18 certified coder auditing jobs found

CVS Health is seeking a Certified Professional Coder (CPC) to review medical records and ensure coding accuracy across multiple payer types. The role emphasizes meticulous documentation, adherence to CPT/HCPCS guidelines, and clear communication of findings to diverse stakeholders. Candidates should have 3+ years of coding or auditing experience, a CPC certification, and strong Excel skills. Travel for meetings and potential testimony may be required. #J-18808-Ljbffr

Schedule PRN - Day - Monday through Friday Reports to the Manager. Reviews, codes, and analyzes medical records for cardiovascular and interventional procedures performed in the cardiovascular/OR areas in order to abstract relevant data from patient medical records into the on-line computer system. Assigns CPT/APC billing codes to Medicare, Medicaid, and other required payors. Determines DRG and APC assignment on outpatient and inpatient records. Maintains productivity and accuracy levels for the assigned job code. Considered to be a single point of accountability to cardiovascular coding and billing. MISSION, VALUES and SERVICE GOALS MISSION: We deliver outstanding care, inspire health, and connect with heart. VALUES: Trust. Respect. Integrity. Compassion. SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team. Maintains the single point of accountability function to cardiovascular coding and billing to ensure that all claims are submitted accurately to the...

Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. Responsible for the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience. 2. Certification in ONE of the following: Registered Health Information...

Medical Device Coder In Some Jobs You Take Orders. In This One, You Write History. Join the healthcare information technology team that's turning drug and medical device data into knowledge used by thousands of hospitals; the majority of U.S. health plans, retail pharmacies, and pharmacy benefit managers; and millions of healthcare decision makers throughout the world. Partnering with our information system developer and healthcare institution customers, you'll help evolve leading-edge thinking into reality and make a measurable difference in improving human health. We're looking for people who are: Intelligent. Productive. Committed. Willing and able to go above and beyond. Passionate about making a difference. Innovative. Energized. And want to play an essential role in a successful company's continued growth. Are you ready for this exciting challenge? First Databank (FDB) is currently seeking a Medical Device Coder in the Quality department. This position is...

Datavant, a data collaboration platform for healthcare, is seeking a Profee Auditing Specialist. The role is fully remote with a flexible schedule, ideally ~20 hours/week, and focuses on professional fee coding audits across medical records, offering education and regulatory updates within a healthcare data environment. Candidates should have 5+ years of coding/auditing experience, CPC certification, and familiarity with EMR systems like Epic or Cerner. #J-18808-Ljbffr

Location: Indianapolis, Indiana, United StatesSalary: $92,880 - $160,218Company: Elevance HealthPosted: 2026-10-06Sign On Bonus: $1,500; paid in two installments: $500 at the time of hire and $1,000 after one year of service.DRG Coding Auditor - MS-DRG and APR-DRGVirtual: 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 if candidates reside within a commuting distance from an office.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.The DRG Coding Auditor is responsible for auditing inpatient medical records and...

Perm - Remote - Hospital Inpatient Coder As a permanent, remote Hospital Inpatient Coder, you will be responsible for accurately coding inpatient medical records, ensuring compliance with coding guidelines, and collaborating with healthcare professionals to maintain data integrity, all while working from home. Essential Job Functions: Assign ICD10CM and PCS codes to hospital inpatient visits Reviews and analyzes the content of medical records and the autosuggested computer assisted codes (CAC) for the appropriate assignment of ICD diagnosis/procedure codes, present on admission indicators, hierarchical condition categories, complication and comorbidities in the proper sequence in accordance with official coding resources resulting in an accurate DRG assignment. Meets 95% accuracy rate in audits Maintains productivity of 2.75 charts per hour after release from training period. Data Analysis- Hospital Inpatient Coding Accurately reviews and codes patient records in the...

Reports to the Manager, Coding & Records. Reviews, codes, and analyzes medical records in order to abstract relevant data from patient medical records into the on-line computer system. Assigns DRGs to Medicare, Medicaid, and other required payors. Determines DRG and APC assignment on outpatient and inpatient records. Maintains productivity and accuracy levels for the assigned job code. MISSION, VALUES and SERVICE GOALS MISSION: We deliver outstanding care, inspire health, and connect with heart. VALUES: Trust. Respect. Integrity. Compassion. SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team. Reviews and analyzes discharged patient medical records to ensure all applicable patient data is available for coding and abstracting by: Checking the diagnosis and procedure to ensure accurate coding and sequencing as specified by established coding principles and guidelines, following AHA, AHIMA, and CMS coding guidelines for outpatient and inpatient...

