37 certified coding auditor jobs found

Responsible for audits which are internal record reviews for compliance with coding regulations and guidelines in order to provide rebuttals to CMS or other payer denials and to assist and improve on physician correct coding/documentation education. Provides assistance with the creation of EMR templates in order to to improve capture of correct documentation to support E&M (Evaluation and Management Coding) levels. Responds to government and other payers records requests and audits. Qualifications Work requires the level of knowledge normally acquired through the completion of two to three years of occupationally specific education beyond high school OR an Associates degree in Medical Record Technology or closely related field and two to three years of previous work related experience. Certified coder with auditing experience required for ensuring accuracy of coding and documentation on hard copy charts and electronic forms and using ICD/CPT. Monitors regulatory changes on...

Job Description Responsible for audits which are internal record reviews for compliance with coding regulations and guidelines in order to provide rebuttals to CMS or other payer denials and to assist and improve on physician correct coding/documentation education. Provides assistance with the creation of EMR templates in order to improve capture of correct documentation to support E&M (Evaluation and Management Coding) levels. Responds to government and other payers records requests and audits. Qualifications Work requires the level of knowledge normally acquired through the completion of two to three years of occupationally specific education beyond high school OR an Associates degree in Medical Record Technology or closely related field and two to three years of previous work related experience. Certified coder with auditing experience required for ensuring accuracy of coding and documentation on hard copy charts and electronic forms and using ICD/CPT. Monitors regulatory...

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...

ExamWorks is seeking a Medical Coding Specialist to join our remote team. A current coding certification (CPC required; CPMA preferred) is needed, with responsibilities including coding, reviewing provider billing, and ensuring compliance with HIPAA and client guidelines. The role offers a Monday–Friday 8am–5pm EST schedule, up to 10% travel, and competitive benefits including medical, vision, dental, paid time off, and 401k. #J-18808-Ljbffr

Physician Billing (PB) Coding Auditor And EducatorOur team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.The Physician Billing (PB) Coding Auditor and Educator is responsible for auditing and educating healthcare providers on related applicable clinical documentation. This work supports coding and billing regulations that ensure appropriate reimbursement, public reporting, and various initiatives as directed by the Hackensack Meridian Health (HMH) Network.A day in the life of an Physician Billing (PB) Coding Auditor and Educator at...

Coding AuditorThe Coding Auditor is responsible for performing comprehensive coding audits to ensure accuracy, compliance, and consistency across all professional services at VMG. This role supports service-line transitions, vendor oversight, and quality validation.Each Coding Auditor will be aligned to a Coding Educator to ensure coordinated education and quality improvement efforts.EducationHigh school diploma or equivalent required.ExperienceMinimum of 5 years of professional coding experienceCertified Professional Coder (CPC) – AAPC required or equivalentMulti-specialty experience in professional codingStrong presentation and communication skillsCPC-H (Hospital Outpatient) preferredCPMA (Certified Professional Medical Auditor) preferredSkillsAdvanced knowledge of coding guidelines.Strong understanding of professional fee coding, reimbursement methodologies, and revenue cycle operations.Demonstrated expertise in conducting audits and evaluating physician documentation for coding...

Coding Auditor The Coding Auditor is responsible for performing comprehensive coding audits to ensure accuracy, compliance, and consistency across all professional services at VMG. This role supports service-line transitions, vendor oversight, and quality validation. Each Coding Auditor will be aligned to a Coding Educator to ensure coordinated education and quality improvement efforts. Education High school diploma or equivalent required. Experience Minimum of 5 years of professional coding experience Certified Professional Coder (CPC) – AAPC required or equivalent Multi-specialty experience in professional coding Strong presentation and communication skills CPC-H (Hospital Outpatient) preferred CPMA (Certified Professional Medical Auditor) preferred Skills Advanced knowledge of coding guidelines. Strong understanding of professional fee coding, reimbursement methodologies, and revenue cycle operations. Demonstrated expertise in conducting...

ExamWorks is seeking a Medical Coding Specialist to join our remote team. A current coding certification (CPC required; CPMA preferred) is needed, with responsibilities including coding, reviewing provider billing, and ensuring compliance with HIPAA and client guidelines. The role offers a Monday–Friday 8am–5pm EST schedule, up to 10% travel, and competitive benefits including medical, vision, dental, paid time off, and 401k. #J-18808-Ljbffr

Experienced Associate, Healthcare ForensicsThe Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients.Job Duties:Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance mattersContributes to forensic engagements related to medical coding and...

