26 audit compliance coder jobs found

Department: 10407 Enterprise Revenue Cycle - Coding Production Operations: Inpatient Coding Operations Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Monday-Friday, Remote, Flexible Hours Remote position and can work remotely out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IN, IL, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY. Pay Range $30.15 - $45.25 EDUCATION/EXPERIENCE Minimum of five years' of coding experience in an academic medical center or an equivalent combination of coding experience and education with demonstrated competency of knowledge base. Coding QA background or similar experience preferred. Satisfactory completion of college level courses in anatomy, physiology and medical terminology preferred. EPIC health information system experience preferred. LICENSURE, CERTIFICATION,...

Job Posting This position is in the Health Information Management (HIM) section at the Durham VA Health Care System. The Medical Record Technician (Coder) Auditor is responsible for abstracting medical record data and assigning codes using current clinical classification systems appropriate for the type of care provided. Duties of the Auditor will include, but are not limited to: Serves as expert of current coding conventions and regulations related to professional and facility coding. Performs audits of encounters to identify areas of non-compliance in coding. Provides recommendations on appropriate coding and is responsible for maintaining current knowledge of the various regulatory guidelines and requirements. Works with staff to ensure that regulations are met or areas of weakness are identified and reported to appropriate supervisor for corrective actions. Performs prospective coding audits and utilizes results to identify processing inadequacies and re-educate coding...

Physician Compliance Auditor Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal...

Certified Professional Coder III As a Certified Professional Coder III, you will be part of a dynamic team of OBGYN coders supporting patient care by driving accuracy and adherence to coding guidelines, governmental and private third-party rules, and regulations. Helping Novant Health deliver the most remarkable patient experience, in every dimension, every time. What You'll Do: Perform monthly on-site visits to assigned clinics. Review surgical operative reports and abstract clinical diagnoses, procedure codes, and other pertinent information to bill appropriately for services. Ensure all technical aspects of the assignment of diagnostic and procedure coding are carried out in accordance with established standards and in compliance with CMS, NCQA, third party payers and other regulatory agencies. Ensure physicians are continually educated on correct coding techniques to maximize reimbursement. Communicate effectively via email, Microsoft Teams, and phone; actively...

Firsthealth Of The Carolinas FirstHealth of the Carolinas is a nationally recognized health care system located in central North Carolina. Comprised of four hospitals with more than 600 beds, the system also offers leading-edge heart care in the Reid Heart Center, the area's only dedicated heart and vascular center. Our growing health system has more than 6,200 employees serving in more than 75 locations throughout a 15-county service area. In addition, FirstHealth has received numerous accolades for its patient care and outcomes, including recognitions from Healthgrades, U.S. News & World Report, and Becker's Healthcare. At FirstHealth of the Carolinas, we believe in supporting our employees' professional growth and personal well-being. That is why we offer a comprehensive benefit package that is designed to help you thrive. Enjoy a free gym-membership to one of our 7 FirstHealth Fitness Centers to stay active and prioritize your health, take advantage of our educational...

The Medical Group Compliance Auditor Senior is responsible for providing audit, coding support and guidance to physicians, APPs, residents and support staff. This role ensures that all coding, billing and documentation complies with federal and/or state regulations, private payer health care program requirements as well as the Compliance and Operations Policies of the organization. This job assists with the development and implementation of educational and training programs as well as coding tools and resources to help achieve organizations goal of consistent, complete and accurate coding and documentation. Essential Job Function Capable of working independently to conduct regularly scheduled compliance reviews for assigned providers, practices, and focused review areas within designated time frames. Provides mentorship and guidance to the more junior Medical Group Compliance Auditor during the audit completion process. Performs Reviews clinical documentation to verify...

What We Offer Why This Role Matters As a Certified Professional Coder III, you will be part of a dynamic team of Surgical and E/M Coders supporting patient care by driving accuracy and adherence to coding guidelines, governmental and private Third-Party rules, and regulations. Helping Novant Health deliver the most remarkable patient experience, in every dimension, every time. What You'll Do: Schedule: Monday - Friday, daytime hours Perform monthly on-site visits to assigned clinics. Review surgical operative reports and abstract clinical diagnoses, procedure codes, and other pertinent information to bill appropriately for services. Ensure all technical aspects of the assignment of diagnostic and procedure coding are carried out in accordance with established standards and in compliance with CMS, NCQA, third party payers and other regulatory agencies. Ensure physicians are continually educated on correct coding techniques to maximize reimbursement....

