71 certified coding auditor jobs found

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

Job Title Certified Coding Professional Certified Professional Medical Auditor Specialized Credentialing through AAPC Associate Three Years

Medical Coder Educator - USFTGP RCO Serves as the coding reviewer and documentation educator for USFTGP Revenue Cycle Operations. Collaborate extensively with compliance; utilizing approved coding industry tools and approved internal documentation. This position is responsible for providing coding literacy and awareness using adult methodologies to revenue cycle, coding professionals, department managers, medical staff and others, ensuring proficiency is accurate and within compliant coding practices for billing. Analyze and report review findings indicating documentation gaps reimbursement and data internation, inpatient, outpatient and professional service coded. Report to compliance focused areas of improvements, recommendations and actions taken to improve medical staff knowledge and coding accuracy. Conduct individual and group coding and documentation support instructions as assigned and acts as an internal coding expert resource. Qualifications Required: High School...

Physician Practice E&M Auditor Educator, MCVI Administration, FT, 8A-4:30P (Remote) Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 25 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2024-2025 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 45 high-performing honors. What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the...

Health Information Management (HIM) Coder Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance. Responsibilities For hospital encounters, routes to billing charge entry errors and/ or account edits preventing completion of coding and/or billing. Makes appropriate coding corrections when advised and follows procedure to notify billing. Reviews chargemaster generated CPT/HCPCS codes, when errors are found Coding Management is notified to alert Charge Management to educate department making errors. Makes appropriate coding corrections when...

Overview Baptist Health is the region’s largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 25 years, we’ve been named one of Fortune’s 100 Best Companies to Work For, and in the 2024-2025 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 45 high-performing honors. What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families...

Serves as the coding reviewer and documentation educator for USFTGP Revenue Cycle Operations. Collaborate extensively with compliance; utilizing approved coding industry tools and approved internal documentation. This position is responsible for providing coding literacy and awareness using adult methodologies to revenue cycle, coding professionals, department managers, medical staff and others, ensuring proficiency is accurate and within compliant coding practices for billing. Analyze and report review findings indicating documentation gaps reimbursement and data internation, inpatient, outpatient and professional service coded. Report to compliance focused areas of improvements, recommendations and actions taken to improve medical staff knowledge and coding accuracy. Conduct individual and group coding and documentation support instructions as assigned and acts as an internal coding expert resource. Qualifications Required: High School Diploma or GED Certification...

Job Description Medical Coder Educator - USFTGP RCO - ( 250004UJ ) Overview Serves as the coding reviewer and documentation educator for USFTGP Revenue Cycle Operations. Collaborate extensively with compliance; utilizing approved coding industry tools and approved internal documentation. This position is responsible for providing coding literacy and awareness using adult methodologies to revenue cycle, coding professionals, department managers, medical staff and others, ensuring proficiency is accurate and within compliant coding practices for billing. Responsibilities Analyze and report review findings indicating documentation gaps, reimbursement and data inaccuracies across inpatient, outpatient and professional service coded. Report to compliance focused areas of improvements, recommendations and actions taken to improve medical staff knowledge and coding accuracy. Conduct individual and group coding and documentation support instructions as assigned and acts as an...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

About the job Medical Record Audit / Coding Auditor OUR CLIENT is a contracting and data management services organization dedicated to primary care physicians throughout Florida IN THIS ROLE YOU are responsible to assist in the development, undertaking and maintenance of a long term comprehensive, clinical coding audit program for inpatient and outpatient activity. To develop and Implement policies to support the clinical coding audit function Receive, review and communicate findings on patient billing coding related complaints. Identify training needs through the audit program of work and liaise with the clinical coding training manager and audit manager to provide the necessary training identified Conduct routine, risk based, proactive or reactive compliance reviews of procedural and diagnosis coding/billing and medical record documentation performed by clinical service providers Prepare reports as required relative to these monitoring and review...

