99 coder auditor jobs found

Job Title Dallas, TX 8hr shift M-F Looking for someone with outpatient or inpatient hospital coding compliance or coding auditing experience. CPC or CCS certification. Responsibilities: Assign, sequence, validate, and edit codes for multi-specialty professional outpatient/inpatient encounters for both adults and pediatrics Assign appropriate E/M, ICD-10-CM and/or CPT codes based on documentation and/or payer requirements HEDIS measures CAT II code reporting for HTN, diabetes, obesity, and cervical cancer Review NCCI and nosology edits for accurate code capture Review LCD's and/or payor policies to appropriately resolve coding edits Evaluate medical record for provider signature and validate provider facility credentials Resolve and/or clarify clinical data as necessary Review and run data reports to monitor individual productivity Utilize Current Coding guidelines, Coding Clinic, CPT Assist for coding accuracy guidance

Role type: Risk Adjustment Coding Auditor Quantity of resources: 2 Duration: 6 months JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's. Required skillset: MS Suite CPC certified CRC certified 5+ years of risk adjustment experience

Job Summary (Par time-Potential for Fulltime) The Certified ER Medical Coding Auditor is responsible for auditing emergency department medical records to ensure accurate coding, compliance, and optimal reimbursement. This role also includes training and mentoring offshore coding teams to maintain high-quality standards and consistency across operations. Key Responsibilities Audit ER charts for accurate assignment of ICD-10-CM, CPT, and HCPCS codes Validate E/M level selection for emergency department visits Ensure compliance with payer guidelines and regulatory standards (CMS, HIPAA) Identify under coding, over coding, and documentation deficiencies Prepare detailed audit reports with corrective recommendations Provide education and feedback to coders and providers Train and mentor offshore coding teams on ER coding guidelines and audit findings Conduct regular quality review sessions and calibration meetings with offshore staff Develop and update...

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:...

Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: • Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to...

Data Quality Auditor Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). IP, OP Coding: Reviews medical records for the determination of accurate assignment of all documented ICD-10-CM codes for diagnoses and procedures. Abstracts accurate required data elements (facility/client specific elements) including appropriate discharge disposition....

Job Description Job Description Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc.   Job Responsibilities/Duties: · Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or...

## CPC-A Certified Coder RepresentativeApplylocations: San Antonio, Texas, USA - Remotetime type: Full timeposted on: Posted Todaytime left to apply: End Date: August 31, 2026 (30+ days left to apply)job requisition id: R\_2606\_7783**About TaskUs:** TaskUs is a provider of outsourced digital services and next-generation customer experience to fast-growing technology companies, helping its clients represent, protect and grow their brands. Leveraging a cloud-based infrastructure, TaskUs serves clients in the fastest-growing sectors, including social media, e-commerce, gaming, streaming media, food delivery, ride-sharing, HiTech, FinTech, and HealthTech.The People First culture at TaskUs has enabled the company to expand its workforce to approximately 45,000 employees globally. Presently, we have a presence in twenty-three locations across twelve countries, which include the Philippines, India, and the United States.It started with one ridiculously good idea to create a different...

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 an 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...

Risk Adjustment Coding Auditor Role type: Risk Adjustment Coding Auditor Quantity of resources: 2 Duration: 6 months This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's. Required Skillset MS Suite CPC certified CRC certified 5+ years of risk adjustment experience #J-18808-Ljbffr

Job Overview Role type: Risk Adjustment Coding Auditor. Quantity of resources: 2. Duration: 6 months. JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's. Required Skills MS Suite CPC certified CRC certified 5+ years of risk adjustment experience Equal Opportunity Statement We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. #J-18808-Ljbffr

Vytwo Technologies Inc. seeks a Risk Adjustment Coding Auditor to perform first and second pass auditing for CMS RADV programs. The role supports a small team with two resources over a 6-month duration, ensuring accuracy and compliance in coding and documentation. The candidate should be a certified risk adjustment coder with CPC and CRC credentials and at least five years of risk adjustment experience. #J-18808-Ljbffr

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. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines Utilize encoders and various coding resources Perform CPT Procedure reviews Maintain strict patient and physician...

