219 certified coding auditor jobs found

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 an outpatient 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 payors. Researching...

The Marwood Group, a New York-based healthcare advisory firm, is hiring an outpatient Certified Coding Auditor for its New York office or remote work. The role focuses on remote audits, researching regulations, and ensuring accurate coding and documentation across diverse payer types. Candidates should have CPC/CCS-P with 5+ years in outpatient coding/auditing, familiarity with EHR/EMR systems, and knowledge of HIPAA and fraud regulations. Hybrid schedule; equal opportunity employer. #J-18808-Ljbffr

The Marwood Group, a healthcare advisory services firm based in New York City with offices in DC and London, is seeking a Certified Coding Auditor to join our New York office or work remotely. You will perform remote billing and coding audits to ensure coding practices meet government and commercial payer regulations. The ideal candidate holds CPC/CCS-P with 5+ years in healthcare coding/auditing, understands E/M, CPT, HCPCS, ICD-10, and demonstrates strong knowledge of coding compliance and #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. Researching state and payer...

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 an outpatient 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 payors....

Job TitleUse 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 ResponsibilitiesReview 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 QualificationsMinimum of 2 years' professional medical coding experience.CPC or CCS-P certification.Proficient computer skillsDesired/Preferred QualificationsInsurance billing knowledgeExcelKnowledge of CMS guidelinesTotal RewardsGenerous benefits package, including:Salary: $27.35 - $37.61 HourlyPaid Time...

Job Title 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 Rewards Generous...

Dane Street is seeking an experienced CPC-certified medical coder to perform coding audits, utilization reviews, and related tasks in Florida. The role emphasizes Florida-based coding expertise, understanding of medical necessity and payer policies, and readiness to support depositions and testimony as required. The candidate should have strong documentation skills, prior audit experience, and the ability to work independently to meet deadlines. #J-18808-Ljbffr

Dane Street is seeking an experienced CPC-certified medical coder to perform coding audits, utilization reviews, and related tasks in Florida. The role emphasizes Florida-based coding expertise, understanding of medical necessity and payer policies, and readiness to support depositions and testimony as required. The candidate should have strong documentation skills, prior audit experience, and the ability to work independently to meet deadlines. #J-18808-Ljbffr

UB Associates, Inc. in the United States (Buffalo, NY area) seeks a Certified Medical Auditor to lead comprehensive audits of medical records and coding to ensure accuracy and compliance. You will evaluate ICD-10-CM, CPT, HCPCS practices, quantify financial impact, and drive process improvements across coding, billing, and compliance teams. The role requires CMA certification or equivalent, strong analytical and communication skills, and the ability to collaborate with multidisciplinary teams #J-18808-Ljbffr

## Medicare Risk Adjustment Compliance Auditor (CPC, CCS, or CCS-P Required) (Remote)Apply: Fully Remote: Anywhere in the U.S.: Full time: Posted Yesterday: End Date: October 16, 2026 (20 days left to apply): R2578Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.The Remote Risk Adjustment Compliance Auditor is to conduct provider and coder level reviews and audits to ensure accurate...

Job Description Job Description Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Auditors with strong expertise in outpatient professional fee coding and coding audits , preferably within academic medical centers. You will review coding records, identify compliance risks, and provide expert feedback to support AI-focused projects. No prior AI experience is required. Key Responsibilities Conduct detailed audits of outpatient professional fee coding records. Review coding accuracy, documentation, and compliance. Identify coding trends, gaps, risks, and improvement opportunities. Apply academic medical center standards and coding guidelines. Document audit findings and provide clear recommendations. Evaluate complex coding and documentation scenarios. Contribute to AI training through expert coding and audit feedback. Support audit program management and quality improvement initiatives. Required Qualifications...

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. 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. Responsibilities: 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.For physician billing, collaborates with billing department to ensure all bills are satisfied. For hospital, routes to billing charge entry errors and/or...

Medical Records Technician (Coder) AuditorThe Medical Records Technician (Coder) Auditor position is located at the Erie East VA Clinic. MRTs (Coders) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. These coding practitioners analyze and abstract patients' health records and assign alpha-numeric codes for each diagnosis and procedure.

Job Title:Quality Assurance Auditor/Coder Location: Phoenix, AZ or Remote Duration: 06 Month+ Conract Pay Range: $45/Hour on w2 Summary We are seeking an experienced Quality Assurance Auditor with coding background. strong background in HCC coding, risk adjustment, and medical record auditing . The ideal candidate will have experience reviewing medical records, conducting QA audits, identifying coding deficiencies, and supporting provider education and risk mitigation initiatives. Required 5+ years of professional coding experience, 3+ years of HCC/risk adjustment experience, 2+ years of auditing/QA experience, and an active CCS-P, CRC, CPC, or COC certification . Experience Experience with Medicare Advantage, RADV, HEDIS, CMS Star Ratings, and provider education is strongly preferred. #J-18808-Ljbffr

