65 coder auditor jobs found

CVS Health is seeking a Certified Professional Coder to perform medical claim reviews for the Special Investigations Unit. The CPC will ensure coding compliance, review medical records, and identify billing irregularities across providers and plans. The role requires CPC certification, 3+ years in coding/auditing, and strong knowledge of CPT/HCPCS/ICD-10. A statewide or NC-based focus with thorough documentation and collaboration with Medical Directors is expected. #J-18808-Ljbffr

Baylor Scott & White Health is seeking a Coding Auditor I to perform coding quality audits and provide feedback to coders using ICD-10-CM/PCS, HCPCS, CPT and related references to ensure accurate classification and billing. The role collaborates with Clinical Documentation Specialists, abstracts data, and completes production coding when required. A certified coder with 5 years of experience (RHIA/RHIT/CCS/CCS-P/CPC/COC/CIC/CIRCC) is preferred, with at least 1 year as an auditor. #J-18808-Ljbffr

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:...

Description Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina. Summary: Performs technical and administrative work reviewing, abstracting and assigning accepted medical CPT, HCPCS, and ICD-10 codes for professional services. Duties are performed in compliance with third party, state and federal regulations according to standardized procedures. Employees report to an administrative superior but independently handle assigned tasks. Responsibilities: Assigns International Classification of Diseases 10-CM diagnostic and ICD-10-PCS procedural codes accurately and productively, and other applicable codes such as MS-DRG on inpatient cases for all Health Care system cases excluding the academic medical center Groups codes and completed product into payment group. Assigns codes that affect Severity of Illness and Risk of Mortality and...

Position SummaryThe RCS Medical Coding Auditor is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback.The ideal candidate brings strong hands-on experience with professional fee coding , deep knowledge of E/M, surgical, and modifier use , and the ability to translate audit findings into actionable insights.Key ResponsibilitiesPerform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedbackValidate ICD‑10‑CM, CPT, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelinesConduct medical chart audits of professional services across multiple specialtiesIdentify coding discrepancies,...

CaroMont Health in Gastonia, NC seeks a compliance auditor/coder to implement and maintain a system-wide program ensuring accurate coding and documentation in line with federal guidelines. The role leads provider meetings, prepares audit reports, and supports risk assessments and annual planning. Requires a health information management degree or 5–10 years of audit/coding experience, plus CPC/COC/CCS certifications and strong regulatory knowledge. #J-18808-Ljbffr

Job Summary Assists with implementing and maintaining a system-wide effective compliance program through performance of compliance and coding quality audits. Under indirect supervision, assures appropriateness and accurate coding assignments in accordance with federal coding regulations and guidelines. Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to professional and facility fee documentation, coding and billing, including CMS and OIG compliance standards. Leads meetings with providers to review the audit findings and recommend ways to improve when indicated. Prepares written reports of findings. Also responsible for providing assistance with coding inquiries from providers, coders, billing staff, etc. Monitors relevant resources and publications related to high-risk compliance areas. Serves as an audit software system administrator as assigned. Serves...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

UNC Health Care in North Carolina seeks a healthcare coder to capture data from medical records for reimbursement, statistics, research and benchmarking. You will work daily with the CDI Auditors as part of the Clinical Documentation Improvement Team (CDI) and support accurate documentation. Requires RHIT/RHIA or CCS credentials, an associate degree in Health Information Technology or Nursing (LPN/RN), 3 years of healthcare coding experience, and ICD-9/ICD-10 proficiency. #J-18808-Ljbffr

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Coder II Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina. UNC Health Nash, an affiliated member of the UNC Health system, invites passionate healthcare professionals to join our esteemed team. Governed locally, we proudly serve a diverse patient base, spanning Nash, Edgecombe, Halifax, Wilson Counties, and beyond. With a steadfast commitment to elevating community health through exceptional care, we prioritize excellence, compassion, and innovation, ensuring every individual receives the highest standard of support. Joining our team means becoming an integral part of our dedication to wellness, where we constantly strive to redefine excellence in healthcare through state-of-the-art facilities and pioneering programs. Join us in this transformative journey, where your contributions will make a lasting impact on our community's health and wellbeing. Summary:...

