26 audit compliance coder jobs found

Lead Medical Coder and Auditor ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. ProSidian Seeks a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land dominance, across the full range of military...

DEPARTMENT: Physician Practice Management FACILITY: Medical Office Building WORK TYPE: Full Time SHIFT: Daytime SUMMARY: Assess the educational needs of coding specialists and providers regarding coding and documentation and direct development of effective regularly scheduled educational programs that meet the needs of the health system. Serve as the primary resource to physicians for documentation and coding issues. Conduct ongoing coding and billing training programs for billing and coding specialists and providers. Creates presentations, develops learning material, handbook, and other training materials. Conducts coding and data quality reviews and prepares complex reports as required. Ensures all education activities comply with clinical billing standards and government regulation with concentration on hospital inpatient procedures, ambulatory, and specialty physician services. RESPONSIBILITIES: * Keeps abreast of pertinent federal, and state regulations...

Are you seeking a career with a growing company, a place where you can make an impact in the community? Then Positive Impact Health Centers is the company for you. What makes us different? We offer our employees the following: • 1 Health Wellness day per quarter • Parental Leave • Free parking at our locations/bus line accessibility • Competitive Salary & Benefits • Automatic 3% Safe Harbor & 2% Profit Sharing (Retirement Program) • 100% allotted for benefit elections for employees, 50% allotted for benefit elections for employees' spouse/dependents • Credit Union Positive Impact Health Centers (PIHC) is a community leader in providing HIV prevention, care and treatment services. The PIHC model of care assures that persons with HIV have access to medical, pharmacy, dental, behavioral health and social services, providing the best opportunity for patients to achieve high-quality health outcomes. Job Summary : The Medical Billing &...

Overview Be inspired. Be valued. Belong. At Emory Healthcare At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs And more Description JOB DESCRIPTION: Responsible for implementing and maintaining a compliance plan for outpatient coding and reimbursement. The Outpatient Coding auditor will assist the Coding Manager with Outpatient and Emergency Coding Services, and the development of policies and procedures. Develops education and Supervises programs regarding elements of the HIM...

Emory Healthcare Job Opportunity Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs And more Job Description This position ensures the accuracy, completeness, and compliance of medical coding and clinical documentation for professional coding services. The role supports accurate coding practices, appropriate reimbursement, and regulatory compliance by reviewing patient records and collaborating with healthcare providers, coding teams, and compliance staff. Responsibilities Ensures the accuracy,...

Outpatient Coding Auditor Responsible for implementing and maintaining a compliance plan for outpatient coding and reimbursement. The Outpatient Coding auditor will assist the Coding Manager with Outpatient and Emergency Coding Services, and the development of policies and procedures. Develops education and supervises programs regarding elements of the HIM Compliance program, such as appropriate documentation and accurate coding, to all appropriate personnel, including HIM coding staff, physicians, billing personnel and ancillary departments. Coordinates and conducts continual reviews, tracking and trending following the outpatient coding audits. Educates new outpatient coders on documentation requirements including how to read an outpatient medical record and extrapolate the required documentation with regards to outpatient surgery coding. Educate outpatient coders on ICD-10-CM guidelines, coding conventions and Coding Clinics pertinent to outpatient surgery coding. Educate...

Professional Coding Auditor & Educator The Professional Coding Auditor & Educator works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Responsibilities: Responsible for reviewing and analyzing all aspects of the department clinical documentation and care to ensure timely, accurate, and compliant charge capture and submission Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges Collaborates with Coding Supervisor to ensure clinical documentation in high-risk areas is consistent and complete Identifies...

Medical Coder A Medical Coder for WellStreet Urgent Care is responsible for supporting all aspects of the Revenue Cycle for our Urgent Care Centers. Responsibilities Coding for our Urgent Care Centers using our internal software Knowledge of ICD-10 Coding and compliance Experience using an encoder Setting up insurance plans within our software Working with the Revenue Cycle Management to identify & resolve issues related to coding and the process flow Interfacing with clinic staff on billing & coding issues. Comply with all legal requirements regarding coding procedures and practices Conduct audits and coding reviews to ensure all documentation is accurate and precise Assign and sequence all codes for services rendered Collaborate with billing department to ensure all bills are satisfied in a timely manner Communicate with insurance companies about coding errors and disputes Contact physicians and other health care professionals with questions about...

Job Description Job Description Description: Job Title: Certified Medical Coder/Biller Location: Richmond Hill, GA | Hybrid Remote Employment Type: Full-time Reports to: Billing Manager Department: Revenue Cycle Management Job Summary: The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key Responsibilities: 1. Claims Processing: · Prepare and submit accurate and timely insurance claims for services rendered. · Verify patient insurance coverage...

Acute Inpatient Coding Auditor We are seeking an experienced Acute Inpatient Coding Auditor with recent acute care hospital experience. This role is responsible for auditing facility-based inpatient coding, DRG assignment, ICD-10-CM/PCS coding accuracy, documentation review, and compliance. Candidates must have a strong background in acute inpatient hospital coding and auditing. This position focuses exclusively on facility (hospital) inpatient services and is not a professional fee/physician coding role. Job Summary: Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and compliance with the Official Coding Guidelines for Coding and Reporting, payer regulations, and hospital policy. Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure...

