26 certified coding auditor jobs found

A leading healthcare company is seeking a medical coding auditor to join their remote team. This role involves managing outpatient Durable Medical Equipment (DME) coding disputes, ensuring compliance and accuracy in coding reviews. Candidates should have CPC or CCS certification, at least 3 years of experience in DME audits, and strong communication skills. This position offers competitive pay, benefits from day one, and opportunities for career development. #J-18808-Ljbffr

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...

Ambulatory Procedure Visit-Outpatient Coder COMPANY OVERVIEW: Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG currently has a contract with the Federal Government. You would be a W-2 employee for HPMG and NOT a government employee. SUMMARY: Responsible for assignment of accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic) for ambulatory procedure visits. Trains and educates MTF staff on coding issues and plays a significant role in departmental and clinic-wide coding compliance activities. MANDATORY KNOWLEDGE AND SKILLS: Position requires excellent computer/communication skills for provider and staff interactions. Knowledge of anatomy/physiology and disease process, medical terminology, coding guidelines (outpatient and...

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...

Coder Reimbursement Specialist - Hospital The Coding and Reimbursement Specialist, CCS is responsible for coding and abstracting thoroughly, clinical data from the medical record. This includes both inpatient, outpatient, commercial, Medicare, Medicaid, and Illinois Public Aid, plus any other payor types. This accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis, grouped to the DRG in accordance with rules and regulations and coding methodologies, resulting in reimbursement and billing compliances as set forth by the Office of Inspector General. Manages workload and assigns work to three inpatient and two outpatient coders and oversees the day to day workings of the coding/reimbursement area. Monitors various regulatory sources to keep HIM coding and other staff informed and trained on various coding rules, regulations and related issues. Works closely with patient financial services to resolve any...

A leading healthcare data company is seeking an Inpatient Auditing Specialist with 3-5 years of experience at a Trauma Level 1 facility. This fully remote role involves conducting outpatient coding audits, providing coder education, and assisting with compliance assessments. Candidates should possess an associate or bachelor’s degree from an AHIMA-certified program, with preferred credentials such as CCS, RHIT, or RHIA. Competitive pay ranges from $35 to $45 per hour, alongside great benefits including medical and dental coverage. #J-18808-Ljbffr

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

Hiring Department University Physicians Job Description #upjobs This part-time position is a dual post linked to Job ID 58803 -MCS-C - University Physicians, and the department will be hiring for one position. Job Duties: Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents...

A reputable educational institution in Columbia Township is seeking a part-time Medical Coding Specialist. This role involves reviewing clinical documents, assisting with audits, and providing training on documentation standards. The candidate must possess relevant coding certifications, including CCA and CCS. Work hours are Monday to Friday, totaling 20 hours per week with potential for remote work. This position does not offer university benefits but allows participation in a tax-deferred annuity plan. #J-18808-Ljbffr

Outpatient/Professional Lead Coder BJC HealthCare is hiring for an Outpatient/Professional Lead Coder. We are looking for previous coding experience in ancillary or ED. This role is responsible for being a mentor for the coders on the team. At least one of the following certifications is required for this position: RHIA RHIT CCS CCS-P CPC COC or CCA. Open remotely to the following states: Alabama Iowa North Carolina Wisconsin Arkansas Kansas Ohio Florida Kentucky Oklahoma Georgia Louisiana South Carolina Illinois Mississippi Tennessee Indiana Missouri Texas. BJC HealthCare is one of the largest nonprofit health care organizations in the United States delivering services to residents primarily in the greater St. Louis, southern Illinois, and southeast Missouri regions. With net revenues of 6.3 billion and more than 30,000 employees BJC serves patients and their families in urban, suburban, and rural communities through its 14 hospitals and multiple community health locations....