Baylor Scott & White Health in Texas seeks a Coding Auditor 1 to join our healthcare coding team. You will perform coding quality audits, review coder work, and provide actionable feedback to ensure accurate ICD-10-CM/PCS, HCPCS, CPT coding and proper DRG classifications. You will abstract data, collaborate with Clinical Documentation Specialists, and complete production coding as assigned by leadership. A strong knowledge of coding rules, HIPAA, and documentation standards is essential, with #J-18808-Ljbffr

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Position is responsible for leading multiple reviews / audits of healthcare coding, billing, documentation, operations, and related risk areas to support compliance with regulatory standards, internal policies and procedures, and other guidelines. Typically reports to Director, Corporate Compliance. Job Description Location : Memorial Hermann, Memorial City Status :...

The Medical Coder is responsible for assigning procedure and diagnosis codes for insurance billing, reviewing claims data, researching medical records, and corresponding with insurance companies to secure accurate reimbursement for healthcare claims. Duties include but are not limited to: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims Adhere to coding policies and procedures consistent with industry-standard guidelines for CPT, ICD-9 and ICD-10 Answer coding questions Review clinical documentation to ensure it meets the level of CPT codes, ICD-10 and ICD-11 codes Perform related duties as...

Position Description Provides day-to-day supervision and support to the coding team responsible for outpatient, in-patient, and clinic-based services across Texas Tech Physician clinics. This role ensures coding accuracy, compliance with regulatory requirements, and timely encounter completion to support revenue cycle integrity and organizational goals. The supervisor serves as a working leader who performs coding and/or auditing functions while supervising team members, monitoring productivity and their quality performance. This position works collaboratively with the Coding Manager, Compliance, and Revenue Cycle teams to implement policies, resolve coding-related issues, and promote consistent application of coding standards across multiple specialties and oversees a staff. Major/Essential Functions Supervise daily operations and employees on your team of the centralized ambulatory coding team, ensuring timely and accurate coding of outpatient encounters. Monitor...

The Medical Coder to assign procedure, diagnosis codes for insurance billing, review claims data, research and correspond with insurance companies in an effort to obtain accurate reimbursement for healthcare claims. Duties include but are not limited to: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims Adhere to coding policies and procedures consistent with the industry-standard guidelines for CPT, ICD-9 and ICD-10. Answer coding questions Review clinical documentation to ensure it meets the level of CPT codes, ICD-10 and ICD-11 codes Performs related duties,...

Medical AI Auditor We are building the future of clinical documentation and need your expert eye to keep it accurate, safe, and reliable. As a Medical AI Auditor, you will act as the ultimate clinical guardrail—reviewing AI‑generated behavioral health notes to detect hallucinations. What You’ll Do Audit AI‑generated behavioral health notes against source session data, catching subtle clinical inaccuracies, unsupported inferences, or errors in medical terminology. Ensure documentation aligns with behavioral health standards and distinguishes between appropriate clinical language and inappropriate or robotic phrasing. Navigate multi‑platform, document‑intensive review systems while maintaining a high level of focus. Apply advanced editing and proofreading skills to perfect English grammar, punctuation, and terminology, directly training the AI to write better notes. What We Are Looking For Baseline Credential: Certified Professional Coder – Apprentice (CPC‑A) from AAPC, or...

Medical Center Health System in Odessa, Texas is seeking a Certified Coding Specialist responsible for reviewing electronic encounter documents to ensure accuracy in coding procedures. The successful candidate will assign applicable codes, audit medical records, and ensure compliance with all guidelines. The role requires a high school diploma or equivalent, certification from an accredited program, and a minimum of two years' experience in medical coding. Excellent communication and problem-solving skills are essential. #J-18808-Ljbffr

Certified Coder -- On Site With Remote Option Accountable for conversion of diagnoses and treatment procedures into codes using an international classification of diseases. Requires skill in the sequencing of diagnoses/procedures to optimize reimbursement. Ensures that records are coded in an accurate and timely manner. Ensures that records are coded within 36 hours of discharge, excluding weekends and holidays. Reviews medical record thoroughly to ascertain all diagnoses/procedures. Queries healthcare providers in accordance to the department query policy. Refers medical record to director, if there is a question regarding the diagnoses/codes. Utilizes computerized coding/abstracting equipment. Codes all diagnoses/procedures in accordance to ICD coding principles and the Coding Manual. Reviews coding periodicals within seven (7) days of receipt. Ensures data quality and optimum reimbursement allowable under the federal and state payment systems. Acts as a...

Join Our Caring Community Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities: Deliver coding and documentation education to providers and clinic staff within IPA clinics. Be a consultative resource and ongoing support for providers in assigned clinics. Conduct documentation audits to identify gaps, trends, and opportunities for improvement. Perform quarterly chart reviews to support coding accuracy...

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,...