28 auditor jobs found

Job Description Job Description Health Ministries Clinic (HMC) is seeking a Coding Auditor as a trusted expert to join our integrated care team in Newton, Kansas. This is a full-time, on-site position offering the opportunity to support patient care in a collaborative, mission-driven environment. At Health Ministries Clinic, we offer more than just primary care with a full spectrum of services including behavioral health, lab, diagnostic, pharmaceutical and dental. We are seeking an experienced Coding Auditor with a multi-speciality coding background. The Coding Quality Auditor is responsible to ensure Health Ministries Clinic's compliance with national coding guidelines, FQHC coding guidelines and regulations. The Coding Auditor plays a crucial role in minimizing coding errors and preventing fraudulent activities. The Coding Auditor is responsible to ensure accurate and consistent coding which results in appropriate reimbursement and data integrity. This role requires...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

Become a part of our caring community and help us put health first 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. 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...

A leading health insurance company is seeking an Inpatient Medical Coding Auditor to review hospital claims from home. The role requires expertise in medical coding and a deep understanding of claims processing. Responsibilities include ensuring accurate payments and handling provider disputes in a metrics-driven environment. Candidates should have relevant certifications and coding experience. The position offers competitive pay, a bonus incentive plan, and comprehensive benefits, promoting a focus on health and wellness for both employees and consumers. #J-18808-Ljbffr

Kansas City KA Vendor Compliance Auditor Monday-Friday 5:30 am-until Finish Potential to earn over $760 paid weekly JOB SUMMARY: This role is responsible for auditing the quality of incoming loads, ensuring compliance with established standards, and identifying any deviations. SUPERVISORY RESPONSIBILITIES: None ESSENTIAL FUNCTIONS: Responsibilities: Observe the quality of loads on arrival Review loads for violations Identify and document root causes through tablet procedures Communicate violations by gathering up to 30 photographs using multiple angles if necessary Validate information prior to reporting violations QUALIFICATIONS: education and/or experience: High school diploma knowledge, skills and abilities: Demonstrated interpersonal and communication skills (written and verbal) Attention to detail Familiarity with pallet building standards Demonstrated commitment to safety standards physical...

DRG Coding Auditor Principal This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case...

Shift: Monday-Friday 5:30 am-until Finish Potential to earn over $760 paid weekly Compensation: Potential to earn over $760 paid weekly Kansas City KA Vendor Compliance Auditor Monday-Friday 5:30 am-until Finish Potential to earn over $760 paid weekly JOB SUMMARY: This role is responsible for auditing the quality of incoming loads, ensuring compliance with established standards, and identifying any deviations. SUPERVISORY RESPONSIBILITIES: None ESSENTIAL FUNCTIONS: Responsibilities: Observe the quality of loads on arrival Review loads for violations Identify and document root causes through tablet procedures Communicate violations by gathering up to 30 photographs using multiple angles if necessary Validate information prior to reporting violations #CB Capstone Logistics, LLC is part of The Transportation and Logistics industry which has been designated a "Critical Infrastructure Segment". As a "critical infrastructure industry" worker in the Transportation and Logistics...

Anticipated End Date 2025-04-21 Position Title Registered Nurse - Diagnosis Related Group (DRG) Coding Auditor Principal - Carelon Payment Integrity Job Description Registered Nurse - Diagnosis Related Group Coding Auditor Principal - Carelon Payment Integrity. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Related Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company and its clients. Specializes in review of DRG coding via medical records and attending physician's statements provided by acute care hospitals on paid DRG, especially on very complex coding cases. Location Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. How you will make an impact Analyzes and...

A leading healthcare company is seeking a Registered Nurse - DRG Coding Auditor Principal. In this role, you'll audit medical records for claims compliance and recovery while utilizing your advanced coding expertise. Candidates should possess substantial experience in claims auditing and relevant certifications. The company offers a hybrid work model, with a comprehensive benefits package and competitive salary ranging from $113,772 to $215,568 based on qualifications and experience. #J-18808-Ljbffr

Overview Health Ministries Clinic (HMC) is seeking a Coding Auditor (with PCP auditing experience) as a trusted expert to join our integrated care team in Newton, Kansas. This is a full-time, on-site position offering the opportunity to support patient care in a collaborative, mission-driven environment. We provide a full spectrum of services including behavioral health, lab, diagnostic, pharmaceutical and dental. We are seeking an experienced Coding Auditor with a multi-speciality coding background. The Coding Quality Auditor is responsible for ensuring Health Ministries Clinic's compliance with national coding guidelines, FQHC coding guidelines and regulations. The role minimizes coding errors and prevents fraudulent activities, ensures accurate and consistent coding which results in appropriate reimbursement and data integrity. This role requires the ability to detect and correct discrepancies and coding errors, provide feedback and collaborate across departments to correct...

A community health center in Newton, Kansas is seeking a Coding Auditor to join their team. This full-time, on-site position involves ensuring compliance with coding guidelines and minimizing errors. The ideal candidate will have expertise in ICD-10, CPT, and HCPCS codes, along with strong analytical skills. The clinic fosters a supportive environment with a focus on patient care and offers competitive benefits including medical insurance and retirement plans. #J-18808-Ljbffr

A health information management provider is seeking Remote Outpatient & Surgery Coding Auditors. Candidates must have at least 3 years of medical coding auditing experience, preferably with VA, and should be able to communicate effectively. The role offers flexibility within a Monday–Sunday work week and requires applicants to be U.S. citizens. Those with an active VA Contractor’s Citrix Access Account, or relevant coding credentials from recognized associations, may have a chance at our Signing Bonus Program. #J-18808-Ljbffr

Job Description Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Seeking RN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Hybrid or Remote Job Responsibility Leverages clinical expertise to identify and validate DRG code assignment. Full review of CDI suggested code changes. Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. Applies coding rules and regulations to the validation review process. Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. Communicates DRG changes and rationale to the coding and CDI staff. Identifies appropriate coding changes...