Job Description Job Description Join the WellStreet Urgent Care Revenue Cycle Team! WellStreet Urgent Care is seeking an experienced Certified Medical Coder to support our growing Revenue Cycle team. In this role, you will accurately assign ICD-10-CM, CPT, HCPCS, and Evaluation & Management (E&M) codes for urgent care encounters while ensuring compliance with coding guidelines, quality standards, and productivity expectations. This is an excellent opportunity for a detail-oriented coding professional with Epic experience who enjoys working in a collaborative, fast-paced healthcare environment. What You'll Do Code patient encounters for WellStreet Urgent Care Centers using internal coding software. Accurately assign ICD-10-CM, CPT, HCPCS, and E&M codes based on provider documentation. Apply current coding guidelines and regulatory requirements to ensure coding accuracy and compliance. Utilize coding encoders and other coding resources to...

Job Description Job Description Job Title: Specialty Inpatient Coder Location: Remote Shift (EST): MondayFriday or SundayThursday; 1st or 2nd shift (flexible) Pay: $29+ (DOE) Essential Job Duties & Responsibilities: Review and code complex inpatient and outpatient records for high-priority service lines Assign accurate ICD-10-CM, ICD-10-PCS, and CPT codes based on physician documentation Focus on specialty areas including cardiovascular, transplant, orthopedic spine, invasive GI, and interventional radiology Use CAC systems (e.g., 3M CAC 360) and UHDDS guidelines for coding accuracy Abstract and enter clinical data into coding systems Ensure documentation supports all coded procedures and services Query providers to clarify incomplete or unclear documentation when needed Identify and correct coding and billing errors from audits and edits Monitor for medical necessity issues and potential non-covered services Maintain productivity, accuracy, and...

The Professional Coding Auditor & Educator works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Responsibilities: Responsible for reviewing and analyzing all aspects of the department clinical documentation and care to ensure timely, accurate, and compliant charge capture and submission Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges Collaborates with Coding Supervisor to ensure clinical documentation in high-risk areas is consistent and complete Identifies inconsistencies in medical reports and works...

Overview Be inspired. Be valued. Belong . At Emory Healthcare At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoingmentorshipand leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs And more Description This position ensures the accuracy, completeness, and compliance of medical coding and clinical documentation for professional coding services. The role supports accurate coding practices, appropriate reimbursement, and regulatory compliance by reviewing patient records and collaborating with healthcare providers, coding teams, and compliance staff....

Certified Medical Coder/Biller The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key responsibilities include: Prepare and submit accurate and timely insurance claims for services rendered. Verify patient insurance coverage and ensure correct billing to the appropriate payer. Review and process Explanation of Benefits (EOBs) and insurance payments. Ensure that all medical services are accurately coded according to current guidelines (CPT, ICD-10, HCPCS). Work closely with...

Description WHAT IT'S LIKE AT SGMC HEALTH Purpose . No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place. Excellence . We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service. Team Spirit. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. Award Winning Performance. We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides. WHY YOU WILL LOVE SGMC HEALTH SGMC has great benefit options, depending on the role that you are going into- including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities...

Description Certified Medical Coder/Biller Location Richmond Hill, GA | Hybrid Remote Employment Type Full-time Reports to Billing Manager Department Revenue Cycle Management Job Summary The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key Responsibilities Claims Processing: Prepare and submit accurate and timely insurance claims for services rendered. Verify patient insurance coverage and ensure correct billing to the appropriate payer. Review and process Explanation...

A healthcare institution in Valdosta, GA is seeking a Professional Coding Auditor/Education Specialist. The ideal candidate will be a Certified Professional Coder (CPC) with expertise in medical coding including ICD-10, HCPCS, and CPT. Strong analytical skills and proficiency in Microsoft Office are essential for this full-time on-site role. Responsibilities include conducting audits, educating healthcare providers, and developing training materials to improve coding compliance and efficiency. Competitive benefits include 401(k), healthcare options, and tuition reimbursement. #J-18808-Ljbffr

Certified Medical Coder/Biller The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key responsibilities include: Prepare and submit accurate and timely insurance claims for services rendered. Verify patient insurance coverage and ensure correct billing to the appropriate payer. Review and process Explanation of Benefits (EOBs) and insurance payments. Ensure that all medical services are accurately coded according to current guidelines (CPT, ICD-10, HCPCS). Work closely with...

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...

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you. Job Summary Responsible for coding and abstracting procedural (CPT) and diagnosis codes (ICD-10) for physician services, reviewing physician documentation in the electronic medical record for completeness and accuracy to ensure proper code assignment, providing physician feedback of discrepancies/trends, resolving edits and denials, and releasing encounters for billing. Utilizes intermediate problem‑solving skills to address coding related tasks of detailed, medium complexity. Duties include procedural (CPT) and diagnosis (ICD-10) coding for all places of service, including, but not limited to ER, observation, inpatient, outpatient, ambulatory surgery, and other ancillary services. Responsible for reviewing, analyzing, and interpreting physician...

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...

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:...

South Georgia Medical Center seeks a Professional Coding Auditor/Education Specialist to conduct audits, educate healthcare providers, and manage coding compliance. Ideal candidates should hold a Certified Professional Coder (CPC) certification, with a strong foundation in medical coding, including knowledge of ICD-10, HCPCS, and CPT. The position is full-time, requiring on-site presence in Valdosta, Georgia, and offers benefits such as healthcare insurance, 401(k) with match, and tuition reimbursement. #J-18808-Ljbffr