65 billing and coding auditor jobs found

Job Title Healthcare Compliance Auditor Job Description This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Essential Functions Conduct prospective and retrospective chart reviews comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings and recommendations to compliance and...

Data Quality Auditor Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). IP, OP Coding: Reviews medical records for the determination of accurate assignment of all documented ICD-10-CM codes for diagnoses and procedures. Abstracts accurate required data elements (facility/client specific elements) including appropriate discharge disposition....

Position Description The Documentation and Coding Auditor supports the billing compliance program by helping prevent, detect, and respond to billing, coding, reimbursement, and documentation risks. This role conducts proactive monitoring, auditing, education and risk assessment activities while also responding to identified concerns, audit findings, regulatory changes, and reported compliance issues. Major/Essential Functions Plan and perform proactive compliance activities, including risk-based audits, pre-bill or concurrent reviews, data monitoring, targeted education, policy or template reviews, and department consultations. Identify and address billing compliance risks before issues escalate by using audit trends, payer updates, denial patterns, regulatory changes, stakeholder feedback, and risk assessment results. Partner with departments before new services, workflows, locations, provider groups, or documentation tools are implemented to assess and reduce...

Job Summary (Par time-Potential for Fulltime) The Certified ER Medical Coding Auditor is responsible for auditing emergency department medical records to ensure accurate coding, compliance, and optimal reimbursement. This role also includes training and mentoring offshore coding teams to maintain high-quality standards and consistency across operations. Key Responsibilities Audit ER charts for accurate assignment of ICD-10-CM, CPT, and HCPCS codes Validate E/M level selection for emergency department visits Ensure compliance with payer guidelines and regulatory standards (CMS, HIPAA) Identify under coding, over coding, and documentation deficiencies Prepare detailed audit reports with corrective recommendations Provide education and feedback to coders and providers Train and mentor offshore coding teams on ER coding guidelines and audit findings Conduct regular quality review sessions and calibration meetings with offshore staff Develop and update...

Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: • Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to...

Extended Job Title Documentation & Coding Auditor Position Description Performs medical billing coding and documentation quality audits; provides feedback to coding and reimbursement specialists, coders, and educates them. This job has no supervisory responsibilities. Requisition ID 42210BR Travel Required Up to 25% Pay Grade Maximum Compensation is commensurate upon the qualifications of the individual selected. Major/Essential Functions Current and active professional medical billing coding certification required from an accredited organization. Billing and coding experience in a multi-specialty group practice and/or academic practice setting is preferred. Five or more years of health care items/services. Managerial/supervisory and program management implementation experience strongly preferred. Ability to initiate administrative activities as necessary. Excellent oral and written communication skills. Ability to write and present ideas and information in a...

Documentation & Coding Auditor Performs medical billing coding and documentation quality audits; provides feedback to coding and reimbursement specialists, coders, and educates them. This job has no supervisory responsibilities. Travel Required: Up to 25% Pay Basis: Hourly Location: Amarillo Shift: Day Major/Essential Functions Current and active professional medical billing coding certification required from an accredited organization. Billing and coding experience in a multi‑specialty group practice and/or academic practice setting is preferred. Five or more years of health care items/services. Managerial/supervisory and program management implementation experience strongly preferred. Ability to initiate administrative activities as necessary. Excellent oral and written communication skills. Ability to write and present ideas and information in a concise manner. Ability to work collaboratively with all individuals. Professional bearing, sound business judgment...

The Texas Tech University Health Sciences Center is seeking a Documentation & Coding Auditor to conduct medical billing coding and documentation quality audits. In this role, you will provide essential feedback to coding specialists and work collaboratively within the team. This position requires strong problem-solving skills and an active professional coding certification. An ideal candidate will have at least five years of experience in medical billing coding and reimbursement, along with knowledge in CPT, ICD-CM, and related coding systems. You will also be responsible for participating in compliance symposiums and conducting annual risk assessments. #J-18808-Ljbffr

## CPC-A Certified Coder RepresentativeApplylocations: San Antonio, Texas, USA - Remotetime type: Full timeposted on: Posted Todaytime left to apply: End Date: August 31, 2026 (30+ days left to apply)job requisition id: R\_2606\_7783**About TaskUs:** TaskUs is a provider of outsourced digital services and next-generation customer experience to fast-growing technology companies, helping its clients represent, protect and grow their brands. Leveraging a cloud-based infrastructure, TaskUs serves clients in the fastest-growing sectors, including social media, e-commerce, gaming, streaming media, food delivery, ride-sharing, HiTech, FinTech, and HealthTech.The People First culture at TaskUs has enabled the company to expand its workforce to approximately 45,000 employees globally. Presently, we have a presence in twenty-three locations across twelve countries, which include the Philippines, India, and the United States.It started with one ridiculously good idea to create a different...

