14 professional coding auditor jobs found in Washington

Job Description Job Description Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Auditors with strong expertise in outpatient professional fee coding and coding audits , preferably within academic medical centers. You will review coding records, identify compliance risks, and provide expert feedback to support AI-focused projects. No prior AI experience is required. Key Responsibilities Conduct detailed audits of outpatient professional fee coding records. Review coding accuracy, documentation, and compliance. Identify coding trends, gaps, risks, and improvement opportunities. Apply academic medical center standards and coding guidelines. Document audit findings and provide clear recommendations. Evaluate complex coding and documentation scenarios. Contribute to AI training through expert coding and audit feedback. Support audit program management and quality improvement initiatives. Required Qualifications...

The Talent Acquisition department hires qualified candidates to fill positions which contribute to the overall strategic success of Howard University. Hiring staff "for fit" makes significant contributions to Howard University's overall mission. At Howard University, we prioritize well-being and professional growth. Here is what we offer: Health & Wellness: Comprehensive medical, dental, and vision insurance, plus mental health support Work-Life Balance: PTO, paid holidays, flexible work arrangements Financial Wellness: Competitive salary, 403(b) with company match Professional Development: Ongoing training, tuition reimbursement, and career advancement paths Additional Perks: Wellness programs, commuter benefits, and a vibrant company culture Join Howard University and thrive with us! https://hr.howard.edu/benefits-wellness JOB PURPOSE: The Certified Medical Coder is responsible to review, analyze and code procedural information...

Certified Medical CoderThe Talent Acquisition department hires qualified candidates to fill positions which contribute to the overall strategic success of Howard University. Hiring staff "for fit" makes significant contributions to Howard University's overall mission.At Howard University, we prioritize well-being and professional growth.Here is what we offer:Health & Wellness: Comprehensive medical, dental, and vision insurance, plus mental health supportWork-Life Balance: PTO, paid holidays, flexible work arrangementsFinancial Wellness: Competitive salary, 403(b) with company matchProfessional Development: Ongoing training, tuition reimbursement, and career advancement pathsAdditional Perks: Wellness programs, commuter benefits, and a vibrant company cultureJoin Howard University and thrive with us!JOB PURPOSE:The Certified Medical Coder is responsible to review, analyze and code procedural information that determines Medicare, Medicaid and private insurance payments. The...

Remote VA Experienced Outpatient Medical Coders Summary Cooper Thomas, LLC, a leading provider of medical coding services to the Department of Veterans Affairs (VA), has immediate openings for experienced Outpatient Coders. Applicants must have at least 2 years of experience for remote outpatient coding positions. Previous experience with VA is required , whether as a VA employee or with another VA contractor. You must be able to pass an initial entrance exam and code at a minimum of 95% accuracy. This work will be performed remotely in your home office. Benefits are available if interested in full-time employment or you can decline benefits to maximize your compensation. If you are working for another VA contractor and are having a difficult time being paid on time, our company pays bi-weekly without exception. This is the perfect opportunity for you. Presently we are only interested in candidates who meet the qualifications below and have an active Background Investigation,...

Connecticut Institute for Communities, Inc. Description: The Team Lead will oversee key components of the revenue cycle including Internal and Outsourced Billing Services and Financial & Insurance Assistance. Serves as the organizations internal lead for oversight of both outsourced billing vendor and internal patient billing activities, including self-pay and sliding fee accounts. This role ensures patients have timely access to insurance enrollment and financial assistance services while maintaining strong internal controls, accurate patient billing processes, vendor accountability, and compliance with healthcare billing and payer requirements. ESSENTIAL JOB RESPONSIBILITIES: Revenue Cycle Oversight: Serve as the primary internal liaison between CIFC Health and the outsourced billing vendor. Monitor revenue cycle performance metrics, including claim submission timeliness, denial trends, accounts receivable aging, and collections. Review billing and...