Coder For over 29 years, Surgical Information Systems (SIS) has empowered surgical providers to Operate Smart by delivering innovative software and services that drive clinical, financial, and operational success. For ambulatory surgery centers (ASCs), SIS provides comprehensive software and services, including ASC management, electronic health records (EHRs), patient engagement capabilities, compliance technology, and revenue cycle management and transcription services, all built specifically for ASCs. For hospital perioperative teams, SIS offers an easy-to-use anesthesia information management system (AIMS). Serving over 2,700 surgical facilities, SIS is committed to delivering solutions that enable surgical providers to focus on what matters most: delivering exceptional patient care and outcomes. Recognized as the No. 1 ASC EHR vendor by Black Book for 10 consecutive years and honored with the Best in KLAS Award for ASC Solutions in 2025, 2023, and 2022, SIS remains the...

HIM Outpatient Surgery/Ambulatory Coder The HIM Outpatient Surgery/Ambulatory Coder is responsible for reviewing outpatient/inpatient EHR. This position monitors CPT, ICD-10, and HCPCS code changes. Audits and/or assigns codes (CPT, HCPCS, and diagnosis) for professional and hospital accounts for Primary Care/Medical Specialty/Simple Procedural services from clinical documentation for accurate professional billing and facility APC assignment. The HIM Outpatient Surgery/Ambulatory Coder is a resource for the physicians and other health care providers in regard to coding and to review medical documentation to insure appropriate physician and facility coding and billing. Responsibilities and Essential Job Functions: Reviews outpatient/inpatient EHR for appropriate documentation and signatures, and reviews interface charges prior to billing. Reviews departmental reporting structures and requests modifications as needed, i.e. adding billing areas, providers, etc. Monitors CPT,...

Position Title HIM Outpatient Surgery/Ambulatory Coder Liberty Hospital Position Summary / Career Interest: The HIM Outpatient Surgery/Ambulatory Coder is responsible for reviewing outpatient/inpatient EHR. This position monitors CPT, ICD-10, and HCPCS code changes. Audits and/or assigns codes (CPT, HCPCS, and diagnosis) for professional and hospital accounts for Primary Care/Medical Specialty/Simple Procedural services from clinical documentation for accurate professional billing and facility APC assignment. The HIM Outpatient Surgery/Ambulatory Coder is a resource for the physicians and other health care providers in regard to coding and to review medical documentation to insure appropriate physician and facility coding and billing. Responsibilities and Essential Job Functions Reviews outpatient/inpatient EHR for appropriate documentation and signatures, and reviews interface charges prior to billing. Reviews departmental reporting structures and requests...

POSITION TITLE: Compliance Auditor REPORTS TO: Director of Compliance CLASSIFICATION: Non-Exempt POSITION SUMMARY: The Compliance Auditor is responsible for developing and executing audit plans based on research and regulatory guidelines and conducting internal and external audits of departments and their policies. They review programs, records, and systems to ensure adherence to regulations and to support an effective compliance program that prevents illegal, unethical, or improper conduct at the health center. Additionally, they compile and present audit findings to department leadership, assist in implementing procedural changes to resolve compliance issues, and may be reassigned duties as needed for accommodation or staffing reasons. ESSENTIAL FUNCTIONS: The following information is considered the definition of essential functions, but does not restrict the tasks that may be assigned. The Compliance Auditor may be reassigned duties and responsibilities...

Join a dedicated healthcare team serving the heart of the Midwest region. This role is perfect for a detail-oriented medical coder who thrives in a remote work environment and values accuracy and compliance. General Summary The medical coder ensures accurate billing by assigning appropriate ICD-10-CM, CPT, and HCPCS Level II codes in accordance with American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. This position involves insurance credentialing and educating providers and staff on coding and billing standards. Routine chart audits and timely documentation review are essential components of this role. Essential Duties and Responsibilities Assign ICD-10-CM, CPT, and HCPCS Level II codes to finalized medical documentation to create accurate medical claims. Abstract relevant data from patient records to determine appropriate claim modifiers. Communicate with providers to clarify unclear or incomplete documentation and...

Hiring Department University Physicians Job Description #upjobs This part-time position is a dual post linked to Job ID 58799 -MCS - University Physicians, and the department will be hiring for one position. Job Duties: Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 58427 - MCS - University Physicians, and the department will be hiring for two positions. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of changes...