Position Summary Elite DNA Behavioral Health is seeking a detail-oriented Certified Medical Coder / Clinical Chart Auditor (AAPC certified) to support our internal compliance and quality assurance program. This role focuses on chart auditing, documentation review, and provider education , with an emphasis on CMS, Florida Medicaid, and behavioral health documentation standards . This position goes beyond CPT coding alone. The Auditor will review each element of the medical record-including assessments, treatment plans, progress notes, and billing documentation-to ensure services meet regulatory, payor, and internal compliance requirements. The Auditor will also provide constructive feedback and education to providers to improve documentation accuracy and reduce audit risk. This is an excellent opportunity for early-career coders (0-3 years experience) looking to build expertise in healthcare compliance and auditing. Essential Duties and Responsibilities Conduct...

DRG Coding Auditor Principal _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. 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...

Job Description Job Description Description: Position Overview The Professional Billing Coder – Cardiothoracic / Special Surgical is responsible for accurate and compliant coding of physician professional services for complex surgical procedures. This role supports timely claim submission, regulatory compliance, and revenue integrity within a hospital-based professional billing environment. Requirements: Key Responsibilities • Assign accurate CPT, HCPCS, and ICD-10-CM codes for cardiothoracic and other special surgical services • Review operative reports, clinic notes, and supporting documentation to ensure complete and compliant coding • Apply appropriate modifiers, bundling rules, and NCCI edits • Ensure compliance with CMS, AMA, and payer-specific billing guidelines • Identify documentation gaps and communicate clarification needs as appropriate • Meet established productivity and quality standards • Participate in internal quality reviews and audits as required...

Job Description Job Description Description: Position Overview The Professional Billing Coder – Vascular Surgery is responsible for accurate coding of professional services related to vascular procedures. This role supports compliant billing practices and contributes to revenue integrity and audit readiness. Requirements: Key Responsibilities • Assign accurate CPT, HCPCS, and ICD-10-CM codes for vascular surgery procedures • Review operative and procedural documentation for coding accuracy and completeness • Apply appropriate modifiers and NCCI edits • Ensure adherence to CMS, AMA, and payer guidelines • Maintain accuracy and productivity standards in a high-volume environment • Support internal audits and quality improvement initiatives Required Qualifications • Minimum 2+ years of professional billing coding experience • Proven experience with vascular surgery coding • Strong knowledge of CPT, ICD-10-CM, modifiers, and NCCI edits • CPC or equivalent certification...

Remote Coding Specialist The Remote Coding Specialist reviews, analyzes, and assigns final diagnoses and procedures as documented by the practicing provider, following all compliance policies and guidelines. This role accurately codes office and hospital procedures to ensure proper reimbursement and provides physician education to ensure accurate completion of Electronic Health Records (EHR) and correct assignment of ICD-10-CM, HCPCS, and CPT codesverbally, physically, and in written forms. Responsibilities Responsibilities: Review clinical documentation and code to the highest level of specificity for accurate charge capture. Interact with providers to provide feedback and education using verbal, written, and in-person communication. Assign and sequence appropriate codes and modifiers using current procedure, diagnosis, and HCPCS codes for billed services. Accurately follow coding guidelines and legal requirements to ensure compliance with federal and state regulations....

Description: If you are interested in applying for this job, please make sure you meet the following requirements as listed below. Join the Team at PedIM Healthcare! Delivering exceptional care, together. Who We Are PedIM Healthcare is the first private medical office of its kind in Citrus County – offering top-quality care for children, adults, and seniors all under one roof. We provide pediatric, adult internal medicine, family practice, geriatrics, women’s care, medical weight-loss, sleep-medicine services and more. Our dedicated, community-focused team is committed to excellence, pride in service, and making a real difference for patients and families across Citrus County. Why Work With Us? A broad, multi-discipline practice where you can grow: pediatrics, internal medicine, weight-loss & sleep medicine specialties. A values-driven environment: we listen, we help, we understand—and we care. Community-oriented and recognized: voted “best of the best” in the region....

