24 coder auditor jobs found

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Outpatient Coding Compliance Auditor performs audits of outpatient facility (OPPS) coding to ensure accurate assignment of ICD-10-CM diagnoses, CPT/HCPCS codes, modifiers, and facility E/M levels (ACEP or client-specific). This role reviews coding for alignment with medical record documentation and established guidelines, ensuring compliance with applicable laws, regulations, and billing standards while...

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:...

Overview The Compliance Auditor Provider Liaison is responsible for conducting detailed audits of professional coding and provider documentation across numerous specialties, identifying compliance risks, and promoting best practices through education and feedback. The auditor partners closely with providers, coders, and revenue cycle leadership to ensure alignment with organizational policies, payer requirements, and federal regulations. Qualifications Education: High School diploma or GED required. License: Certified Coder with Auditing Certification with AAPC Experience: Minimum of 5 years of experience in a hospital or professional revenue cycle. Minimum of 5 years coding experience with CPC certification. Minimum of 3 years of coding auditing experience. Broad exposure to multiple specialties such as cardiology, general and specialized surgery, oncology, and primary care/nternal medicine strongly preferred. Deomonstrated experience educating or training providers on...

Overview The Compliance Auditor Provider Liaison is responsible for conducting detailed audits of professional coding and provider documentation across numerous specialties, identifying compliance risks, and promoting best practices through education and feedback. The auditor partners closely with providers, coders, and revenue cycle leadership to ensure alignment with organizational policies, payer requirements, and federal regulations. Qualifications Education: High School diploma or GED required. License: Certified Coder with Auditing Certification with AAPC Experience: Minimum of 5 years of experience in a hospital or professional revenue cycle. Minimum of 5 years coding experience with CPC certification. Minimum of 3 years of coding auditing experience. Broad exposure to multiple specialties such as cardiology, general and specialized surgery, oncology, and primary care/nternal medicine strongly preferred. Deomonstrated experience educating or training providers on...

Overview The Compliance Auditor Provider Liaison is responsible for conducting detailed audits of professional coding and provider documentation across numerous specialties, identifying compliance risks, and promoting best practices through education and feedback. The auditor partners closely with providers, coders, and revenue cycle leadership to ensure alignment with organizational policies, payer requirements, and federal regulations. Qualifications Education: High School diploma or GED required. License: Certified Coder with Auditing Certification with AAPC Experience: Minimum of 5 years of experience in a hospital or professional revenue cycle. Minimum of 5 years coding experience with CPC certification. Minimum of 3 years of coding auditing experience. Broad exposure to multiple specialties such as cardiology, general and specialized surgery, oncology, and primary care/nternal medicine strongly preferred. Deomonstrated experience educating or training providers on...

Job Title Individual responsible for coding all hospital ED, RCR, CLI, REF records for purposes of reimbursement, research, and compliance with federal regulations. Responsibilities Reviews patient's entire current medical record and assigns appropriate ICD-10 diagnosis and CPT procedure codes according to accepted coding guidelines and hospital's policies and procedures. Assigns accurate APC and E-APG's to patient's record utilizing hospital encoding system. Corrects any edits flagged by encoder and financial system. Understands and applies modifiers appropriately. Charge entry. Accurately abstracts statistical data from records using hospital abstracting system. Attends hospital sponsored coding educational programs and department coding meetings. Participates in and practices lean management principles and processes. DCH Standards: Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation....

Medical Coder Individual responsible for coding all hospital records for purposes of reimbursement, research, and compliance with federal regulations. Applies correct ICD-10-CM diagnosis, ICD-10-PCS or CPT procedure codes, applies modifiers and assigns appropriate DRG, APC, and E-APG's. Coder must abstract statistical data from records into hospital abstracting system in accordance with hospital policies and procedures. Individual must have knowledge of ICD-10-CM/PCS, CPT, APC's, E-APG's, and DRGs, federal and state coding guidelines. Responsibilities Reviews patient's entire current medical record and assigns appropriate ICD-10-CM diagnosis, ICD-10-PCS or CPT procedure codes according to accepted coding guidelines and hospital's policies and procedures. Assigns accurate DRG, APC, or E-APG to patient's record utilizing hospital encoding system. Accurately abstracts statistical data from records using hospital abstracting system in accordance with hospital policies and...

