27 certified coding auditor jobs found

Datavant is seeking a Profee Auditing Specialist to conduct coding audits and ensure compliance within the healthcare sector. This fully remote position requires 5+ years of experience in Professional Fee coding, with a strong emphasis on customer service and leadership skills. The ideal candidate will have a CPC certification and experience with software such as Epic and Cerner, contributing to healthcare data solutions that improve health outcomes. #J-18808-Ljbffr

Compliance Coding Auditor Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year. All queries arising from the audit process are...

***To be considered for the role, you must permanently reside in one of the following states: Alabama, Arkansas, Florida, Georgia, Kentucky, Kansas, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, South Carolina, Tennessee, Texas, Virginia, or West Virginia*** The Senior Compliance Auditor reviews complex audits, performs quality assurance reviews, acts as a peer mentor, and assists management with onboarding process of new auditors. The Senior Compliance Auditor supports the audit supervisor with the development and maintenance of the quarterly audit work plan and audit workflow processes. The Senior Compliance Auditor recommends changes to improve business operations by using professional judgement and knowledge of best practices. This position contributes to special projects, as applicable. The Senior Compliance Auditor performs documentation/chart audits on inpatient and outpatient records, and to provide analysis of the records (provider and facility)...

Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Tidewater Community College's Workforce Solutions Department seeks an experienced Medical Coder/Auditor to lead a hands-on Certified Professional Medical Auditor (CPMA) exam–preparation course. This position is an adjunct instructor position in the college's non-credit program under Workforce Solutions. This program includes both continuing education for professional development and industry recognized credential attainment, which may be offered Asynchronously, at TCC campuses and other convenient locations throughout the community. The CPMA instructor will prepare students to audit medical records and ensure coding accuracy and compliance. Emphasis is placed on healthcare regulations, documentation review, and revenue integrity. The candidate will deliver engaging CPMA-focused instruction using real-world coding scenarios, chart reviews, and denial analysis. The instructor must be...

Posting Details Posting Summary Working Title Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Role Title Role Code FLSA Exempt Pay Band UG Position Number 295A0003 Agency Tidewater Community College Division Tidewater Community College (Div) Work Location Suffolk - 800 Hiring Range Commensurate with qualifications and experience. Emergency/Essential Personnel No EEO Category I-Faculty Full Time or Part Time Part Time Does this position have telework options? -Telework options are subject to change based on business needs- No Does this position have a bilingual or multilingual skill requirement or preference? Work Schedule Varies Sensitive Position No Job Description Tidewater Community College has served South Hampton Roads - both students and employers - for 50 years. It has grown from 1 campus into a regional educational and economic force. TCC is...

Title: Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Agency: Tidewater Community College Location: Suffolk - 800 FLSA: Exempt Hiring Range: Commensurate with qualifications and experience. Full Time or Part Time: Part Time Additional Detail Job Description: Tidewater Community College has served South Hampton Roads - both students and employers - for 50 years. It has grown from 1 campus into a regional educational and economic force. TCC is the largest provider of higher education and workforce services in Hampton Roads, enrolling nearly 25,000 students in 2024-25. Founded in 1968 as a part of the Virginia Community College System, Tidewater Community College (TCC) services South Hampton Roads with 4 campuses in Chesapeake, Norfolk, Portsmouth, and Virginia Beach, 7 regional centers and 2 important cultural institutions. The college had 3,399 graduates in 2024-2025, 40 percent of whom pursued degrees...

Job Title: Medical Biller (Medicaid & MCO - Behavioral Health) Full-time Office Address: 20116 Ashbrook Pl #100 Ashburn, VA Compensation: USD 25 - USD 28 - hourly Position Summary The Medicaid & MCO Biller is responsible for accurate and timely submission, tracking, and reconciliation of claims for services billed to DC Medicaid and Managed Care Organizations (MCOs). This role ensures compliance with District of Columbia Department of Health Care Finance (DHCF) regulations and payer‑specific billing requirements while supporting revenue cycle efficiency. Eligibility & Authorization Verification Verify Medicaid eligibility using systems such as DC Access System or other payer portals. Confirm MCO enrollment and service coverage prior to claim submission. Track and manage prior authorizations and limitations. Claims Submission & Processing Submit clean claims to DC Medicaid and MCOs (e.g., AmeriHealth Caritas DC, MedStar Family Choice DC, Wellpoint, HSCSN)....