Certified Coding Analyst We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The Certified Coding Analyst will perform medical claim reviews for waste and error to ensure compliance with coding practices through a comprehensive record review for medical and institutional providers. The Analyst must have the ability to determine correct coding and appropriate documentation during the review of medical records. The Analyst must also ensure state; federal and company requirements are met. Conduct a comprehensive medical record audit to ensure the CPT/HCPCS or modifiers billed are consistent...

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Activities include: Conduct a...

Join to apply for the Certified Coding Auditor (2506830) role at Community Health Network Your role The Certified Coding Auditor aims to enhance documentation, specificity, and coding precision to ensure continuity of care and clean claims for appropriate reimbursement. What you’ll do Review coding accuracy Apply coding updates Adhere to coding guidelines Documentation requirements for both facility and professional coding Draft audit findings to communicate audit scope, methodologies, results, and identified trends to Coding Leadership Remember that individuals may perform additional related duties not listed here. What we’re looking for High School Diploma or GED (Required) Vocational / Technical Degree (Preferred) Associate Degree (Preferred), Bachelor’s Degree (Preferred) Certifications: Certified Coding Specialist (CCS) OR Certified Procedural Coder (CPC) (Required) AAPC CPMA certification is preferred 3+ years medical coding experience with knowledge of...

We're building a world of health around every individual – shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The Certified Coding Analyst will perform medical claim reviews for waste and error to ensure compliance with coding practices through a comprehensive record review for medical and institutional providers. The Analyst must have the ability to determine correct coding and appropriate documentation during the review of medical records. The Analyst must also ensure state; federal and company requirements are met. Conduct a comprehensive medical record audit to ensure the CPT/HCPCS or modifiers billed are consistent with medical record documentation....

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:...

Sign On Bonus: $1,500; paid in two installments: $500 at the time of hire and $1,000 after one year of service. DRG Coding Auditor - MS-DRG and APR-DRG Virtual: 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 if candidates reside within a commuting distance from an office. 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. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of...

Perm - Remote - Hospital Inpatient Coder OOJ - 35267 job at Hatch Global Search. Mishawaka, IN. Job Description As a permanent, remote Hospital Inpatient Coder, you will be responsible for accurately coding inpatient medical records, ensuring compliance with coding guidelines, and collaborating with healthcare professionals to maintain data integrity, all while working from home. Perm - Remote - Hospital Inpatient Coder Essential Job Functions: Assign ICD10CM and PCS codes to hospital inpatient visits Reviews and analyzes the content of medical records and the autosuggested computer assisted codes (CAC) for the appropriate assignment of ICD diagnosis/procedure codes, present on admission indicators, hierarchical condition categories, complication and comorbidities in the proper sequence in accordance with official coding resources resulting in an accurate DRG assignment. Meets 95% accuracy rate in audits Maintains productivity of 2.75 charts per hour after release from training...

First Databank (FDB) seeks a Medical Device coder for the Quality department in Carmel, IN, focusing on HCPCS coding research and content accuracy. You will leverage AI tools with supervision to ensure robust medical device data and mappings. The role requires 2–3 years of medical coding experience, CPC/COC/CCS credentials, and familiarity with CMS LCDs/NCDs, GMDN, and UNSPSC. Hybrid work onsite three days weekly with strong auditing responsibilities. #J-18808-Ljbffr

Registered Nurse - Diagnosis Related Group Coding Auditor Principal – Carelon Payment Integrity 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. 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 rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, 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,...

ResponsibilitiesEvaluates coding based on Coding Guidelines.Reviews records for all care settings.Identifies high volume, high risk coding, and reimbursement and quality problems.Responsible for accurate assessment, analysis and summary of findings for coding validation.Provide auditing and feedback that is incorporated into training education programs.This position offers a fully remote work opportunity.Employees in this role must reside in one of the following states to be considered for fully remote positions :Kentucky, Indiana, Missouri, Ohio, Tennessee, Alabama, Virginia, Mississippi, North Carolina, South Carolina or Louisiana.QualificationsRequired :One year coding in healthcare settingOne of :CCA or CCS or CPCDesired :DiplomaCertified Coding Associate OR Certified Coding Specialist OR Certified Professional CoderJ-18808-Ljbffr.