Medical Coder Individual responsible for coding all hospital records for purposes of reimbursement, research, and compliance with federal regulations. Applies correct ICD-10-CM diagnosis, ICD-10-PCS or CPT procedure codes, applies modifiers and assigns appropriate DRG, APC, and E-APG's. Coder must abstract statistical data from records into hospital abstracting system in accordance with hospital policies and procedures. Individual must have knowledge of ICD-10-CM/PCS, CPT, APC's, E-APG's, and DRGs, federal and state coding guidelines. Responsibilities Reviews patient's entire current medical record and assigns appropriate ICD-10-CM diagnosis, ICD-10-PCS or CPT procedure codes according to accepted coding guidelines and hospital's policies and procedures. Assigns accurate DRG, APC, or E-APG to patient's record utilizing hospital encoding system. Accurately abstracts statistical data from records using hospital abstracting system in accordance with hospital policies and...

Certified Professional Coder A Certified Professional Coder (CPC) job description generally involves reviewing patient medical records, abstracting relevant clinical information, and assigning appropriate medical codes using ICD-10, CPT, and HCPCS code sets. CPC responsibilities also include ensuring accurate documentation and coding, facilitating claims processing, and complying with regulatory requirements. Key Responsibilities / Essential Functions Accurately translate patient encounters into standardized medical codes (ICD-10, CPT, and HCPCS). Analyze patient records for completeness, accuracy, and compliance with coding guidelines. Research and analyze data needs for accurate and timely reimbursement. Conduct chart audits, identify coding discrepancies, and implement corrective actions. Communicate effectively with healthcare providers to clarify coding issues and ensure accurate documentation. Keep abreast of changes in coding guidelines, regulations, and...

Overview Individual responsible for coding all hospital ED, RCR, CLI, REF records for purposes of reimbursement, research, and compliance with federal regulations. Applies ICD-10 diagnosis and CPT procedure codes and appropriate APC or E- APG. Coder must abstract statistical data from records into hospital abstracting system in accordance with hospital policies and procedures. Individual must have knowledge of CPT, APCs, E-APG's, federal and state coding guidelines. Responsibilities Reviews patient's entire current medical record and assigns appropriate ICD-10 diagnosis and CPT procedure codes according to accepted coding guidelines and hospital's policies and procedures. Assigns accurate APC and E-APG's to patient's record utilizing hospital encoding system. Corrects any edits flagged by encoder and financial system. Understands and applies modifiers appropriately. Charge entry. Accurately abstracts statistical data from records using hospital abstracting...

Overview A Certified Professional Coder (CPC) job description generally involves reviewing patient medical records, abstracting relevant clinical information, and assigning appropriate medical codes using ICD-10, CPT, and HCPCS code sets. CPC responsibilities also include ensuring accurate documentation and coding, facilitating claims processing, and complying with regulatory requirements. Responsibilities Coding and Abstracting: Accurately translate patient encounters into standardized medical codes (ICD-10, CPT, and HCPCS). Documentation Review: Analyze patient records for completeness, accuracy, and compliance with coding guidelines. Reimbursement Analysis: Research and analyze data needs for accurate and timely reimbursement. Auditing and Compliance: Conduct chart audits, identify coding discrepancies, and implement corrective actions. Communication and Collaboration: Communicate effectively with healthcare providers to clarify coding issues and ensure accurate...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

A leading healthcare company is seeking an experienced Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement from the comfort of your home. This crucial role involves extracting clinical information from medical records, assigning codes, and ensuring payment accuracy. You will need to have at least 4 years of experience with relevant qualifications and skills in medical coding. Join us to make an impact in the health sector and work with a Fortune 100 employer that rewards performance. #J-18808-Ljbffr

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Clearview Cancer Institute is north Alabama's leading cancer treatment facility. For over 30 years Clearview Cancer Institute has provided leading-edge treatment and compassionate care to those diagnosed with cancer or blood disorders. Clearview offers every service and amenity needed in an outpatient setting and our dedication to research and involvement in Phase I-IV clinical trials gives our patients the opportunity to receive potentially life‑saving treatment options. Why Join Us? We are looking for talented and highly‑motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve. Job Purpose The purpose of the Certified Professional Coder is to input diagnostic codes for medical services rendered and ensuring that the assigned codes meet required regulations. Essential Job Functions Input appropriate diagnostic codes for various medical services. Ensure that the assigned codes meet all federal, legal,...