Job Description Job Description Mb Staffing Services is seeking a detail-oriented Medicaid Coding & Reimbursement Analyst with direct experience in Medicaid billing, coding, claims review, and financial reconciliation. This role is ideal for professionals who understand the financial side of healthcare operations and are passionate about accuracy, compliance, and reporting. Key Responsibilities Review and analyze Medicaid claims, billing, and reimbursement data. Perform data entry and validate coding information for accuracy. Utilize ICD-10, CPT, HCPCS, and Medicaid-specific codes. Reconcile reports, payments, and billing discrepancies. Research and resolve claim denials and coding issues. Conduct audits and support compliance initiatives. Generate reports and analyze trends to improve billing accuracy. Review financial and operational data to identify variances and opportunities for improvement. Collaborate with providers and internal teams to ensure timely...

Georgia Washington DC Tennessee Full time R104549 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...

Compliance Program AssistantAssists in the MedStar Family Choice compliance program related to program integrity. Conducts provider audits to identify and address improper billing practices. We recruit, retain, and advance associates with diverse backgrounds skills and talents equitably at all levels.Primary Duties and ResponsibilitiesAnalyzes current payment policies and makes recommendations to improve program integrity and organizational processes.Assists with and tracks responses to external government inquiries investigations data requests subpoenas and fair hearings. Responds to government requests for claims data/information.Prepares written audit reports and communicates the results to management. Initiates corrective action plans or continuous improvement plans identified through audits.Coordinates monthly exclusion data base checks review and report findings.Completes assigned routine and selected audits all within assigned time frames. Ensures timely completion of risk...

Requirements Review E/M services under 2021+ guidelines MUST RESIDE IN FLORIDA AND HAVE CODING AND AUDITING EXPERIENCE. Deposition as well as Testimony experience is preferred. We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong Florida-based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. Responsibilities Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS) Conduct utilization reviews to determine medical necessity and documentation compliance Review and prepare demand packages and audit response materials Analyze records for payer disputes and recoupments Prepare written audit findings and defensible reports Provide expert support for depositions and testimony as...

Dane Street seeks an experienced CPC-certified medical coder to perform audits, utilization reviews, and related tasks. The candidate must reside in Nevada with strong Nevada-based coding knowledge and a background in medical necessity and payer policies. Role includes supporting legal cases with depositions/testimony, reviewing E/M under 2021+ guidelines, and preparing defensible audit reports. Minimum 5 years coding experience and prior audit work are required. #J-18808-Ljbffr

Review E/M services under 2021+ guidelines MUST RESIDE IN NEVADA AND HAVE CODING AND AUDITING EXPERIENCE. Deposition as well as Testimony experience is preferred. Requirements We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong Nevada-based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. Responsibilities Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS) Conduct utilization reviews to determine medical necessity and documentation compliance Review and prepare demand packages and audit response materials Analyze records for payer disputes and recoupments Prepare written audit findings and defensible reports Provide expert support for depositions and testimony as needed Review...

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...

Summary We are seeking a highly skilled, hands-on Medical Bill Review (Working) Supervisor to lead our day-to-day bill review operations while actively participating in complex case reviews and serving as a key resource for our legal services division. In this dual-capacity role, you will manage a small team of bill reviewers and maintain a production workload focused on high-dollar, complex medical bill review/legal cases. You will leverage an intimate knowledge of major medical bill review software and national repricing/payer systems, ensuring absolute accuracy in identifying excessive or unsupported charges, determining reasonable reimbursement amounts, and defending those findings in litigation. Crucially, you will serve as a Subject Matter Expert (SME) and Expert Witness for legal proceedings, providing forensic billing analyses, affidavits, and deposition/trial testimony. This is a national role; however, Texas-specific expertise is preferred in billing regulations,...

Description Medical Coder Venesco LLC is seeking a Medical Coder to perform clinical coding activities for adverse events, medical histories, procedures, and concomitant medications for FDA-regulated clinical trials, ensuring consistency, accuracy, and regulatory compliance. Requirements Duties and Responsibilities Code adverse events using MedDRA terminology. Code medications using WHO Drug Dictionary. Develop coding conventions and coding guidelines. Review CRFs and contribute to data review activities. Perform coding reconciliation activities. Generate coding reports and quality control reviews. Support database testing and validation activities. Conduct coding-related training for study personnel. Maintain coding documentation and audit trails. Support regulatory submissions and database lock activities. Minimum Qualifications Bachelor's degree in Health Sciences, Clinical Research, Nursing, Pharmacy, or related discipline. MedDRA Certified and WHO-Drug Certified. Minimum 7...