter coded data in a system and validate data entered. - Research correct coding practices, clearly document and share findings with others. - Review denials and recommend billing corrections. - Train staff members on the coding process. Minimum Requirements - High School diploma or equivalent with 0 - 2 years of experience. - Additional clinical licensure may be required based on project. - Must be a Certified Medical Coder, Certified Professional Coder, or a Certified Coding Specialist. - Knowledge of Medical Billing and Coding Systems such as CPT and HCPCS. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday. Preferred Skills and Experience: - At least 2 years of coding experience. - Experience with CPT modifiers and how they impact...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

Essential Duties and Responsibilities: - Abstract and code clinical data. - Audit medical records to ensure compliance with the organization's coding procedures and standards. - Accurately enter coded data in a system and validate data entered. - Research correct coding practices, clearly document and share findings with others. - Review denials and recommend billing corrections. - Train staff members on the coding process. Minimum Requirements - High School diploma or equivalent with 0 - 2 years of experience. - Additional clinical licensure may be required based on project. - Must be a Certified Medical Coder, Certified Professional Coder, or a Certified Coding Specialist. - Knowledge of Medical Billing and Coding Systems such as CPT and HCPCS. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday. Preferred Skills and Experience: - At least 2 years of coding experience. - Experience with CPT modifiers and how they impact...

Essential Duties and Responsibilities: - Abstract and code clinical data. - Audit medical records to ensure compliance with the organization's coding procedures and standards. - Accurately enter coded data in a system and validate data entered. - Research correct coding practices, clearly document and share findings with others. - Review denials and recommend billing corrections. - Train staff members on the coding process. Minimum Requirements - High School diploma or equivalent with 0 - 2 years of experience. - Additional clinical licensure may be required based on project. - Must be a Certified Medical Coder, Certified Professional Coder, or a Certified Coding Specialist. - Knowledge of Medical Billing and Coding Systems such as CPT and HCPCS. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday. Preferred Skills and Experience: - At least 2 years of coding experience. - Experience with CPT modifiers and how they impact...

Coder OP McKenzie-Willamette Medical Center is your community medical provider, serving the Willamette Valley and its residents. Our 113-bed hospital offers inpatient, outpatient, diagnostic, medical, surgical and emergency care. We are a family of caregivers offering care to our larger family - our community. Position Details: Hourly Base Rate: $18.28 - $26.37 Shift: Days Hours Per Week: 40 hours Date Posted: 02/20/2026 Job Summary: Certified Coder required. Working knowledge of basic medical terminology, ICD-10, CPT and HCPCS codes. Preferred experience in multiple specialties including: Cardiology, Cardiology diagnostic testing, Cardiothoracic Surgery, Critical Care, General Surgery, Gastroenterology, Pulmonology, Vascular Surgery and Vascular Imaging services. Ability to assign codes to diagnoses, procedures, E&M visits, and diagnostic testing. Ability to research and analyze clinical documentation as well as produce reports from a variety of...