11 documentation coding auditor jobs found in Washington

Become a part of our caring community The 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 Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

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 Description Job Description Job Title: Coding Specialist-New Jersey Ave. Location: Washington, DC Organization: Unity Health Care Employment Type: Full-Time About Unity Health Care Unity Health Care is a mission-driven, federally qualified health center committed to providing high-quality, compassionate, and comprehensive health care services to underserved communities throughout Washington, DC. Our team is dedicated to improving health outcomes through accessible, patient-centered care while supporting excellence in clinical operations and revenue cycle management. Position Summary Under the supervision of the Medical Billing Coding Manager, the Coding Specialist plays a critical role in ensuring accurate medical coding, charge capture, and reimbursement for healthcare services. This position reviews medical documentation, assigns appropriate diagnosis and procedure codes, supports compliance with federal and payer regulations, and helps maintain the integrity of the...

Corporate Coder The Corporate Coder functions under the direction of the Health Information Corporate Coding Manager. The CC is responsible for accurate coding and abstracting of clinical information from the medical record. The CC is responsible for maintaining standards for coding data quality and integrity, as well as productivity within established guidelines. The CC is responsible for coding of Tenet facilities as assigned, assisting with productive coding to maintain DNFC, assisting with quality chart reviews, assisting with the training of new CC's and/or other projects where indicated. Responsibilities Accurately and productively code/abstract patient health documentation for Tenet facilities. Utilize coding abilities to review flagged cases, in CARDS and RevInt for coding accuracy. Assisting in coding quality reviews/audits and second level reviews as needed. Attends Tenet coding educations and maintains coding credentials. Qualifications Required:...

About Integrated Management Strategies (IMS) LLC We area women-owned small business and management consulting firm that provides an array of business and technical services. IMS is headquartered inthe Washington, D.C. metropolitan area, with employees across 39 US states. What We Do We support the mission critical needs of federal agencies and commercial businesses by leveraging our experience, talent and can-do attitude, and solve their strategic and operational challenges. How We Do It We earn our clients’ trust through our personalized approach and attention to detail, allowing us to collaborate and solve even the most complex problems. About the role Are you ready for your next career adventure?! Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting. We are seeking an experienced Medical Coder to join our healthcare consulting practice. The...

Coding Specialist-New Jersey Ave. Coding Specialist Location: Washington, DC Organization: Unity Health Care Employment Type: Full-Time About Unity Health Care Unity Health Care is a mission-driven, federally qualified health center committed to providing high-quality, compassionate, and comprehensive health care services to underserved communities throughout Washington, DC. Our team is dedicated to improving health outcomes through accessible, patient-centered care while supporting excellence in clinical operations and revenue cycle management. Position Summary Under the supervision of the Medical Billing Coding Manager, the Coding Specialist plays a critical role in ensuring accurate medical coding, charge capture, and reimbursement for healthcare services. This position reviews medical documentation, assigns appropriate diagnosis and procedure codes, supports compliance with federal and payer regulations, and helps maintain the integrity of the organization's electronic...

Overview Better Morning emerged as an outpatient behavioral health practice in Ashburn, VA in 2014. In addition to providing counseling from the Ashburn office, Better Morning started as a certified provider for intensive in-home and community-based services (IHCBS) for at‑risk youth in the District of Columbia. In August 2017, Better Morning was certified as a Core Service Agency (CSA) by the DC Department of Behavioral Health. The founder's passion for at‑risk youth and their families motivated the expansion of evidenced‑based programs to serve underserved populations. Job Description The Medicaid & MCO Biller is responsible for accurate and timely submission, tracking, and reconciliation of claims for services billed to DC Medicaid and Managed Care Organizations (MCOs). This role ensures compliance with District of Columbia Department of Health Care Finance (DHCF) regulations and payer-specific billing requirements while supporting revenue cycle efficiency....

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...

Medical Biller (Medicaid & MCO - Behavioral Health) The Medicaid & MCO Biller is responsible for accurate and timely submission, tracking, and reconciliation of claims for services billed to DC Medicaid and Managed Care Organizations (MCOs). This role ensures compliance with District of Columbia Department of Health Care Finance regulations and payer‑specific billing requirements while supporting revenue cycle efficiency. Eligibility & Authorization Verification Verify Medicaid eligibility using systems such as DC Access System or other payer portals. Confirm MCO enrollment and service coverage prior to claim submission. Track and manage prior authorizations and limitations. Claims Submission & Processing Submit clean claims to DC Medicaid and MCOs (e.g., AmeriHealth Caritas DC, MedStar Family Choice DC, Wellpoint, HSCSN). Ensure proper use of CPT, HCPCS, and ICD-10 codes for behavioral health services. Verify authorization requirements prior to billing...

Ankura is a team of excellence founded on innovation and growth. Practice Overview Ankura’s Health Care Disputes, Compliance and Investigations practice advises outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters involving research...

Ankura is a team of excellence founded on innovation and growth. Practice Overview Ankura's Health Care Disputes, Compliance and Investigations practice advises outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters involving research...