27 coder auditor jobs found

POSITION PURPOSE Areas of emphasis will include inpatient and outpatient coding of provider charges as well as documentation reviews and audits. Secondary responsibilities will include assisting Physicians Billing staff and clinic staff with coding questions. SITE(S) Kenosha Campus Urgent Care Physicians Billing Service MINIMUM EDUCATION REQUIRED High School or Equivalent (GED) MINIMUM EXPERIENCE REQUIRED 1-3 years Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician (CCS-P) MINIMUM EXPERIENCE PREFERRED LICENSES / CERTIFICATIONS REQUIRED Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician (CCS-P). SUPERVISES N/A KNOWLEDGE, SKILLS & ABILITIES REQUIRED Knowledge of CPT and ICD-10 codes Ability to accurately audit provider documentation to ensure all CPT codes and ICD-10 codes are accurately assigned...

A healthcare solutions provider is seeking a DRG Quality Auditor to perform quality assurance audits for clinical and coding staff. Responsibilities include reviewing medical records, validating DRG assignments, and ensuring compliance with coding guidelines. The ideal candidate should have an active RN license, coding certification, and extensive clinical experience. This remote position offers flexible hours and requires a strong knowledge of DRG reimbursement methodologies. #J-18808-Ljbffr

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world. At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you're interested in joining a health care system that is changing the face of care and well-being in our community, we...

Job Summary Are you dedicated to advancing compliance in healthcare? Join our dynamic team as a Lead Compliance Auditor. Your expertise will be vital in protecting our health plans from regulatory and contractual discrepancies. Your role will significantly contribute to the detection and management of compliance risks, ensuring the integrity and safety of Molina Healthcare. Essential Job Duties Lead and conduct thorough pre-delegation and annual audits to guarantee adherence to all regulatory and accreditation standards. Examine delegate policies, procedures, and case files meticulously, ensuring high-quality service delivery. Work closely with delegate leadership to evaluate risks and create effective solutions together. Leverage your analytical skills to identify systemic issues and collaborate with other departments to mitigate risks. Analyze audit outcomes, determine root causes, and develop comprehensive corrective action plans (CAPs). Prepare and manage...

Working Conditions Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure The Coding Auditor, Senior performs code audits and is responsible for chart auditing processes as well as contributing to the education of providers and internal stakeholders on coding topics. The position is responsible for keeping up to date on the newest coding guidelines and best practices while promoting compliance with existing American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. Specific approaches to job duties vary depending on the department. Estimated Hiring Range $81,000.00 - $99,000.00 Bonus Target Bonus - SIP Target, 5% Annual Current CareOregon Employees: Please use the internal Workday site to submit an application for this job. Essential Responsibilities Perform and lead a variety of coding-related audits for providers and other entities. Review medical records to verify that complete and accurate...

Risk Adjustment Coding Auditor, Sr page is loaded## Risk Adjustment Coding Auditor, Srremote type: Remotelocations: Remote Oregon: Remote Utah: Remote Texas: Remote Idaho: Remote Wisconsintime type: Full timeposted on: Posted 2 Days Agojob requisition id: JR100739Risk Adjustment Coding Auditor, Sr---------------------------------------------------------------The Coding Auditor, Senior performs code audits and is responsible for chart auditing processes as well as contributing to the education of providers and internal stakeholders on coding topics. The position is responsible for keeping up to date on the newest coding guidelines and best practices while promoting compliance with existing American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. Specific approaches to job duties vary depending on the department.**Estimated Hiring Range:**$81,000.00 - $99,000.00**Bonus Target:**Bonus - SIP Target, 5% AnnualCurrent...

Working Conditions Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure The Coding Auditor, Senior performs code audits and is responsible for chart auditing processes as well as contributing to the education of providers and internal stakeholders on coding topics. The position is responsible for keeping up to date on the newest coding guidelines and best practices while promoting compliance with existing American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. Specific approaches to job duties vary depending on the department. Estimated Hiring Range $81,000.00 - $99,000.00 Bonus Target Bonus - SIP Target, 5% Annual Current CareOregon Employees: Please use the internal Workday site to submit an application for this job. Essential Responsibilities Perform and lead a variety of coding-related audits for providers and other entities. Review medical records to verify that complete and accurate...