A healthcare provider is seeking a Clinical Coding Auditor & Trainer to develop training and quality auditing programs. The role primarily offers remote work with some travel to New York expected annually. Candidates should have a valid clinical license and experience in DRG and Medical Record Audits. This full-time position focuses on training, quality assurance, and compliance in a hospital environment. #J-18808-Ljbffr

Conducting audits of medical records, the full-time Certified Medical Review Auditor will evaluate the accuracy of medical coding and compliance with health plan policies for Fraud, Waste & Abuse clients while working remotely. Key responsibilities Conduct audits of medical records and healthcare claims to assess coding accuracy and compliance with regulations Prepare and submit detailed reports on audit findings, recommending corrections and process improvements Maintain current knowledge of federal, state, and payer policy and coding guidelines to support review findings Required qualifications Bachelor's Degree in a related discipline or equivalent combination of education and experience Certified Professional Coder (CPC, CCS, CCS-P) credential required 2-5 years of related experience in auditing medical records Preferred licenses: Licensed Practical Nurse (LPN) or Registered Nurse (RN) Proficiency in MS Office suite

Auditing medical records for compliance with federal coding regulations, the full-time Coding Compliance Audit & Education Specialist will conduct various audits, prepare reports, and provide education to providers on CPT, ICD-10, and HCPCS coding guidelines. Key responsibilities Conduct baseline, routine, and focused audits comparing medical record documentation to coding standards Prepare audit reports summarizing findings and conduct post-audit education for providers Act as an internal expert on coding issues, ensuring compliance with state and federal regulations Required qualifications 5+ years of audit and provider education experience preferred Extensive knowledge of CPT, ICD-10, and HCPCS codes and guidelines Certified Professional Coder (CPC) and Certified Professional Medical Auditor (CPMA) required Experience with MDAudit and Athena is a plus Must comply with all HIPAA rules and regulations

To ensure accurate risk adjustment data submission to CMS, the full-time Remote Medicare Risk Adjustment Compliance Auditor will conduct provider and coder level reviews, develop tracking tools, and monitor compliance with federal and state regulations. Key responsibilities Conduct audits and reviews of coding practices to identify outliers and ensure compliance with CMS regulations Develop and maintain tracking tools for risk adjustment compliance and monitor corrective action plans Collaborate with Risk Adjustment Management to validate data accuracy and support coding audits Required qualifications Minimum 3 years of professional coding experience in a medical group or health plan setting Bachelor's degree in business administration, health care management, or a related field, or 4 years of additional experience in lieu of education Certified Coder (CPC, CCS, or CCS-P) required Experience with strategic planning in risk mitigation Proficient in MS Office Suite; experience...

Regulatory Affairs Associate ENT and Allergy Associates, LLP and Hümi is seeking a self-motivated, people-friendly full time Regulatory Affairs Associate for our Tarrytown Corporate office location. Salary: $80,000-$85,000/year The Compliance Auditor and Coder supports the organization's Compliance Program by conducting risk-based medical record, coding, billing, and documentation audits for professional services. This role evaluates the accuracy and completeness of CPT, ICD-10-CM, HCPCS Level II, and modifier assignment; assesses compliance with applicable federal and state requirements, payer guidance, internal policies, and documentation standards; and identifies opportunities to reduce coding risk, prevent fraud, waste, and abuse, and strengthen revenue integrity. The position also serves as a coding and documentation resource to providers, staff, and management and supports education, corrective action, and follow-up monitoring. Audit priorities may be driven by...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation. Striving for...

Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team! Responsibilities The Outpatient Coder Auditor reviews and analyzes documentation present in the medical record for Outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Outpatient Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the assignment of International...

WellStreet Urgent Care is redefining the urgent care experience through patient-focused service, high-quality care, and strong partnerships with health systems. As a rapidly growing healthcare organization, we are building a national network of urgent care facilities and creating opportunities for talented professionals to make a meaningful impact. If you're an experienced medical coder who enjoys digging into documentation, identifying coding opportunities, and helping providers and coding teams improve accuracy, this could be a great opportunity to join our team. About the Role The Professional Coding Auditor reviews clinical documentation and coding to ensure accuracy, completeness, compliance, appropriate charge capture, and alignment between documentation and assigned CPT and ICD-10 codes. This role goes beyond identifying errors—you'll help educate providers and coders, identify trends, and partner with leadership to improve coding quality and reimbursement. What You'll Do...

Prime Healthcare is seeking an Outpatient Coder Auditor to review medical records for outpatient visits and ensure accurate coding. You will finalize coding and abstraction, verifying ICD-10-CM, CPT, and HCPCS accuracy based on clinical documentation. The role requires CCS or equivalent certification, familiarity with hospital coding and CMS guidelines, and the ability to work accurately in a fast-paced health system. Full-time daytime position with competitive benefits. #J-18808-Ljbffr