17 coder auditor jobs found

The position audits and reports on the accuracy of procedural billing, payment consideration and accuracy in reimbursement based on the correct interpretation and application of codes, modifiers and payment rules. The incumbent reviews and audits physician and institutional billing from multiple departments and entities across the organization, and assists in training departmental personnel in correct coding and documentation. This position is not responsible for providing patient care. Responsibilities Essential Functions Performs audits and reports on the accuracy of procedure coding, facility E&M coding, ICD-10 coding and billing. Reviews insurance payments for reimbursement accuracy, which is based on correct interpretation of clinical data and application of codes, modifiers and payment rules. Reviews and audits institutional coding and billing from multiple departments and entities across the organization. Assists in training personnel in...

Are you passionate about physician coding, compliance, and education? Gill Compliance Solutions is growing, and we're looking for an experienced Audit & Education Manager (remote) to join our nationally recognized consulting team. Our consultants work directly with physician practices, hospitals, health systems, new tech, and legal firms across the country to defend providers,  improve documentation, coding accuracy, compliance, and reimbursement. Every day presents new specialties, new challenges, and opportunities to make a measurable impact. If you enjoy educating providers, solving complex coding issues, presenting audit findings to executive leadership, and staying at the forefront of healthcare regulations, we'd love to meet you. Duties may include but are not limited to the following:      Managing and performing audits from electronic medical records initiated by a health care provider and ensures accuracy of diagnosis, procedure codes, and modifiers in...

About the role:                                                        The Audit and Coding Specialist (“Audit and Coding Specialist”) is an integral member of Community Reach Center’s Quality Improvement (“QI”) Division. The Audit and Coding Specialist is responsible for managing all aspects of assigned projects, reviewing compliance standards to maintain quality assurance functions, and support risk management activities for the agency. Additionally, the Audit and Coding Specialist will have other duties and responsibilities as determined from time to time by the Utilization Manager. Essential Functions:  Designs and implements internal compliance audits, regularly monitoring accuracy and adherence to documentation requirements in collaboration with Utilization Manager to support continuous quality improvement and compliance as identified in the Quality Management Plan (QMP). Conducts audits as determined by the Manager or Director. Oversees...

Lead Coding. Drive Revenue Integrity. Shape Provider Performance.  El Camino Health is seeking a highly experienced HIM Professional Billing Coding Manager to lead coding operations across its medical network. This is a critical leadership role directly tied to revenue cycle performance, compliance, and provider documentation excellence. If you bring deep expertise in professional billing (PB) coding, auditing, and provider education , this is your opportunity to make a meaningful impact within a respected, nonprofit health system. About El Camino Health El Camino Health is an integrated, nonprofit health system known for delivering high-quality, patient-centered care across its communities. With a strong commitment to innovation, compliance, and clinical excellence, the organization plays a vital role in driving healthcare outcomes and access across the region. This position is onsite in Mountain View, CA 2 days a week, with 3 days available for remote work....

University of Colorado Medicine (CU Medicine) is the region’s largest and most comprehensive multi-specialty physician group practice. The CU Medicine team delivers business operations, revenue cycle and administrative services to support the patients of over 4,000 University of Colorado School of Medicine physicians and advanced practice providers. These providers bring their unparalleled expertise at the forefront of medicine to deliver trusted, compassionate health care services at primary and specialty care clinics as well as facilities operated by affiliate hospitals of the University of Colorado. We are seeking a motivated Coding Education Specialist with an emphasis in Surgery experience to join our Coding Services department.    This job can be performed 100% remotely and out of state candidates will be considered. The Coding Education Specialist will primarily be responsible for supporting and leading ongoing education to existing coding staff,...

The goal is this position is to educate providers on proper use of CPT codes, ICD10 codes,  modifiers and audit activities related to health plan operations, risk adjustment, payer audits and  regulatory requirements. This role ensures accurate medical coding, documentation integrity, and  adherence to federal, state, and payer-specific guidelines. The ideal candidate will possess  advanced CPC coding expertise, strong analytical skills, and extensive experience  supporting compliance initiatives within a managed care or health plan environment. This is a full-time position, on site, 5 days a week. Responsibilities: • Serve as subject matter expert on CPT, HCPCS, ICD10 and modifier coding for physicians  and coders. • Ensure provider documentation and coding practices comply with CMS, Medicare,  Medicaid, commercial payer, and applicable federal and state regulatory requirements.  • Conduct coding compliance audits to identify...

About Med USA Med USA is a Utah-based medical billing/provider services company with a nationwide presence. We have been in business for over 45+ years and provide practice management, payer credentialing and contracting, and full-cycle management (RCM) services, including coding, billing, follow-up, and denial resolution. Join our fast-paced, high-energy team as a medical billing specialist, with great company benefits and opportunity for growth. The ideal candidate is motivated, professional, and detail-oriented, with a strong commitment to producing high-quality work and making a positive impact on the team. If you enjoy helping others, solving problems, and working in an open, collaborative, fast-paced environment, this is a great opportunity for you. Medical billing or insurance experience is preferred, but we’re happy to train the right candidate. Position Summary The Certified Medical Coder is responsible for reviewing clinical documentation and...

Candidates must be able to work on-site. This position is not remote. GENERAL PURPOSE OF JOB: The Claims and Appeals Specialist II is a certified medical coder that performs audits for correct coding and claims payments and oversees the claims appeal process for provider and member appeals. This position also investigates Coordination of Benefit (COB) claims. The Claims and Appeals Specialist II reports to the Director of Claims Oversight. ESSENTIAL DUTIES AND RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate...

Join Our Team We are seeking a detail-oriented and experienced   Medical Billing and Coding Specialist   to join our growing team. This role is ideal for a motivated professional who thrives in a fast-paced, team-oriented environment while maintaining the ability to work independently. This is an onsite position located in Linden, NJ. This position has the ability to go remote after six months. If you enjoy solving complex billing challenges, analyzing denial trends, and contributing to process improvements, this is a great opportunity to advance your career. What You’ll Do As a key member of our revenue cycle team, you will take ownership of complex billing processes and serve as a resource for coding and payer-related issues. Core Responsibilities: Review, code, and submit provider/practice claims with accuracy and timeliness Independently manage assigned work queues to ensure proper charge capture Investigate and resolve complex claim denials and...

Bring your coding expertise to SSM Health in a role where education, quality, and compliance come together. As a Coding Educator, you’ll partner with providers and coders, lead training initiatives, and influence documentation and coding practices that support accuracy, consistency, and revenue integrity across the organization. PRIMARY RESPONSIBILITIES Drives optimal clinical and financial outcomes through thorough assessment of provider documentation and coding competency, identification of improvement opportunities. Develops and delivers training and education of all coding processes. Stays abreast of regulatory changes and works with leadership to ensure compliance and revenue integrity. Act as subject matter expert for providers and coders while providing guidance and clarification on issues which present in their daily account processing. Establishes and coordinates internal quality review processes and corresponding training for providers and coders....