A healthcare organization is seeking a Senior Coding Auditor to lead coding audits, ensure compliance with regulations, and educate internal stakeholders. The ideal candidate will have over 5 years of experience as a certified coder, with strong knowledge of diagnosis coding conventions. The role requires maintaining active coding certification and engaging in continuous education on coding topics. Benefits include competitive pay and a comprehensive rewards program, along with opportunities for professional development. #J-18808-Ljbffr

*Location:* *Remote (WI/IL preferred).* Candidates must reside in the U.S.; *not eligible* from CA, CO, CT, IL, ME, MN, NJ, NY, OR, or WA. *Schedule:* Full-time, remote | Flexible hours after training *Work Setup:* Private, dedicated workspace with a door required *About the Role* We're seeking a detail-oriented and experienced *Inpatient Coder (Coder Inpatient II)* to join our Health Information Management team. In this remote role, you will accurately assign *ICD diagnosis/procedure codes* and *MS-DRGs* for inpatient hospital services at an academic, Level I Trauma environment. You'll code across complex specialties (e.g., Neurology, Oncology, Urology, Transplant, OB/Newborn, Orthopedics, Cardiology, Critical Care), collaborate with providers via compliant queries, and partner closely with CDI to ensure documentation supports the most appropriate DRG assignment. This is an advanced, independent role where accuracy, communication, and sound judgment are essential. *What...

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. ***** FT and PRN Openings *** Up to $5,000 Sign On Bonus ***** 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...

Become a part of our caring community and help us put health first 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. 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...

We are seeking a *detailoriented and experienced Inpatient Coder* to join our Health Information Management team. This role focuses on qualitydriven inpatient coding within a collaborative, highperformance environment. The ideal candidate values accuracy over volume and is comfortable managing a focused inpatient workload while maintaining compliance with MSDRG standards. *Key Responsibilities* * Review and analyze *inpatient medical records* to assign accurate *ICD10CM, ICD10PCS, and CPT codes* * *Ensure compliance with MSDRG classification* and coding guidelines * Work from a designated *Work Queue*, receiving one inpatient chart at a time * Average *4-5 inpatient accounts per day*, prioritizing quality and accuracy * Utilize *Epic EHR*, *3M Encoder*, and *Viziant (REM score calculator)* to support compliant coding * Maintain high coding quality standards, including participation in *monthly audits (10% of charts)* * *Engage in coaching, feedback, and quality improvement...

*Description* Key Responsibilities: Review and analyze inpatient medical records to assign accurate ICD and CPT codes. Utilize Epic, 3M (encoder), and Viziant (REM score calculator) to support coding accuracy and compliance. Work from a designated Work Queue, receiving one inpatient chart at a time. Maintain a high standard of coding quality, with monthly audits covering 10% of coded charts. Participate in coaching and quality improvement initiatives as needed. Communicate effectively and professionally with clinical and non-clinical staff. Adapt to changing priorities and multitask in a fast-paced environment. Work independently while contributing to a collaborative team culture. Qualifications: Strong knowledge of medical terminology, anatomy & physiology, and pathophysiology. Proficient in ICD and CPT coding systems and MS-DRG classification. Experience using Epic, 3M Encoder, and Microsoft Office products. Excellent attention to detail and organizational...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Senior auditor responsible for clinical or physician compliance topics. Assigned the most complex clinical/documentation/coding/billing reviews. Provides guidance to other auditors within AHN on audit approach and analysis. Responsible for creating and overseeing orientation of auditors. Leads all hospital or physician audits/investigations, auditing support and responses related to external audit activity. ESSENTIAL RESPONSIBILITIES: Establishes and implements orientation for all members of the AHN audit compliance team. Evaluates the progress of team members including review of reports and audit activities. Works with senior management responsible for AHN-wide case management/physician programs to develop processes that meet Medicare and 3rd party payor requirements. Provides guidance to staff auditors on audit topics and reports. (20%) Conducts educational sessions for...

Major Responsibilities: This role will have all responsibilities of coder I, II and III in addition to: reviews complex inpatient documentation at a highly skilled and proficient level to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software. Adhere to organizational and internal department policies and procedures to ensure efficient work processes. Responsible for coding high dollar and long length of stay cases for all patient types. Expertise in query guidelines, and coding standards. Follow up and obtain clarification of inaccurate documentation as appropriate ....

Medical Billing Specialist Full-time • 80 hours per pay period • Monday-Friday • Benefited - 8th Street Campus Black River Health is seeking a detail-oriented, motivated professional to join our Finance & Revenue Cycle team as a Medical Billing Specialist. In this role, you will ensure accurate billing, timely claim submission, effective follow-up, and strong collaboration across departments to support the financial health of our organization. What You'll Do As a Medical Billing Specialist, you will play a key role in ensuring claims are processed accurately and efficiently while supporting both patients and internal teams. Your responsibilities include: Essential Duties Correct, complete, and process claims for all payors according to established standards Perform follow-up with payors on unpaid accounts identified through aging reports, denials, or payer rejections Demonstrate thorough knowledge of billing policies and procedures, including editing,...