Description Summary: The Compliance Auditor II will assist in the overall quality, compliance, and auditing activities to ensure compliance of standard operating procedures, corporate policies, industry standards, and applicable federal and state laws. Conducts audit activities, reporting and communicates audit findings. Works in conjunction with Compliance Director on compliance work plans, internal and external audits and reviews, and provides assurance that the organization is operating in an efficient and effective manner. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Manages compliance audit activities pertaining to compliance and coordinates with Corporate Compliance Director and Senior Leadership as it relates to such audits Responsible for answering inquiries related to professional documentation, coding, and billing regulatory requirements. Work with VP/Senior/Manager/Director on...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Position is responsible for leading multiple reviews / audits of healthcare coding, billing, documentation, operations, and related risk areas to support compliance with regulatory standards, internal policies and procedures, and other guidelines. Typically reports to Director, Corporate Compliance. Job Description Location : Memorial Hermann, Memorial City Status :...

Description Providence is calling for Compliance Auditor - Remote The Revenue Cycle Compliance Hospital Auditor conducts audits to evaluate compliance with a wide variety of Federal and State laws, regulatory rules & regulations, PSJH policies and procedures. Areas of audit focus for this position may involve clinical and non-clinical services, including but not limited to revenue cycle: Rev Cycle departments, Rev Cycle Billing Offices, External Vendor; HIM Coding, Revenue Integrity RI, Chargemaster CDM, EPIC, and Clinical Documentation CDT. This position works collaboratively with Case Management, Utilization Review, Revenue Integrity, our PB Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs and Finance under the supervision of the Rev Cycle Compliance Senior Manager. The Revenue Cycle Compliance Hospital auditor navigates and analyzes data across both the Clinical EMR and Epic Billing systems. This includes reviewing...

The Medical Coder is responsible for assigning procedure and diagnosis codes for insurance billing, reviewing claims data, researching medical records, and corresponding with insurance companies to secure accurate reimbursement for healthcare claims. Duties include but are not limited to: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims Adhere to coding policies and procedures consistent with industry-standard guidelines for CPT, ICD-9 and ICD-10 Answer coding questions Review clinical documentation to ensure it meets the level of CPT codes, ICD-10 and ICD-11 codes Perform related duties as...

Position Description Provides day-to-day supervision and support to the coding team responsible for outpatient, in-patient, and clinic-based services across Texas Tech Physician clinics. This role ensures coding accuracy, compliance with regulatory requirements, and timely encounter completion to support revenue cycle integrity and organizational goals. The supervisor serves as a working leader who performs coding and/or auditing functions while supervising team members, monitoring productivity and their quality performance. This position works collaboratively with the Coding Manager, Compliance, and Revenue Cycle teams to implement policies, resolve coding-related issues, and promote consistent application of coding standards across multiple specialties and oversees a staff. Major/Essential Functions Supervise daily operations and employees on your team of the centralized ambulatory coding team, ensuring timely and accurate coding of outpatient encounters. Monitor...

The Medical Coder to assign procedure, diagnosis codes for insurance billing, review claims data, research and correspond with insurance companies in an effort to obtain accurate reimbursement for healthcare claims. Duties include but are not limited to: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims Adhere to coding policies and procedures consistent with the industry-standard guidelines for CPT, ICD-9 and ICD-10. Answer coding questions Review clinical documentation to ensure it meets the level of CPT codes, ICD-10 and ICD-11 codes Performs related duties,...

Under general supervision of the Director, the Coder II provides consistency and efficiency in outpatient claims processing and data collection to optimize APC reimbursement and facilitate data quality in outpatient services.  Reviews, audits, and reports on charge capture. Maintains patient confidentiality at all times. ESSENTIAL JOB FUNCTIONS Every effort has been made to make this job description as complete as possible.  However, it in no way states or implies that these are the only duties the incumbent will be required to perform.  The omission of specific statements of duties does not exclude them from the position if the work is similar, related or is a logical assignment to the position. Analyzes IP, OP, Recurring, & SDC records and appropriately codes per coding guidelines, ICD-10-CM and CPT rules and updates, creating APC or DRG group assignments. Queries physicians when code assignments are not straightforward or documentation in the record is...