A healthcare facility in Lawrence, KS seeks an Audit and Compliance Specialist to ensure accurate coding and billing practices. This role includes conducting compliance audits, training staff on documentation, and collaborating to enhance healthcare operations. Ideal candidates will have extensive coding experience and relevant certifications. The position offers competitive pay and benefits, fostering a culture of healthy communities. #J-18808-Ljbffr

A leading health data platform company is seeking an Inpatient Auditing Specialist to perform coding audits and provide education. The ideal candidate should have over 5 years of inpatient coding experience with expertise in MS-DRG and APR-DRG coding. This fully remote role offers a flexible schedule and a supportive work environment with comprehensive benefits. Competitive pay offered between $35 and $45 per hour. #J-18808-Ljbffr

A leading health data exchange company is seeking a Profee Auditing Specialist to perform coding audits and ensure compliance. This fully remote role offers flexibility and requires extensive coding experience. Key responsibilities include auditing medical records and providing coder education. Ideal candidates will have their CPC certification and a commitment to excellence in healthcare data quality. #J-18808-Ljbffr

A healthcare organization in Kansas is seeking a professional for a full-time medical coding position. You will be responsible for auditing and abstracting medical records to identify and submit ICD codes, ensuring compliance with regulations. The ideal candidate will have at least 1 year of experience, necessary certifications, and proficiency in Microsoft Office. This role offers competitive pay ranging from $18.50 to $42.35 per hour, along with comprehensive benefits. #J-18808-Ljbffr

Job Type Full-time Description *Required to work on-site in Manhattan, KS* Position Summary: The Medical Billing and Coding Specialist processes insurance claims, invoices and payments ensuring medical information and patient data is accurately communicated between patients, physicians, and third-party payers. They use medical coding protocols to create claims or statements. Essential Functions: Transcribe patient information into medical codes and ensures the accuracy of the codes and medical reports Prepare and submit claims for payment, follow up on unpaid claims and correct rejected claims Prepare and send invoices for remaining balances Track outstanding payments and follow up with patients and insurance companies about outstanding bills. Communicate with medical providers, insurance companies and patients Verifies insurance coverage and eligibility and communicates with insurance companies. Correct rejected claims and re-submit as needed....

A leading healthcare institution in Lenexa is seeking a Physician Coder to review and audit outpatient and inpatient EHR for accurate billing. This role involves maintaining coding accuracy and collaborating with healthcare providers regarding coding practices. Candidates should have a high school diploma or GED and ideally possess an associate's degree in Health Information Management along with CPC certification. The position offers full-time employment in a supportive healthcare environment. #J-18808-Ljbffr

Position Title Physician Coder Remote Position Summary / Career Interest The HIM Outpatient Surgery / Ambulatory Coder is responsible for reviewing outpatient / inpatient EHR. This position monitors CPT, ICD-10, and HCPCS code changes. Audits and / or assigns codes (CPT, HCPCS, and diagnosis) for professional and hospital accounts for Primary Care / Medical Specialty / Simple Procedural services from clinical documentation for accurate professional billing and facility APC assignment. The HIM Outpatient Surgery / Ambulatory Coder is a resource for the physicians and other health care providers in regard to coding and to review medical documentation to insure appropriate physician and facility coding and billing. Responsibilities and Essential Job Functions Reviews outpatient / inpatient EHR for appropriate documentation and signatures, and reviews interface charges prior to billing. Reviews departmental reporting structures and requests modifications as needed, i.e. adding...

Company 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, interpreting, and coding outpatient cardiology and...

ASC–CIRCC Certified Coder (Cardiovascular / Interventional Radiology) Department: Revenue Cycle / Business Office Reports To: Revenue Cycle Manager FLSA Status: Non-Exempt Location: Remote Position Summary The ASC–CIRCC Certified Coder is responsible for accurately assigning CPT®, ICD-10-CM, and HCPCS codes for cardiovascular and interventional radiology procedures performed in an ambulatory surgery center (ASC) or hospital outpatient setting. This role ensures compliant coding, appropriate reimbursement, and adherence to federal, state, and payer regulations. The coder works closely with physicians, clinical staff, billing teams, and compliance personnel to support revenue integrity and audit readiness. Key Responsibilities Assign accurate CPT®, ICD-10-CM, and HCPCS Level II codes for cardiovascular and interventional radiology procedures Apply correct modifiers in accordance with payer and regulatory guidelines Review operative reports, procedure notes, and supporting...

Job Description Job Description Join KVC Hospitals as a Medical Coding Specialist Work wellbeing score of 82 on Indeed – where your career and purpose align Are you an expert in medical coding with a passion for precision and compliance? KVC Hospitals is seeking a Medical Coding Specialist to lead our coding initiatives, maximize billing opportunities, and ensure documentation accuracy across our hospital network. This role is vital to maintaining financial health while upholding our commitment to quality care and regulatory compliance. Why KVC? At KVC, we value our people. Our work wellbeing score of 82 on Indeed reflects our dedication to creating a positive, supportive, and purpose-driven workplace. You’ll join a team that embraces innovation, respects diversity, and works collaboratively to make a real difference in the lives of children and families. Key Responsibilities Serve as the subject matter expert on medical coding for KVC Hospitals...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We’re Looking For We’re looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this...