36 coder auditor jobs found

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines.  Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties. Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient accounts across the system,...

Hispanic Alliance for Career Enhancement is seeking a Medical Records Auditor to review and abstract records, assign ICD codes, and ensure accuracy for CMS risk adjustment. You will work to support compliant coding practices in healthcare settings. The role requires CPC or CCS-P credentials, at least one year of related experience, and a high school diploma. Competitive benefits and full-time hours are offered. #J-18808-Ljbffr

Hispanic Alliance for Career Enhancement is seeking a Medical Records Auditor to review and abstract records, assign ICD codes, and ensure accuracy for CMS risk adjustment. You will work to support compliant coding practices in healthcare settings. The role requires CPC or CCS-P credentials, at least one year of related experience, and a high school diploma. Competitive benefits and full-time hours are offered. #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: Benefits may vary based upon position type and/or level. Job...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Medical Coder II Red Lodge, MT, US 6 days ago Requisition ID: 1064 Salary Range: $20.83 To $28.63 Hourly Medical Coder II Status: Part Time (20 hours/week) | Non-Exempt Reports to: Health Information and Technology Manager Purpose and Scope of Position Responsible for reviewing and interpreting medical records, documents, and other patient data to assign appropriate codes for healthcare procedures, diagnoses, and services provided. These codes are used for insurance reimbursement, statistical purposes, and maintaining accurate patient records. Medical coders work closely with healthcare providers, insurance companies, and billing departments. Job Requirements Required Qualifications Education: High school diploma or equivalent. Certification: Certification from a recognized body such as the American Academy of...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards....

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...

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....

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU). The CPC will audit medical records for proper CPT/HCPCS coding and documentation, ensuring compliance with state, federal, and company guidelines. Strong communication and analytical skills are essential to articulate findings to investigators and regulators. The role requires 3+ years of coding experience, CPC certification, and knowledge of CPT/HCPCS, ICD-10, #J-18808-Ljbffr

Humana Inc. seeks a Senior Medical Coding Professional, Inpatient, to support payment integrity by reviewing inpatient claims for coding accuracy, DRG assignment, and compliance with guidelines. You will report to the Manager, Payment Integrity. You will apply ICD-10-CM/PCS coding guidelines, assess reimbursement impact, conduct retrospective audits, and collaborate with clinical reviewers and data analysts to drive accurate DRG coding and financial outcomes. #J-18808-Ljbffr

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...

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the SIU, ensuring coding accuracy and compliant documentation across medical, behavioral, and other healthcare areas. The role requires 3+ years in coding/audit, CPT/HCPCS/ICD-10 knowledge, and strong communication to share findings with investigators, leadership, and regulators. 40 hours weekly, full-time, with comprehensive benefits. #J-18808-Ljbffr

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...

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...

CVS Health is seeking a Medical Records Auditor to perform audits and abstract medical records, ensuring ICD codes are accurate and compliant with CMS, OIG, and state/federal regulations. Role requires CPC/CCS-P certification, at least 1 year of related experience, and proficiency with Microsoft Office and coding applications. Full-time, on-site position offering competitive benefits and schedule consistency. #J-18808-Ljbffr

Job Description Job Description The Ambulatory Coding and Reimbursement Specialist is responsible for reviewing, analyzing, and accurately coding ambulatory and/or hospital-based encounters. This role performs initial charge review for E/M visits, diagnostic tests, and procedures across multiple specialty departments to determine the appropriate assignment of CPT, ICD-10, HCPCS codes, and modifiers for reporting physician services to third-party payers. The Specialist ensures all coding aligns with established coding standards, regulatory requirements, and reimbursement policies. Essential Duties and Responsibilities: Analyzes provider documentation to assure the appropriate Evaluation & Management levels are assigned using the correct CPT and current Evaluation and Management Guidelines Interprets outpatient office visit notes and charge documents to determine services provided and accurately assign CPT , Modifiers, and ICD-10 coding to these services. Performs...

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...

NACBA is seeking a full-time Medical Records Auditor to perform audit and abstraction of medical records to identify and submit ICD codes for CMS risk adjustment, ensuring accuracy and compliance with state and federal regulations. Responsibilities include supporting coding judgments, auditing for medical necessity, distinguishing active vs historical conditions, meeting project deadlines, and performing self-audits to align with CMS, OIG, and internal policies. #J-18808-Ljbffr

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,...

Summary Join a leading healthcare organization as an Inpatient Health Information Coding Specialist, where you\'ll play a vital role in ensuring the accuracy, integrity, and quality of clinical data. This opportunity is ideal for experienced inpatient coders who enjoy working with challenging medical cases, collaborating with clinical teams, and contributing to both financial and patient care outcomes. You\'ll have the chance to work within a complex healthcare environment that values professional expertise, continuous learning, and coding excellence. About the Opportunity This position offers the opportunity to work with a highly skilled healthcare team supporting a large, sophisticated hospital environment. You\'ll be involved in coding some of the most medically complex patient encounters, helping ensure accurate reimbursement, regulatory compliance, and quality reporting. Success in this role comes from combining strong coding expertise with sound clinical judgment, attention...

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...

## Coder - Outpatient (Local Only - Texas/New Mexico)Applylocations: Business and Technology Centertime type: Full timeposted on: Posted Todayjob requisition id: R20874We’ve learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas.Job Summary The Coder-Outpatient is responsible for the ICD-10-CM, ICD-10-PCS, CPT and modifier assignment of diagnosis and procedures of an outpatient visit. Reports to: Job Specific Responsibilities Daily assignments may include but are not limited to: • Assign and sequence diagnostic and procedural codes for patient care, utilizing ICD-10, CPT, and HCPCS coding systems. • Ensure accurate and compliant coding of medical services and procedures based on clinical documentation. • Review patient records and physician documentation to validate coding accuracy and completeness. • Work collaboratively with healthcare providers and staff to clarify and address documentation...

Job Overview We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVSHealth®, 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. Responsibilities Determine correct coding and appropriate documentation during the review of medical records. Ensure that state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a comprehensive medical record audit...

## Coder - Outpatient (Local Only - Texas/New Mexico)Applylocations: Business and Technology Centertime type: Full timeposted on: Posted Todayjob requisition id: R20874We’ve learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas.Job Summary The Coder-Outpatient is responsible for the ICD-10-CM, ICD-10-PCS, CPT and modifier assignment of diagnosis and procedures of an outpatient visit. Reports to: Job Specific Responsibilities Daily assignments may include but are not limited to: • Assign and sequence diagnostic and procedural codes for patient care, utilizing ICD-10, CPT, and HCPCS coding systems. • Ensure accurate and compliant coding of medical services and procedures based on clinical documentation. • Review patient records and physician documentation to validate coding accuracy and completeness. • Work collaboratively with healthcare providers and staff to clarify and...