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Certified Professional Coder III As a Certified Professional Coder III, you will be part of a dynamic team of Cardiovascular Coders supporting patient care by driving accuracy and adherence to coding guidelines, governmental and private third-party rules, and regulations. Helping Novant Health deliver the most remarkable patient experience, in every dimension, every time. This position requires monthly onsite visits to assigned clinics within the Charlotte, NC area. Location: Charlotte, NC region Schedule: Monday Friday, daytime hours What You'll Do: Perform coding of cardiovascular events (surgeries, procedures, office visits) Perform monthly on-site visits to assigned clinics Ensure all technical aspects of the assignment of diagnostic and procedure coding are carried out in accordance with established standards and in compliance with CMS, NCQA, third party payers and other regulatory agencies Functions include but are not limited to reviewing surgical operative...

Summary This position is in the Health Information Management (HIM) section at the Durham VA Health Care System. The Medical Record Technician (Coder) Auditor is responsible for abstracting medical record data and assigning codes using current clinical classification systems appropriate for the type of care provided. Responsibilities The duties of the Auditor will include, but are not limited to: Serves as expert of current coding conventions and regulations related to professional and facility coding. Performs audits of encounters to identify areas of non-compliance in coding. Provides recommendations on appropriate coding and is responsible for maintaining current knowledge of the various regulatory guidelines and requirements. Works with staff to ensure that regulations are met or areas of weakness are identified and reported to appropriate supervisor for corrective actions. Performs prospective coding audits and utilizes results to identify processing inadequacies and...

Help Ensure Accurate Care, Compliance, and Reimbursement Mercy Urgent Care is seeking a Medical Coding Specialist to support the integrity of our revenue cycle and ensure accurate, compliant coding for urgent care and occupational health services. This role is ideal for an experienced coder who enjoys accuracy, problem-solving, education, and collaboration within a fast-paced healthcare environment. You'll work closely with providers, billing, and revenue cycle teams to ensure documentation supports coding, payer requirements are met, and reimbursement is optimized-all while maintaining the highest standards of compliance. Role Overview The Medical Coding Specialist is responsible for reviewing clinical documentation, assigning appropriate medical codes, auditing for compliance, and supporting provider credentialing and enrollment with insurance payers. This role plays a critical part in revenue cycle operations by reducing denials, ensuring regulatory compliance, and...

Overview FirstHealth of the Carolinas is a nationally recognized health care system located in central North Carolina. Comprised of four hospitals with more than 600 beds, the system also offers leading-edge heart care in the Reid Heart Center, the area's only dedicated heart and vascular center. Our growing health system has more than 6,200 employees serving in more than 75 locations throughout a 15-county service area. In addition, FirstHealth has received numerous accolades for its patient care and outcomes, including recognitions from Healthgrades, U.S. News & World Report, and Becker's Healthcare. Employee Benefits At FirstHealth of the Carolinas, we believe in supporting our employees' professional growth and personal well-being. That is why we offer a comprehensive benefit package that is designed to help you thrive. Enjoy a free gym-membership to one of our 7 FirstHealth Fitness Centers to stay active and prioritize your health, take advantage of our...

Certified Professional Coder (CPC) Independent Contractor Remote Who We Are Constellation Quality Health is a non-profit health care quality consultancy and QIO-like Entity certified by Centers for Medicare and Medicaid Services (CMS) founded by physicians in 1983. Headquartered in North Carolina's Research Triangle, we offer an array of quality improvement, clinical review, audit, technical, and consulting services and solutions to improve care delivery, system performance, and patient outcomes. What You'll Do The Certified Professional Coder (CPC) is responsible for reviewing and comparing provider service documentation to billed claims in order to determine compliance with clinical policies, state and federal regulations. We expect you to: Perform reviews in a manner consistent with contract requirements for timeliness and accuracy. Our requirement for this role: Associate or bachelor's degree required in a human services field or five (5) years...

Core Responsibilities Code & Abstract: Assign ICD-10-CM (diagnoses) and CPT (procedures) codes from physician documentation and medical records. Documentation Review: Evaluate records for completeness, accuracy, and compliance with coding guidelines and payer policies. Billing & Revenue Cycle: Resolve billing edits, manage charge capture, prevent denials, and ensure proper service capture for accurate reimbursement. Physician Collaboration: Educate physicians on documentation standards and work with Clinical Documentation Improvement (CDI) specialists. Data & Reporting: Ensure accurate data for DRGs, quality outcomes, internal/external reporting, and regulatory compliance. Auditing & Training: Conduct internal audits, defend coding decisions, and provide training for Coder I/II roles. Key Requirements Certifications: CPC, CCS, RHIA, RHIT, or similar are required. Experience: Varies by role (e.g., 2+ years for Coder II, 5+ years for Coder III in acute care)....

