1363 certified coding auditor jobs found

Focused on ensuring accurate coding and compliance with regulations, the full-time Certified Coding Auditor - Oregon will perform documentation and coding reviews across various specialties while maintaining current knowledge of coding guidelines and standards in a remote work environment. Key responsibilities Perform documentation and coding reviews within assigned work queues across various specialties Utilize coding tools to assist in the accurate assignment of coding and escalate trends and issues as necessary Engage in continued development of coding knowledge and maintain certification while addressing complex coding issues and project work as assigned Required qualifications Minimum two (2) years of work experience in a healthcare setting Minimum one (1) year of professional coding experience Certification as a Certified Professional Coder, Registered Health Information Technician, or equivalent coding certification Working knowledge of Microsoft Word, Excel, and medical...

Focused on ensuring accurate coding and claim submission, the full-time Certified Coding Auditor - Oregon will perform documentation and coding reviews across various specialties while maintaining compliance with regulatory guidelines and audit standards in a remote work environment. Key responsibilities: Perform documentation and coding reviews within work queues across assigned specialties Maintain current knowledge of coding and documentation standards to ensure compliance with regulatory guidelines Address complex coding issues and participate in project work as assigned Required qualifications: Minimum two (2) years of work experience in a healthcare setting Minimum one (1) year of professional coding experience Certification as a Certified Professional Coder, Registered Health Information Technician, or equivalent coding certification Working knowledge of Microsoft Word, Excel, and medical terminology Strong time management skills with the ability to meet deadlines

To ensure accurate coding and claim submission, the full-time Oregon Certified Coding Auditor will perform documentation and coding reviews across various specialties, maintain knowledge of regulatory guidelines, and assist with complex coding issues in a remote work environment. Key responsibilities Perform documentation and coding reviews within assigned work queues Maintain current knowledge of coding and documentation regulatory guidelines and audit standards Assist with complex coding issues and project work as requested Required qualifications Minimum two (2) years of work experience in a healthcare setting Minimum one (1) year of professional coding experience Certification as a Certified Professional Coder, Registered Health Information Technician, or equivalent Working knowledge of Microsoft Word, Excel, and medical terminology Strong time management skills and ability to meet deadlines

Working remotely from a home office, the part-time Certified Coding Auditor will conduct coding audits of outpatient facility services and professional E&M documentation to ensure accuracy and compliance while providing feedback and education to coding staff. Key responsibilities Conduct coding audits of outpatient facility services and professional E/M documentation to ensure coding accuracy and regulatory compliance Perform comprehensive reviews of clinical documentation and assigned codes to validate code assignment and reimbursement accuracy Provide ongoing feedback and coaching to coding staff to improve coding quality and adherence to guidelines Required qualifications AHIMA or AAPC certification 2-3 years of hospital outpatient and professional E&M auditing experience Experience in ICD-10-CM, CPT, HCC, and procedural/surgical coding Ability to participate in client-facing discussions regarding audit findings Excellent communication skills, both verbal and written

Title: Senior Certified Coding Auditor and Trainer Location: Columbia, SC Status: Full-Time Who Are We? Part of the Novant Health family based in North Carolina, Novant Health Urgent Care (formerly Doctors Care) provides exceptional healthcare through our network of more than 50 urgent care centers and 20 physical therapy facilities across South Carolina. Our Columbia-based headquarters delivers non-medical management and administrative services to support these locations. For decades, we have been committed to delivering exceptional, convenient, and affordable healthcare experiences to families and communities throughout the Palmetto State. What Do We Offer? Competitive wages Generous PTO that increases with tenure 403B Health, dental, vision insurance Flexible Spending Account Short term and Long term Disability Whole and Term Life Insurance Rewarding Careers What Are We Looking For? Novant Health Urgent Cares is currently seeking a...

A healthcare organization is seeking a Certified Coding Auditor in Indianapolis to ensure coding precision and maintain documentation standards. The successful candidate will review coding accuracy, apply updates, and draft audit findings. Key requirements include a High School Diploma or GED, certifications like CCS or CPC, and 3+ years of medical coding experience. The role offers competitive pay and benefits, contributing to a dedicated healthcare team. #J-18808-Ljbffr

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for a Certified Coding Auditor to work in its New York office or remotely. Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers....

Working remotely, the full-time Certified Coding Auditor will ensure accurate and timely reimbursement by resolving medical coding claim defects, optimizing the revenue cycle, and maintaining financial integrity. Key responsibilities Research and review coding-related claim denials, providing expert guidance on necessary corrections to prevent future issues Proactively address pre-billing resolution of coding defects to safeguard against reimbursement impacts Utilize a robust understanding of medical coding and reimbursement methodologies to maximize financial accuracy and efficiency Required qualifications High school diploma or equivalent Minimum of one (1) year of coding experience or two (2) years in a healthcare environment or medical office setting Certification from AAPC or AHIMA, such as CPC, CCA, CCS, CCS-P, RHIT, or RHIA Working knowledge of human anatomy, physiology, disease processes, and medical terminology Ability to work under pressure to meet deadlines...