Job description Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties: Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to...

POSITION SUMMARY:Conducts reviews and provides recommended corrections of billed services as it relates to clinical documentation for the VMG enterprise. Assists in the reviews and responses to payor and governmental audits of billed services. Assists the CBO in replying to payor denials and patient inquiries as it relates to services billed. Reviews and research new coding guidelines and codes. Assists the staff of the VHS corporate compliance.EDUCATION:CPC (AAPC) required. Degree in Heath Services Management, Business or another related field preferred. Extensive knowledge of ICD-9-CM/ICD-10 CM and CPT coding principles and guidelines required. Extensive knowledge of reimbursement systems required.EXPERIENCE:Eight to ten years' experience (college degree can be substituted for years of experience) and expertise in ICD-9 CM/ICD-10 CM Coding.SPECIAL SKILLS:Medical Terminology, ICD-9 CM/ICD-10 CM and CPT-4 Coding, Ability to relate to people and work closely with physicians and...

Certified Professional Coder (Cpc) The Certified Professional Coder (CPC) serves as liaison between the medical group and the external coding vendor. This role ensures consistent communication, accurate and compliant coding practices, timely issue resolution, and alignment with organizational policies and payer requirements. The Coding Liaison supports documentation integrity, monitors vendor performance, and acts as a subject matter expert for coding-related inquiries. This role works closely with providers, clinical staff, and revenue cycle teams to review medical records, validate documentation completeness, apply correct CPT®, ICD-10-CM, and HCPCS codes, and educate providers on documentation best practices. Key Responsibilities Serve as the liaison to ensure coding queries issued by the vendor are addressed by providers, resolved appropriately, and returned to the vendor in accordance with established timelines. Identify documentation deficiencies and initiate...

Job: Professional Coder I Duration: 6+ Months Location: Newark, NJ [100% Remote] Job Description: This position is accountable for accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities: Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy and compliance with applicable coding guidelines and regulations. Identify, compile and...

Experience Required Eight to ten years' experience and expertise in ICD-9 CM/ICD-10 CM Coding is required. Minimum Education Required PROFESSIONAL License(s) Required No Expected Start Date 09/15/2026 Compensation $32.36 - $40.45 / Hourly Hours Per Week 40 Number Of Positions 1 Shift First Shift (Day) Job Description POSITION SUMMARY: Conducts reviews and provides recommended corrections of billed services as it relates to clinical documentation for the VMG enterprise. Assists in the reviews and responses to payor and governmental audits of billed services. Assists the CBO in replying to payor denials and patient inquiries as it relates to services billed. Reviews and researches new coding guidelines and codes. Assists the staff of the VHS corporate compliance. EDUCATION: CPC (AAPC) required. Degree in Heath Services Management, Business or other related field preferred. Extensive knowledge of ICD-9-CM/ICD-10 CM and CPT coding principles and...

Provider Liaison - Certified Professional Coder (CPC) / Certified Coding Specialist (CCS) A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description One of our direct client is looking for potential candidate with the below mentioned skills Direct Client: Immediate Interview Contract to Hire Position: Provider Liaison MUST HAVE: 5 years of experience into Project Management At least 2 years of experience after CPC or CCS certification Bachelor's degree is a must Certifications AAPC Certified Professional Coder (CPC) or...

The Certified Professional Coder (CPC) serves as liaison between the medical group and the external coding vendor. This role ensures consistent communication, accurate and compliant coding practices, timely issue resolution, and alignment with organizational policies and payer requirements. The Coding Liaison supports documentation integrity, monitors vendor performance, and acts as a subject matter expert for coding-related inquiries. This role works closely with providers, clinical staff, and revenue cycle teams to review medical records, validate documentation completeness, apply correct CPT, ICD-10-CM, and HCPCS codes, and educate providers on documentation best practices.Key ResponsibilitiesServe as the liaison to ensure coding queries issued by the vendor are addressed by providers, resolved appropriately, and returned to the vendor in accordance with established timelines.Identify documentation deficiencies and initiate provider queries when clarification is neededApply...