Supervisor Certified Professional Coder Under the direction of the Revenue Cycle Manager, the Supervisor Lead Certified Professional Coder provides operational oversight, leadership, and supervisory support to the coding team and Lead Certified Professional Coder. This role ensures accurate, compliant, and timely coding and charge capture for physician services, while supporting workflow optimization, staff development, performance management, and quality assurance. The position serves as a key leadership layer to support team growth, scalability, and operational excellence. Primary Job Responsibilities/Tasks May Include, But Are Not Limited To: Provides direct supervision, mentorship, and daily operational oversight of the Lead Certified Professional Coder and coding staff. Supports staffing, scheduling, workload distribution, and productivity management. Assists with onboarding, training, coaching, and performance evaluations of coding staff. Promotes accountability,...

Ambulatory Surgery Center (ASC) Cardiology Coder MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and above all excellent customer service. MedHQ, LLC, is a 2022 Becker's Top 150 Places to Work in Healthcare company. We believe our quality of service begins with our quality of team member. We offer exceptional benefits and working environments to exceptional employees. Position Summary The Ambulatory Surgery Center (ASC) Cardiology Coder is responsible for accurately reviewing,...

Medical Coder Job Duties: Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Reviews and verifies documentation supports diagnoses, procedures and treatment results. Identifies diagnostic and procedural information. Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes. Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines. Follows coding conventions. Serves as coding consultant to care providers. Identifies discrepancies, potential quality of care, and billing issues. Researches, analyzes, recommends, and facilitates plan of action...

Medical Billing Specialist We are looking for a dedicated Medical Billing Specialist to join our team at a healthcare facility in Fayettevlle, North Carolina. In this long-term contract position, you will play a crucial role in managing billing processes and ensuring accuracy in financial transactions. This is an excellent opportunity for professionals with experience in medical billing who are eager to contribute to the smooth operation of a healthcare environment. Responsibilities: Process and submit medical claims to insurance providers with accuracy and efficiency. Verify patient insurance coverage and eligibility for services. Resolve billing discrepancies and follow up on unpaid claims to ensure timely payments. Maintain detailed records of financial transactions and patient accounts. Collaborate with healthcare providers to ensure proper coding and documentation for billing purposes. Respond to inquiries from patients and insurance companies regarding billing...

Experienced Multi-Specialty Surgery Coder The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours: Monday - Friday, working 40 hours a week Location: Fully Remote - U.S You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Provide coding and abstraction of physician or professional records Provide communications to Coordinator, Supervisors and Managers Complete RAI's, denials, charge hold reports, and coding edits Assist on special coding projects as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Virginia, South Carolina, Tennessee, Florida, and Texas. Occ Summary The medical coder specialist will have frequent and daily interactions with internal and external clients, including but not limited to physicians and...

Job Type Full-time Description We are looking for a detail-oriented, highly organized, and motivated Medical Billing Specialist to join our team! The Billing Specialist will play a critical role in ensuring accurate billing, timely claims submission, insurance follow-up, and patient account management for our growing multidisciplinary pediatric therapy practice. If you thrive in a fast-paced healthcare environment and enjoy supporting families in accessing care, we'd love to meet you! Requirements The Medical Billing Specialist will be responsible for managing the revenue cycle for therapy services, including Occupational Therapy (OT), Speech Therapy (ST), Physical Therapy (PT), Mental Health (MH), Psychology (PSY), and Applied Behavior Analysis (ABA). This position requires close attention to detail, knowledge of insurance billing practices (including Medicaid and private payers), and strong communication skills to work with families, therapists, and payers to ensure...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Virginia, South Carolina, Tennessee, Florida, and Texas. Occ Summary The Medical Coder Specialist will have frequent and daily interactions with internal and external clients, including but not limited to physicians and...

Job Description Job Description Description: Full Time, Remote Exempt / Salary Organization High Country Community Health (HCCH) is a federally funded Community and Migrant Health Center with medical locations in Watauga, Avery, Burke, and Surry Counties. The mission of HCCH is to provide comprehensive and culturally sensitive primary health care services that may include dental, mental and substance abuse services to the medically under-served population of Watauga, Avery, Burke, and Surry Counties and the surrounding rural communities. Supervisory Relationship: Reports to: Deputy CFO Job Summary and Responsibilities Provides thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and patient complexity of care. Utilizes knowledge of official coding guidelines, HCC standards, Risk Adjustment Factor (RAF)...

Job Description Position Summary The coding auditor is responsible for ensuring the integrity of inpatient and/or outpatient medical records by auditing them to confirm that clinical documentation accurately supports the diagnosis, CPT and/or DRG assigned. This position requires a detailed understanding of medical coding principles, coding guidelines, coding clinics, CPT Assistant and the ability to perform objective medical audits. The auditor will conduct audits drawing on advanced ICD-10 and CPT coding expertise, and coding guidelines to substantiate their recommendations. In this role, the auditor will review accounts flagged by Streamline, eValuator and provide recommendations if determined necessary. The auditor will also be responsible for identifying potential trends and educational opportunities. The coding auditor will also conduct focus reviews as determined by the coding manager. The auditor must be task oriented and have strong ability to work independently...