Job Description Job Description Medical Billing Specialist Full-time • 80 hours per pay period • Monday–Friday • Benefited – 8th Street Campus Black River Health is seeking a detail-oriented, motivated professional to join our Finance & Revenue Cycle team as a Medical Billing Specialist. In this role, you will ensure accurate billing, timely claim submission, effective follow-up, and strong collaboration across departments to support the financial health of our organization. What You’ll Do As a Medical Billing Specialist, you will play a key role in ensuring claims are processed accurately and efficiently while supporting both patients and internal teams. Your responsibilities include: Essential Duties Correct, complete, and process claims for all payors according to established standards Perform follow‑up with payors on unpaid accounts identified through aging reports, denials, or payer rejections Demonstrate thorough knowledge of billing policies...

CSI Companies is seeking an experienced Professional Fee (ProFee) Coder with a strong background in Mental Health and/or Primary Care coding. This role is responsible for accurately reviewing, assigning, and validating CPT, ICD-10-CM, and HCPCS codes for outpatient provider services to ensure compliance with federal regulations and payer-specific guidelines. The ideal candidate brings strong knowledge of behavioral health documentation standards, E/M coding guidelines, and regulatory compliance within physician practice or outpatient settings. This role requires high accuracy, productivity, and the ability to work independently in a remote environment. Hours: 40 hours/week – Monday to Friday, standard business hours Location: Remote (CST) – Must reside in Texas Pay: Competitive Market Rate Work Authorization Visas are acceptable (any EAD). Candidates must be eligible to work on W2 and must not require sponsorship for at least 6–12 months. What you’ll do Review and assign...

A healthcare organization is seeking a Coder Inpatient III to manage coding for complex inpatient cases in a remote setting. The ideal candidate will have at least 3 years of coding experience, exceptional skills in anatomy and physiology, and be familiar with various software tools. Responsibilities include accurate coding assignments and performing audits. This position offers a competitive pay range and various employment benefits. #J-18808-Ljbffr

A healthcare provider organization in Wisconsin seeks a Senior Coding Auditor. This role requires performing code audits, ensuring compliance with coding guidelines, and educating providers on coding practices. Candidates should have at least 5 years of coding experience, current certification, and expertise in risk adjustment programs. A comprehensive benefits package and a bonus opportunity are also offered. Join a team committed to excellence in healthcare coding. #J-18808-Ljbffr

A healthcare solutions company seeks an experienced CPC certified medical coder to conduct medical coding audits and utilization reviews. The ideal candidate must reside in Texas and have at least 5 years of coding experience, with strong knowledge of Texas Medicaid policies. Responsibilities include performing audits, preparing reports, and providing litigation support. The position may be part-time, offering comprehensive benefits such as medical coverage, paid time off, and a 401k plan with a company match. #J-18808-Ljbffr

MUST RESIDE IN TEXAS AND HAVE CODING AND AUDITING EXPERIENCE. Counter Affidavit as well as Testimony experience is preferred. We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong Texas based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. Counter Affidavit experience is preferred. Responsibilities Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS) Conduct utilization reviews to determine medical necessity and documentation compliance Review and prepare demand packages and audit response materials Analyze records for payer disputes and recoupments Prepare written audit findings and defensible reports Provide expert support for depositions and testimony as needed Review...

A leading medical coding firm is seeking an experienced CPC certified medical coder in Texas to conduct coding audits and provide litigation support. Candidates should have a minimum of 5 years of coding experience, with at least 3 years in Texas. The role includes performing audits, conducting reviews for medical necessity, and preparing documentation. The firm offers a comprehensive benefits package, including medical, dental, vision coverage and a 401k plan with company match. #J-18808-Ljbffr

CODER INPATIENT III – Froedtert Health Location: Menomonee Falls, WI – Woodland Prime 400 facility (Remote) Sign-On Bonus: Eligible for a $2,000 sign‑on bonus. Job Summary This is a remote, high‑level coding position functioning under general supervision. The Coder III accurately assigns ICD diagnosis and procedure codes, MS‑DRGs, and APR‑DRGs for inpatient hospital services at Froedtert Health, which includes an academic Level I Trauma Center. The role focuses on highly complex trauma and acutely ill patients, including mortality, extended length of stay, and high‑dollar cases. A key responsibility is performing chart audits for levels I and II coders, applying official and departmental coding rules, regulations, and guidelines, and meeting or exceeding productivity and quality standards. Coding staff communicate directly with care providers to clarify information needed for complete and accurate coding and partner with clinical documentation improvement specialists....