Valley Health System seeks an experienced coding professional to review and correct billed services based on clinical documentation for the VMG enterprise. You will assist in audits and respond to payer denials and inquiries related to services billed. Ideal candidates have CPC certification, extensive ICD-9/ICD-10 and CPT coding knowledge, and 8–10 years of coding experience, with strong collaboration with physicians and VMG staff. #J-18808-Ljbffr

Facility-Fee Emergency Department Medical CoderThe Facility-Fee Emergency Department Medical Coder is responsible for the accurate review, abstraction, and assignment of ICD-10-CM, CPT, HCPCS, facility-specific charging methodologies, and applicable modifiers for Emergency Department (ED) facility encounters. This role ensures coding accuracy, regulatory compliance, appropriate reimbursement, and adherence to client-specific coding guidelines, payer requirements, and industry standards.The coder will review clinical documentation, emergency department records, physician documentation, nursing notes, ancillary reports, and charging information to accurately capture facility services rendered during emergency department visits. The position requires strong knowledge of facility fee coding, emergency department leveling methodologies, and outpatient reimbursement regulations.Essential Duties and ResponsibilitiesReview emergency department medical records to assign accurate ICD-10-CM...

Certified Professional CoderJob Location: Hopewell, NJJob Duration: 6 Months (possibility of extension)Payrate: $35 - $38/ hr. on w2Job Summary: This position is responsible for leading on-site and desk audits of hospital billing and coding practices, including forms development, audit profiling, and tracking institutional audit trends. The role involves designing audit protocols, handling special projects, and performing/finalizing per diem audits, bill verification, DRG validation (utilization review audits), and credit balance reviews. The position also provides education and guidance on ICD-10-CM coding, DRG assignment, payment methodologies, and auditing practices.Key Responsibilities:Lead hospital billing and coding audits, both on-site and remoteIdentify and present billing discrepancies and coordinate improper claim payment referralsAnalyze trends related to documentation, billing errors, and provider contract interpretation issuesCompile audit reports, statistics, and...

Professional Coder IThis position is accountable for accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business.Responsibilities:Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction.Review medical records for completeness, accuracy and compliance with applicable coding guidelines and regulations.Identify, compile and code member/patient data, using ICD-9/ICD 10-CM and other standard classification coding systems.Support the...

Atlantic Health is seeking a Lead HIM Coder to oversee the coding team, educate staff, and monitor work queues to support timely and accurate billing across encounters. You will audit records and collaborate with CDI, physicians, and Revenue Integrity to improve documentation and reimbursement. Responsibilities include auditing DRG accuracy, driving denials reduction, and staying current with Medicare guidelines and industry updates. #J-18808-Ljbffr

Rowan-Virtua School of Osteopathic Medicine Job Description Job Title : Practice Supervisor Department : OBGYN Location : Washington Township/Sewell & Stratford, NJ Reports to : Director of Administration, OBGYN Date : August 2026 Summary The Practice Supervisor oversees daily non-physician operations in Rowan Medicine outpatient offices, ensuring efficient workflows and exceptional patient experiences. This role supports physicians, manages front desk and billing processes, leads hiring and performance management, resolves concerns, and maintains compliance with departmental and university standards. Ideal for candidates who thrive in fast-paced clinical settings and enjoy coaching teams to deliver high-quality care. ESSENTIAL DUTIES AND RESPONSIBLITIES include the following. Other duties may be assigned. Staffing Supervises and assists with the overall daily operations of Site. Responsible for all practice related activities involving personnel management, patient...

Capital Health Coding SpecialistCapital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ...

Description Exam Works is looking for a Medical Coding Specialist to join our team remotely! *Must possess current coding certification in CPC. CPMA certification & Certified Life Care Planner certification preferred. The Medical Coding Specialist (Internally called a Coding Specialist) is responsible to create and write reports based on medical records and appropriate guideline criteria. This position utilizes the system database to determine usual and customary and/or state fee schedule allowances and this position is responsible for analyzing provider billing for proper coding and billing guidelines across all provider types and ensures reviews are completed with highest quality and integrity and that all work is in full compliance with client contractual agreements, regulatory agency standards and/or federal and state mandates. Schedule for this role is: Monday - Friday 8am-5pm EST ESSENTIAL JOB FUNCTIONS Receive and input client and examinee data in...