8 certified coder auditing jobs found

Senior Medical Coding Analyst CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix's autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. Reporting to the Senior Manager, Medical Coding & Audit, as a Senior Medical Coding Analyst, this role will be a key member of the team responsible for ensuring that CodaMetrix meetsand exceedsour customers' coding quality expectations. They will leverage their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency of coding...

CVS Health in New Hampshire is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit, ensuring coding accuracy and compliant documentation across medical, behavioral, transportation and other healthcare services. The role requires CPC certification, 3+ years of coding or auditing, and strong knowledge of CPT/HCPCS/ICD-10, CMS 1500/UB04, plus proficiency with Excel and Word. #J-18808-Ljbffr

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 Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) 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. Conduct a...

Professional Fee Cardiology / Cardiac Cath Coder - On-Site Healthcare Coding Job in Cambridge, Massachusetts We are seeking an experienced Professional Fee Cardiology / Cardiac Cath Coder for a full-time on-site healthcare opportunity supporting complex cardiology, vascular surgery, and cardiac catheterization coding services. This position is ideal for a detail-oriented coding professional with strong knowledge of professional fee coding, CPT and ICD-10-CM coding, and compliance standards. Located in Cambridge, Massachusetts 02138, this opportunity offers the chance to work in one of the nation's most respected healthcare and academic hubs, known for innovation, world-class medicine, and a vibrant New England setting. Job Details Employment Type: Full-time on-site contract Weekly Estimated Pay: $1310-$1560 Start Date: 6/10/2026 Duration: 46-week contract with potential for long-term opportunity Schedule: 5 shifts per week Shift Duration:...

Humana Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. The role involves assigning ICD-10-CM, ICD-10-PCS, and DRG codes and ensuring accurate payments. Remote position with occasional travel to Humana offices, 40 hours per week, pay range $71,100-$97,800 with bonus eligibility. Requires 4+ years in MS-DRG coding auditing and RHIA/RHIT/CCS certification. #J-18808-Ljbffr

Physician Specialty Coder | Boston Childrens Hospital At Boston Children's Hospital, the quality of our care and our inclusive hospital working environment lies in the diversity of our people. With patients from local communities and 160 countries around the world, we're committed to reflecting the spectrum of their cultures while opening doors of opportunity for our team. Here, different talents pursue common goals. Voices are heard and ideas are shared. Join us and discover how your unique contribution can change lives. Yours included. Position Summary: The Physician Specialty Coder works independently to manage complex coding review, validation, and charge submission processes for assigned specialty departments. Specifically Surgical Coding. This role ensures accurate and compliant ICD-10, CPT, and/or ASA coding while partnering closely with physicians, billing teams, and operational staff to resolve coding and reimbursement issues. The position also serves as a resource for...

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...

Position Summary Performs coding validation and review of charges for assigned medical departments to ensure timely and compliant submission of charges. Assigns, sequences, validates, and/or edits codes for assigned medical departments. Initiates, reviews, and/or edits physician queries in compliance with company policy, when appropriate. Reviews all official data quality standards, coding guidelines, company policies and procedures, and clinical/medical resources to ensure coding knowledge and skills remain current. Key Responsibilities Performs complex ICD-10 and CPT review and validation or ASA coding for assigned primary or medical departments. Establishes and maintains working relationships with Physicians to resolve specific case issues, as well as general questions and or principles. Participates in coding and reimbursement training programs. Provides instruction and education to staff on accurate charge entry and medical record documentation. Develops and...