Job Description Job Description Certified Professional Coder (CPC-A/CPC) – Surgical Practice Location: Daphne, AL (In-Office) Pay: $22–$25 per hour Benefits: Health Insurance, 401(k) Match, 10 Days PTO About the Opportunity We are seeking a detail-oriented and motivated Certified Professional Coder (CPC-A or CPC) to join our growing surgical practice in Daphne, Alabama. This position will support a team of six surgeons by accurately coding surgical procedures and related services. The ideal candidate will have strong surgical coding experience and a solid understanding of Evaluation & Management (E/M) coding , although E/M experience is preferred rather than required. You will work alongside a collaborative coding team of two additional coders and play a key role in ensuring coding accuracy, compliance, and revenue cycle success. Key Responsibilities Review and accurately assign CPT, ICD-10-CM, and HCPCS codes for surgical services provided by six...

Responsibilities After training, this position may work remote. Must be located in the State of Alabama or Georgia. Interpret and bill for physician, clinical, and surgical services using Allscripts EHR/PM, using ICD-10 coding. Ensure billing for payors is accurate and transmitted on time. Audit batches and documentation as necessary to ensure compliance with UCA and regulatory standards. Qualifications Be a CPC, or equivalent, certified coder with at least two years of experience. Benefits We are located in Homewood, away from the hectic downtown Birmingham area. We are a local, physician owned practice. We are more than just urology, we have a men's health and women's center, a comprehensive cancer center, and 17 locations across Alabama. BCBS Health Insurance. Generous time off and paid holidays. #J-18808-Ljbffr

Huntsville Hospital Health System is seeking a Compliance Auditor Provider Liaison to conduct detailed audits of professional coding and documentation across specialties. You will identify compliance risks and promote best practices through education and feedback. The role requires collaboration with providers, coders, and revenue cycle leadership to ensure alignment with policies, payer rules, and federal regulations. #J-18808-Ljbffr

Under general supervision of the Director, the Coder II provides consistency and efficiency in outpatient claims processing and data collection to optimize APC reimbursement and facilitate data quality in outpatient services. Reviews, audits, and reports on charge capture. Maintains patient confidentiality at all times. ESSENTIAL JOB FUNCTIONS Analyzes IP, OP, Recurring, & SDC records and appropriately codes per coding guidelines, ICD-10-CM and CPT rules and updates, creating APC or DRG group assignments. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Concurrently codes Recurring records for interim billing. Processes records for deficiencies and return for completion. Enters codes into the Abstracting Module as needed, including use of the 3M encoder. Performs data quality reviews on outpatient encounters to validate the ICD-10-CM, CPT, and HCPCS Level II code and...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2814 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced...

About the Team We areQuadcode, a fintech company excelling in financial brokerage activities and delivering advanced financial products to our global clientele. Our flagship product, an internal trading platform, is offered as a Software-as-a-Service (SaaS) solution to other brokers. About a year and a half ago, we launched an ambitious AI project: Quadcode.ai — a next-generation IDE for multimodal AI generations (code, images, video, sound) and agentic scenarios. Quadcode.ai is already available for download: https://quadcode.ai/ AI Creator This isn't just about creating examples. You develop full‑fledged applications and solutions within Quadcode.ai that demonstrate the entire spectrum of platform capabilities. This means: writing complex prompts, creating high‑quality content portfolios, recording video presentations, becoming an ambassador for the platform. Essentially, your projects are the showcase for all users — proof of what our IDE can do. This is a role for someone...

Huntsville Hospital Health System is seeking a Compliance Auditor Provider Liaison to conduct detailed audits of professional coding and documentation across specialties. You will identify compliance risks and promote best practices through education and feedback. The role requires collaboration with providers, coders, and revenue cycle leadership to ensure alignment with policies, payer rules, and federal regulations. #J-18808-Ljbffr

Certified Professional Coder A Certified Professional Coder (CPC) job description generally involves reviewing patient medical records, abstracting relevant clinical information, and assigning appropriate medical codes using ICD-10, CPT, and HCPCS code sets. CPC responsibilities also include ensuring accurate documentation and coding, facilitating claims processing, and complying with regulatory requirements. Responsibilities Coding and Abstracting: Accurately translate patient encounters into standardized medical codes (ICD-10, CPT, and HCPCS). Documentation Review: Analyze patient records for completeness, accuracy, and compliance with coding guidelines. Reimbursement Analysis: Research and analyze data needs for accurate and timely reimbursement. Auditing and Compliance: Conduct chart audits, identify coding discrepancies, and implement corrective actions. Communication and Collaboration: Communicate effectively with healthcare providers to clarify coding issues...