Inpatient Coder (Remote) Full-time Work From Home Must have CCS, RHIA, or RHIT certification Job Summary As a Coding Integrity Specialist III WORK FROM HOME, you will review and evaluate hospital inpatient medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM and ICD-10-PCS codes. A CIS III performs coding and/or code/DRG validation across multiple entities by applying all appropriate coding guidelines and criteria for code selections. Job Qualifications Assign, sequence, validate, and/or edit codes/DRGs and abstracted data (e.g., physician, discharge disposition, query tracking) for inpatient records for multiple facilities using ICD-10-CM and ICD-10-PCS Maintain or exceed established accuracy standards Maintain or exceed established productivity standards Utilize the complete patient medical record documentation in code/DRG assignment, validation, and/or editing of codes/DRGs Undergraduate (Associate's or Bachelor's)...

Job Title Newport News, Virginia FOR APPLICATION REVIEW - PROVIDE YOUR AAPC CERTIFICATION NUMBER ON YOUR APPLICATION OR RESUME This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA. Hours: Labor Pool (as needed) Overview Ensures high quality documentation that is thorough, accurate and complete to ensure correct reimbursement capture. Assigns diagnostic and procedure codes to simple record types up to highly complex record types. Contributes to the proper management of health information through consistent and accurate code assignment processes adhering to all regulatory coding principles, rules and regulations. What You Will Do Organizes and prioritizes assigned work to ensure that work is completed within the assigned time frame. Reviews charts and entire medical records, assigning ICD and CPT code combinations to each data element. Audits for documentation opportunities and queries clinical...

Coding Specialist Newport News, Virginia This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA. Overview Responsible for maintaining coded data quality through ongoing quality review and assessment of outpatient or inpatient records. Performs audits on accuracy of APC or MSDRGs as well as on quality of medical record documentation needed for accurate coding. Works with DRG and CPT denials from commercial payers and writes appeal letters as indicated. What you will do Ensures coding compliance. Applies all coding guidelines and principles as defined in the Coding Clinic and leading authorities. Complies with standardized coding standards, conventions and regulations, corporate compliance standards and reimbursement policies. Identifies training needs and provides education to team members. May teach or coordinate coding huddles. Coaches and mentors staff. Performs focused reviews and quality...

Summary This position is located in the Health Information Management (HIM) section at the Central Virginia Health Care System, Fredericksburg Virginia. MRTs (Coder) 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. Responsibilities Total Rewards of a Allied Health Professional Outpatient MRTs (Coder) at this level perform the full scope of outpatient coding including ambulatory surgical cases, diagnostic studies and procedures, outpatient encounters, and/or inpatient professional services. Specific Functions: Assigns codes to documented patient care encounters (outpatient and/or inpatient professional services) covering the full range of health care services provided by the VAMC. Patient encounters are often complicated and complex requiring extensive coding expertise. Applies advanced knowledge of medical...

Newport News, VirginiaFOR APPLICATION REVIEW - PROVIDE YOUR AAPC CERTIFICATION NUMBER ON YOUR APPLICATION OR RESUMEThis position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA.Hours: Labor Pool (as needed)OverviewEnsures high quality documentation that is thorough, accurate and complete to ensure correct reimbursement capture. Assigns diagnostic and procedure codes to simple record types up to highly complex record types. Contributes to the proper management of health information through consistent and accurate code assignment processes adhering to all regulatory coding principles, rules and regulations.What you will doOrganizes and prioritizes assigned work to ensure that work is completed within the assigned time frame. Reviews charts and entire medical records, assigning ICD and CPT code combinations to each data element. Audits for documentation opportunities and queries clinical staff to fill in any gaps...

Company Overview Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities Acentra Health is looking for a Medical Coder-Inpatient to join our growing team. Job Summary: The Medical Coder is responsible for reviewing inpatient medical record documentation to ensure the accuracy, completeness, and...

Position: Medical Coding Specialist (Outpatient) Location: Falls Church, VA (Hybrid-3 days onsite) Duration: Long Term(03/24/2026 - 09/23/2026 with 960 hours in total and with further extensions) Job Description: • We are seeking a certified and experienced Medical Coding Specialist (Outpatient) to support Client- Patient Administration Division (PAD) initiatives. The ideal candidate will have strong expertise in outpatient coding, auditing, and compliance within Military Health System (MHS) and MHS GENESIS environments, ensuring accurate and timely coding aligned with DoD standards. Responsibilities: • Perform accurate Outpatient Medical Coding using ICD-10-CM, CPT, and HCPCS in compliance with Client and DoD guidelines • Conduct Coding Audits and Quality Reviews to ensure accuracy, completeness, and regulatory compliance • Review and analyze clinical documentation to assign appropriate diagnosis and procedure codes • Work within MHS (Military Health Systems) and...