Medical Billing Specialist (CPC) - Feb 2026 California Medical Billing Specialist (CPC) Remote, California residents only (Full Time) Compensation: $28- $32 per hour About Us Zócalo Health is the first tech-driven provider built specifically for Latinos, by Latinos. We are developing a new approach to care that is designed around our very own shared and lived experiences and brings care to our gente. Founded in 2021 on the idea that our communities deserve more than just safety nets, we are backed by leading healthcare and social impact investors in the country to bring our vision to life. Our mission is to improve the lives of our communities—communities that have dealt with generations of poor experiences. These experiences include waiting hours in waiting rooms, spending mere minutes with doctors who don’t speak their language, and depending on their youngest kids to help them navigate our complex healthcare system. At Zócalo Health, we meet our members where they are,...

Coder Reimbursement Specialist - Hospital Full‑time position. The Coding and Reimbursement Specialist (CCS) is responsible for coding and abstracting clinical data from the medical record, including inpatient, outpatient, commercial, Medicare, Medicaid, Illinois Public Aid, and all other payor types. Accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis and DRG in accordance with rules and regulations and coding methodologies, resulting in reimbursement and billing compliances as set forth by the Office of Inspector General. The CCS manages workload, assigns work to three inpatient and two outpatient coders, and oversees day‑to‑day operations of the coding/reimbursement area. The CCS monitors regulatory sources to keep HIM coding and other staff informed and trained on coding rules, regulations and related issues, works closely with patient financial services to resolve claim denials, assists in...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 58429-MCS-C- University Physicians, and the department will be hiring for two positions Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of...

Spine Surgery Coder Remote Role 6-Month Contract to Hire Compensation: $30 per hour Start Date: ASAP ABOUT THE ROLE Our client is seeking a highly skilled Spine Surgery Coder for a remote, 6-month contract-to-hire opportunity. In this role, you will leverage your expertise in spine surgery coding—particularly within the outpatient Ambulatory Spine Center (ASC) environment—to ensure accurate and compliant coding of spinal procedures. You will play a critical part in supporting revenue integrity, audits, and denials prevention, while adhering to regulatory and payer-specific guidelines. The ideal candidate will have a strong background in CPT and ICD-10-CM coding for spine surgeries, with a focus on neurostimulator procedures, and familiarity with the Epic electronic health record system is preferred. This is an immediate need with a start date as soon as possible. WHAT YOU’LL DO Review full operative reports to assign accurate CPT and ICD-10-CM codes for outpatient spine...

Spine Surgery Coder – Remote – 6-Month Contract-to-Hire Compensation: $30 per hour Start Date: ASAP ABOUT THE ROLE Our client seeks a highly skilled Spine Surgery Coder for a remote 6‑month contract‑to‑hire opportunity. The role focuses on accurate coding of outpatient spine procedures within an Ambulatory Spine Center (ASC) setting, supporting revenue integrity, audits, and denial prevention while adhering to regulatory and payer guidelines. WHAT YOU'LL DO Review operative reports and assign accurate CPT and ICD‑10‑CM codes for outpatient spine surgeries. Abstract and code all billable components of spine cases, ensuring completeness and accuracy. Apply correct modifiers and validate procedures against CMS and commercial payer ASC‑approved code lists for ASC and hospital outpatient reimbursement. Maintain strict adherence to coding and regulatory standards, including CMS, payer‑specific spine policies, and internal compliance guidelines. Support audits, denial prevention, and...

City/State: Saint Louis, Missouri Categories: Health Information Management Job Status: Full-Time Req ID : 103131 Pay Range: $23.10 - $38.36 / hour (Salary or hourly rate is based on job qualifications and relevant work experience) Additional Information About the Role BJC is hiring for a Outpatient/Professional Lead Coder. We are looking for previous coding experience in ancillary or ED. This role is responsible for being a mentor for the coders on the team. At least one of the following certifications is required for this position: RHIA, RHIT, CCS, CCS-P, CPC, COC, or CCA. Open remotely to the following states: Alabama Iowa North Carolina Wisconsin Arkansas Kansas Ohio Florida Kentucky Oklahoma Georgia Louisiana South Carolina Illinois Mississippi Tennessee Indiana Missouri Texas Overview BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to...