To enhance the effectiveness of the Clinical Chart Validation team, the full-time Certified Coding Auditor Trainer will be responsible for planning, developing, and delivering technical training, mentoring team members, and assessing training outcomes while collaborating with various stakeholders in a remote environment. Key responsibilities Develop and deliver technical training plans and materials to improve audit productivity and performance Mentor and support audit team members, including conducting orientation for new hires and promoting audit accuracy Evaluate training effectiveness and provide recommendations for improvements based on performance assessments Required qualifications Associates Degree or equivalent relevant experience; Bachelor's degree in a related field preferred 5 to 7 years of experience in claims auditing, quality assurance, or recovery auditing Coding certification (e.g., CCS, CPC) required, with a willingness to obtain within 6 months for...

To enhance the effectiveness of the Clinical Chart Validation team, the full-time Certified Coding Auditor Trainer will be responsible for planning, developing, and delivering technical training, mentoring team members, and assessing training outcomes while collaborating with various stakeholders in a remote environment. Key responsibilities Develop and deliver technical training plans and materials to improve audit productivity and performance Mentor and support audit team members, including conducting orientation for new hires and promoting audit accuracy Evaluate training effectiveness and provide recommendations for improvements based on performance assessments Required qualifications Associates Degree or equivalent relevant experience; Bachelor's degree in a related field preferred 5 to 7 years of experience in claims auditing, quality assurance, or recovery auditing Coding certification (e.g., CCS, CPC) required, with a willingness to obtain within 6 months for candidates...

Universal Health Services, Inc. seeks a Coding Auditor to determine ICD-10, CPT-4, and HCPCS coding alignment with clinical documentation and to validate medical necessity per LCDs. The role requires CPC certification and experience in professional billing, auditing, and the revenue cycle. The position involves reviewing documentation, educating providers on coding requirements, and ensuring timely, accurate audits across IPM services. #J-18808-Ljbffr

Independence Physician Management (IPM), a UHS subsidiary, seeks a Coding Auditor to ensure ICD-10, CPT-4 and HCPCS coding is supported by medical records and meets CMS LCD guidelines. The role requires CPC certification, auditing experience, and strong knowledge of coding policies; you will review documentation, educate providers, and support front-end coding accuracy. IPM offers comprehensive benefits and opportunities within a national health system; on-site in Wayne, PA with collaboration #J-18808-Ljbffr

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...

Job Title Melville,NY - USA Position Requirements Use coding skills to review clinical documentation to accurately code for anesthesia services. Retrieve information from hospital EMR systems to resolve coding questions to support offshore vendors. To work daily tasks/edits in billing system. Primary Responsibilities Review medical record documentation to identify correct coding based on billing and payor guidelines. Research, analyze and respond to inquiries regarding compliance and inappropriate coding denials. Retrieve missing patient documentation required for accurate billing. Work task queues within various systems. Support offshore vendor coding questions. Recommend vendor education based on tasks reviewed. Required Qualifications Minimum of 2 years' professional medical coding experience. CPC or CCS-P certification. Proficient computer skills Desired/Preferred Qualifications Insurance billing knowledge Excel Knowledge of CMS guidelines Total...

Job Title Melville,NY - USA Position Requirements Use coding skills to review clinical documentation to accurately code for anesthesia services. Retrieve information from hospital EMR systems to resolve coding questions to support offshore vendors. To work daily tasks/edits in billing system. Primary Responsibilities Review medical record documentation to identify correct coding based on billing and payor guidelines. Research, analyze and respond to inquiries regarding compliance and inappropriate coding denials. Retrieve missing patient documentation required for accurate billing. Work task queues within various systems. Support offshore vendor coding questions. Recommend vendor education based on tasks reviewed. Required Qualifications Minimum of 2 years' professional medical coding experience. CPC or CCS-P certification. Proficient computer skills Desired/Preferred Qualifications Insurance billing knowledge Excel Knowledge of CMS...

Job DescriptionResponsible for accurately abstracting data following the Official International Classification of Diseases (ICD)-10-Clinical Modification (CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Guidelines for Coding and Centers for Medicare and Medicaid Services (CMS) directives. Performs data entry of required abstracted patient information into the system. Queries physicians when appropriate.QualificationsHigh School diploma, general equivalency diploma (GED), and/or GED equivalent programs.Certified Professional Coder with Minimum of two to three year of coding for professional servicesStrong understanding of physiology, medical terms and anatomy.Proficiency in computer skills including typing speed and accuracy.Excellent written and verbal communication skills.Proficient computer skills including but not limited to Microsoft OfficeMust be able to achieve and maintain appropriate coding quality and productivity as...