Job Family : Operational Effectiveness Consulting Travel Required : Up to 25% Clearance Required : Ability to Obtain Public Trust What You Will Do: Guidehouse is seeking a Revenue Integrity Analyst (Medical Biller) with strong billing, coding, and revenue cycle expertise to support the modernization of MHS GENESIS, the DoD's enterprise EHR. The role ensures accurate billing, compliant charge capture, and efficient claim resolution by analyzing data, auditing documentation, and collaborating with clinical, coding, IT, and financial teams across the Military Health System. Responsibilities of this role are as follows, to include but not limited to: Revenue Integrity & Charge Capture Optimize and validate MHS GENESIS / Cerner charge capture workflows, CDM logic, billing rules, and revenue cycle configuration. Conduct charge capture validation, reconciliation of clinical activity to billing outputs, and identification of DNFB risks and...

USA Government Jobs - - Responsibilities: Perform outpatient medical coding using ICD-CM, CPT, and HCPCS; Review health records to abstract diagnoses and procedures; Consult with clinical staff to clarify documentation; Use encoder software to assign codes and transmit data; Ensure audit findings are corrected and refiled

Newport News, Virginia FOR APPLICATION REVIEW - PROVIDE YOUR CREDENTIAL OR AHIMA ID NUMBER ON YOUR APPLICATION OR RESUME This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA. Overview Responsible for maintaining coded data quality through ongoing quality review and assessment of outpatient or inpatient records. Performs audits on accuracy of APC or MSDRGs as well as on quality of medical record documentation needed for accurate coding. Works with DRG and CPT denials from commercial payers and writes appeal letters as indicated. What you will do Ensures coding compliance. Applies all coding guidelines and principles as defined in the Coding Clinic and leading authorities. Complies with standardized coding standards, conventions and regulations, corporate compliance standards and reimbursement policies. Identifies training needs and provides education to team members. May teach...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and or level. Job...

Under the direction of the Health Information Management Director, the Outpatient Coder I accurately determines ICD-10-CM diagnosis, ICD-10-CM, CPT and HCPCS procedure codes for all outpatient medical records, which may include Emergency Department (ED), outpatient laboratory, diagnostic imaging, minor outpatient procedures, infusion and injections, outpatient labor and delivery, recurring accounts and observation stays. POSITION RESPONSIBILITIES Abstract pertinent information from patient records within various outpatient types and assign appropriate ICD-10-CM, ICD-10 PCS, and HCPCS codes, creating ambulatory payment classifications (APC). Monitor and manage the discharged not final billed (DNFB) accounts within assigned patient types daily to meet financial goals and expectations. Meet coding productivity standards and accuracy rates as determined by company policy. Query clinical staff to achieve accuracy in coding. Educate, train and communicate with medical staff...

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...

Starts out onsite, then transitions to REMOTE 4 days/week. Job Summary: Required Services provide single path medical coding services and related medical records functions. Single path coding combines facility coding and professional coding and allows one coder to code facility and professional codes for the same patient utilizing a single coding platform. perform technically complex professional services coding for medical conditions and assign the correct International Classification of Diseases, ICD-10-CM, Procedure Coding System (PCS) Current Procedural Terminology (CPT), Health Care Financing Administration Common Procedure Coding System (HCPCS), and Evaluation and Management (E&M) codes for diagnosis, acuity of care and procedures for a wide range of medical specialties to include coding of complicated cases identified as difficult to classify such as treatment of burn injuries, combat related injuries, orthopedic surgery, cardiothoracic surgery, interventional...

Job Description Job Description Medical Biller Job Summary Performs billing of clinical services rendered. General Accountabilities Determines appropriate charges based on services provided. Reviews patient accounts to ensure accuracy and completeness of claims billing for maximum reimbursement. Reviews explanations of benefits from third-party payers to determine if payment was made correctly and if denials can be re-billed. Analyzes and maintains reports to ensure timely submission of claims. Identifies problem accounts requiring further work. Provides information to insurance carriers or patients regarding patient accounts. Assists patients with billing problems. Notifies supervisor of ongoing problems. Resolves or clarifies codes or diagnoses with conflicting, missing, or unclear information by consulting with doctors, and the Practice Manager. Audits appeals of denied claims. Maintains files on all documentation, such as charge slips, Explanations of...

Coder RMG (Labor Pool) page is loaded## Coder RMG (Labor Pool)remote type: Remotelocations: Newport Square Professional Center - Newport News, Virginiatime type: Part timeposted on: Posted Todayjob requisition id: 2026-034308Newport News, Virginia**FOR APPLICATION REVIEW - PROVIDE YOUR AAPC CERTIFICATION NUMBER ON YOUR APPLICATION OR RESUME*****This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA.*****Hours:** Labor Pool (as needed)**Overview** Ensures high quality documentation that is thorough, accurate and complete to ensure correct reimbursement capture. Assigns diagnostic and procedure codes to simple record types up to highly complex record types. Contributes to the proper management of health information through consistent and accurate code assignment processes adhering to all regulatory coding principles, rules and regulations. **What you will do*** Organizes and prioritizes...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...