UNC Health Nash is seeking a Credentialed Medical Coder to support clinical documentation and accurate reimbursement across Nash Counties. You will capture data from medical records, assign ICD-9/ICD-10 and CPT codes for IP and OP accounts, and collaborate with the CDI team to ensure appropriate severity of illness. As part of the Clinical Documentation Improvement Team, you will work with CDI auditors, provide education within Health Information Management, and perform duties in a remote, #J-18808-Ljbffr

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Internal Auditor The Internal Auditor is responsible for conducting regular medical record and coding compliance reviews to ensure that organizational strategies, practices and internal controls are in place and in compliance with all legal and industry regulations. Regularly reviews appropriate federal and state regulations, industry standard policies and procedures, i.e., CMS, AHIMA, AMA, etc., to ensure compliance Conducts internal audits, following established protocols, furnishing detailed reports and periodic updates of audit findings, presenting any irregularities or exceptions, as well as pertinent recommendations for improvement, to the Provider, Auditing Supervisor, executive management, the Compliance Committee, Physician Board and others as appropriate Provides feedback and instruction to the Provider regarding documentation improvements, to include EHR best practices Essential Duties/Responsibilities: Serve as a compliance resource for all coding...

Join First Choice Community Health Centers Nestled in the heart of North Carolina, Harnett County offers a unique blend of small-town charm and convenient access to big-city amenities. Located less than an hour from both Raleigh and Fayetteville, residents enjoy the tranquility of rural living with the benefit of nearby urban excitement. At First Choice, we're proud to offer employment opportunities in this beautiful area, giving you the chance to work in a close-knit community while staying connected to the vibrant Triangle region. With a perfect balance of peaceful + affordable living and easy access to cultural and career opportunities, Harnett County is an ideal place to call home. Position Summary The Medical Billing Specialist will be responsible for billing and collections for Medicare, Medicaid, Insurance, and Self Pay patients for all Medical and Dental clinics. Responsibilities of individual Billing Specialist will vary depending on assignment of responsibilities...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Description At BLS, we pride ourselves on providing high-quality financial services with a focus on supporting our clients’ unique needs. We are currently seeking an experienced Employee Benefit Plan Accountant to join our growing team. This position offers the opportunity to work with a dynamic group of professionals in an engaging and fast-paced environment. Job Responsibilities: Assist in the preparation and review of financial statements of employee benefit plans (including defined contribution (401(k), 403(b), etc.), defined benefit, and health & welfare plans) Assist in the preparation of Form 5500 and related filings Manage the audits of employee benefit plans and coordinate with clients and their service providers Ensure compliance with ERISA regulations and other applicable laws Perform related testing procedures including reconciliation of reports, analysis of certifications and trust reports, sample selection procedures, participant data, contribution,...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas,...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington. *Now offering a $10,000 sign-on bonus that will pay out in 4 equal installments over 24 months6-month increments. Occ Summary The Medical Records Coder II is a certified coder. Coordinate/review the work of subordinate employees and assist with...

Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington. *Now offering a $10,000 sign-on bonus that will pay out in 4 equal installments over 24 months - 6-month increments. Occ Summary The Medical Records Coder II is a certified Coder. Coordinate/review the work of subordinate employees and assist...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Jobtailor is seeking a medical billing and coding specialist to review records, assign CPT and ICD-10 codes, and oversee end-to-end billing processes. The role includes audits of coding accuracy and handling denials to maximize payments. Applicants should have 2–5 years in medical environments, CPT/ICD-10 proficiency, and EMR experience. Strong MS Office skills and HIPAA knowledge are essential for daily operations. #J-18808-Ljbffr

If you are an Enrolled Catawba Citizen and need help with resume writing and interview prep this is available. Please contact: maddison.montgomery@catawba.comJob Summary:The compliance auditor is responsible for ensuring that the company is adhering to legal aspects of regulatory compliance reporting. This would include examinations of gaming transaction-related activities, reviewing records, reports, software and any other relevant programs and activities affected by regulations. As part of their responsibilities, Compliance Auditors will analyze potential risks within specific areas of their duties to avoid compliance issues. They also review and enforce compliance with standards or regulations imposed by professional organizations or even a company’s internal guidelines. They might conduct audits in the areas of accounting, finance, information technology or security.Responsibilities:Ensures compliance with regulations and controls by examining and analyzing records, reports,...