Certified Professional Coder Think of yourself as someone who will provide world-class service to our customers or clients in an accurate, efficient, and respectful manner on every call as measured by different performance metrics, so not everyone can qualify for this role. We make sure we get the best of the best, after all, we are a ridiculously good company so we make sure our employees are top-notch. So come on, now we need your full concentration because it's time to imagine what it's like being a Certified Professional Coder. As a Certified Professional Coder you will... Audit charts to ensure accurate ICD-10 CM and CPT code assignment as well as documentation integrity to prevent claim denials. Use critical and logical thinking skills in chart-auditing based on the guidance set forth by the client. Uphold netiquette and professionalism in any interaction with the TaskUs team, other vendors and the client. Job Summary: The CPC will be responsible for reviewing...

Job Opportunity At Memorial Hermann At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Description Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data integrity and validation of the coded information for external and internal affairs. This position typically reports to the Coding Compliance Manager. Minimum Qualifications Education: High school...

Risk Adjustment Coder II The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization. Job Specifications and Core Competencies: Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions, utilizing ICD-10 coding guidelines for Commercial and Medicare risk...

Medical Coder Multi-Specialty (Hospital & Clinic) Location: Kingwood or Remote Employment Type: Full-Time Reports To: Revenue Cycle Manager Position Summary We are seeking a highly skilled, detail-driven, and high-producing certified medical coder with multi-specialty experience to join our growing healthcare organization. This role requires strong proficiency in both hospital and outpatient clinic coding, with specialty expertise in: Cardiology Urology Dermatology General Surgery Pulmonology The ideal candidate has 2+ years of coding experience, maintains current certification (AAPC or equivalent), and consistently demonstrates accuracy, productivity, and strong clinical understanding across multiple service lines. This is a high-impact role within a performance-driven, collaborative organization focused on compliance, precision, and revenue integrity. Core Responsibilities Coding & Documentation Review Accurately assign ICD-10-CM, CPT, and HCPCS Level...

HIM/Medical Records Analyst/Coding Specialist Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility is fully accredited and included a 16-bed residential treatment center for adult chemical dependency. We offer a broad range of behavioral health programs for children, adolescents and adults. Treatment is offered at multiple levels of care including inpatient, partial hospitalization and intensive outpatient. The hospital is easily accessible off the Southwest Freeway near the Galleria. West Oaks Hospital is seeking a dynamic and talented HIM/Medical Records Coding Specialist to join our team of compassionate, dedicated professionals. The HIM/Medical Records Coding Specialist will be responsible for assigning diagnostic and procedures codes and abstracts data to outpatient and/or inpatient encounters based upon documentation within the medical record while maintaining...

Job Summary JOB SUMMARY The primary purpose of the SPEC, PHYS SVC CODING II is to code physician charges by assigning ICD-10, CPT, HCPCS codes and modifiers from medical record documentation. Must have the ability to utilize multiple resources to support code assignment. Must possess knowledge on how to resolve coding denials and pre-bill coding edits. Productivity and accuracy are measured via internal audits and must be maintained. Level II roles include but are not limited to evaluation and management coding, radiology, and emergency department coding. ESSENTIAL DUTIES AND RESPONSIBILITIES Assign ICD-10, CPT, HCPCS and modifiers codes from documentation Review and appropriately resolve pre-bill edits Review and appropriately resolve coding denials Meet or exceed productivity standards Meet or exceed accuracy rate of 95.5% in monthly internal audits Effectively present coding issues to internal team members, internal clients, or external clients Deliver...

Job Title This is a full-time position. The first two weeks require in-office training, after which the role is remote, except for monthly office meetings. The hours will be Monday-Friday 8:30am-5pm with a 30 minute lunch. Job Description Review, analyze, and input clinic claim codes (ICD-9/ICD-10, HCPCS, CPT) based on EMR records, ensuring proper modifiers and documentation. Educate and consult with physicians and nursing staff on coding practices, ensuring accurate and thorough clinical documentation. Stay current with updates on medical treatments, procedures, diagnosis classifications, payer updates, and coverage changes, and communicate relevant information to providers, supervisors, and the billing team. Use coding manuals and software to ensure proper code selection and compliance with industry standards, including HIPAA, AHIMA, and AAPC ethical guidelines. Enter coded data into EHR or practice management systems for billing accuracy and maintain organized, accurate...