Humana, Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. You will assign ICD-10-CM, ICD-10-PCS, and DRG codes and contribute to accurate payments. The role requires 4+ years of MSDRG coding auditing, RHIA/RHIT or CCS certification, and experience with inpatient audits in health insurance or hospital settings. Remote work with potential traveling for training or meetings. #J-18808-Ljbffr

Reviewing the accuracy of HCC coded records, the full-time remote Certified HCC Coding Auditor will ensure compliance with Medicare and ICD-10-CM guidelines while supporting coders in identifying errors and maintaining high-quality standards. Key responsibilities Review and audit HCC coded records for accuracy in alignment with guidelines Provide feedback to coders to help them learn from errors and improve coding practices Maintain a quality score of 95% or higher and meet ongoing productivity requirements Required qualifications Certification through AAPC or AHIMA (CPC, CRC, CCS, or CCS-P) is mandatory At least 3 years of HCC coding experience and 2 years of auditing experience Global experience in HCC auditing is preferred Proficient in using EMRs, billing systems, and abstraction platforms Strong understanding of Risk Adjustment Data Abstraction Rules

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

Reviewing the accuracy of HCC coded records, the full-time remote Certified HCC Coding Auditor will ensure compliance with Medicare and ICD-10-CM guidelines while supporting coders in identifying errors and maintaining high-quality standards. Key responsibilities Review and audit HCC coded records for accuracy in alignment with guidelines Provide feedback to coders to help them learn from errors and improve coding practices Maintain a quality score of 95% or higher and meet ongoing productivity requirements Required qualifications Certification through AAPC or AHIMA (CPC, CRC, CCS, or CCS-P) is mandatory At least 3 years of HCC coding experience and 2 years of auditing experience Global experience in HCC auditing is preferred Proficient in using EMRs, billing systems, and abstraction platforms Strong understanding of Risk Adjustment Data Abstraction Rules

To ensure optimal coding efficiency and compliance, the full-time remote Certified Physician Coding Auditor will perform audits on professional coding, analyze physician and coder charges, and collaborate with the Education Team to identify documentation improvement opportunities. Key responsibilities Conduct internal audits of professional coding across all service lines and monitor results for inaccuracies Review medical records for coding accuracy and communicate improvement opportunities to physicians and staff Collaborate with the Physician Coding Education Team to ensure compliance with payor guidelines and coding standards Required qualifications High School diploma or equivalent CPMA certification or equivalent coding credential required, with five years of auditing experience preferred Five years of professional coding experience in multiple specialties Exceptional knowledge of official coding guidelines as per AMA, AHCA, and CMS Proficiency in Microsoft Office Suite...

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 focuses on ensuring accuracy in DRG assignments, ICD-10-CM/PCS coding, and overall payment integrity. Remote position with potential travel for training or meetings. 40-hour work weeks, pay range $71,100–$97,800 annually, with eligibility for a bonus incentive plan and comprehensive benefits. #J-18808-Ljbffr

To support the Coding Audit and Compliance team, the fully remote Certified Coding Compliance Auditor will conduct documentation and coding reviews, provide education and training to internal and external stakeholders, and manage client projects while ensuring adherence to productivity and quality standards. Key responsibilities Conduct detailed analysis of medical records and assign diagnostic codes according to regulatory guidelines Develop audit reports and corrective action plans based on findings, ensuring timely delivery of client projects Provide education and training sessions to both internal teams and clients on coding, documentation, and compliance matters Required qualifications High School Diploma; Bachelor's degree preferred Minimum of 3 years of CPT and ICD-10 medical coding and auditing experience Certified Risk Coder (CRC) certification and/or significant HCC coding experience required AHIMA - Certified Coding Specialist-Physician (CCS-P) or AAPC - CPC...

To support the Coding Audit and Compliance team, the fully remote Certified Coding Compliance Auditor will conduct documentation and coding reviews, provide education and training to internal and external stakeholders, and manage client projects while ensuring adherence to productivity and quality standards. Key responsibilities Conduct detailed analysis of medical records and assign diagnostic codes according to regulatory guidelines Develop audit reports and corrective action plans based on findings, ensuring timely delivery of client projects Provide education and training sessions to both internal teams and clients on coding, documentation, and compliance matters Required qualifications High School Diploma; Bachelor's degree preferred Minimum of 3 years of CPT and ICD-10 medical coding and auditing experience Certified Risk Coder (CRC) certification and/or significant HCC coding experience required AHIMA - Certified Coding Specialist-Physician (CCS-P) or AAPC - CPC...