Coder III Location Requirement: Candidates must reside in one of the following states- Florida, Alabama, or Georgia. If offered the position, will be required to come onsite in Pensacola, FL for orientation The Coder III reviews inpatient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines with a 97% accuracy rate, while maintaining coding standards for productivity. This position must preserve confidentiality of health information. This position must be able to use tact and diplomacy when communicating with employees, physicians, administration, and public, under complex or emotional situations. Responsibilities Reviews patient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines. Meets productivity standard for inpatient coding: 17 charts/day. Understands appropriate assignment of MS-DRG, POA, and discharge disposition. Assists with all levels of coding including inpatient,...

Service Warranty Booker/Coder AutoNation is one of the largest automotive retailers in the United States, offering innovative products, exceptional services, and comprehensive solutions, empowering our customers to make the best decisions for their needs. With a network of dealerships nationwide strengthened by a recognized brand, we offer a wide variety of new and used vehicles, customer financing, parts, and provide expert maintenance and repair services. Through DRV PNK, we have raised over $40 million for cancer-related causes, demonstrating our commitment to making a positive difference in the lives of our Associates, Customers, and the communities we serve. So what do you say? Are you ready to be part of something big? The Service Warranty Booker/Coder is responsible for reviewing and coding warranty repairs and claims. This includes booking, coding, researching warranty claims and billing them to the appropriate operation codes. What Are The Day-To-Day...

Overview Position: Remote Coder Office/Hospital FTE: 1.0 Shift Hours: Monday Friday Work Location: Remote (within approved states: FL, GA, MO, PA, SC, TN, and TX) Position Summary: Under general supervision, this role reviews, analyzes, and assigns final diagnoses and procedures based on provider documentation, following all compliance policies and guidelines. The Coder accurately codes office and hospital procedures to ensure proper reimbursement. Additionally, this position provides physician education to ensure proper completion of Electronic Health Records and accurate assignment of ICD-10, CDM, HCPCS, and CPT codes , delivered verbally, physically, and in written form. Responsibilities Review clinical documentation and code to the highest level of specificity for accurate charge capture Interact with providers to provide feedback and education using physical, verbal, and written communication Assign and sequence appropriate codes...

Coding Specialist At Memorial, we are dedicated to improving the health, well-being and, most of all, the quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments. For hospital...

Coding Specialist At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up. Seeks clarification from providers...

Remote Coder Office/Hospital Under general supervision, this role reviews, analyzes, and assigns final diagnoses and procedures based on provider documentation, following all compliance policies and guidelines. The Coder accurately codes office and hospital procedures to ensure proper reimbursement. Additionally, this position provides physician education to ensure proper completion of Electronic Health Records and accurate assignment of ICD-10, CDM, HCPCS, and CPT codes, delivered verbally, physically, and in written form. Key Responsibilities: Review clinical documentation and code to the highest level of specificity for accurate charge capture Interact with providers to provide feedback and education using physical, verbal, and written communication Assign and sequence appropriate codes and modifiers using current procedure, diagnosis, and HCPCS for billed services Follow coding guidelines and legal requirements to ensure compliance with federal and state regulations...

Job Posting Overview: FTE: .20 Shift Hours: Monday Friday - VARIABLE Work Location: Remote - Authorized remote work states - FL, GA, MO, PA, NC, SC, TN and TX Position Summary: Under general supervision, the Coder reviews, analyzes, and assigns final diagnoses and procedures based on provider documentation, adhering to all compliance policies and guidelines. The Coder accurately codes office and hospital procedures to ensure proper reimbursement. This position also provides physician education to ensure proper completion of Electronic Health Records and accurate assignment of ICD-10, CDM, HCPCS, and CPT codes , delivered verbally, physically, and in written form. Responsibilities: Review clinical documentation and code to the highest level of specificity for accurate charge capture. Interact with providers to provide feedback and education using verbal, written, and in-person communication. Assign and sequence appropriate codes and modifiers using current...