19 coder auditor professional jobs found

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:...

Requisition number: 2366610 Job category: Regulatory & Compliance 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,...

Improve the lives of others while Caring. Connecting. Growing together. Job Description - Outpatient Facility Coding Compliance Auditor (2366610) Outpatient Facility Coding Compliance Auditor - 2366610 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...

Become a part of our caring community The 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 Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

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. Responsibilities 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...

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. 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...

Position Details Title: Accountant 1 – Medical Billing Specialist Location: Salem, OR – Equitable Center Agency: Oregon Youth Authority Position Type: Employee Salary Range: $4,519.00 - $6,904.00 Initial Posting Date: 06/04/2026 Application Deadline: (not specified) Overview Put your medical billing expertise to work for Oregon’s youth. The Oregon Youth Authority (OYA) is hiring an Accountant 1 – Medical Billing Specialist to manage the Medicaid billing and reimbursement that directly funds treatment and services for youth in our care. This is a hybrid role based in Salem to handle Medicaid Management Information System (MMIS) billing, Title XIX eligibility reviews, and remittance reconciliations, making sure every claim is accurate, compliant, and timely. If you have healthcare revenue‑cycle experience plus accounting coursework — or an accounting credential and the drive to master Medicaid billing — we want to hear from you. OYA offers competitive state benefits,...

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...

Overview Individual responsible for coding all hospital IP records for purposes of reimbursement, research, and compliance with federal regulations. Applies correct ICD-10CM diagnosis and /ICD-10PCS procedure codes and assigns appropriate DRG. Coder must abstract statistical data from records into hospital abstracting system in accordance with hospital policies and procedures. Individual must have knowledge of DRG’s and federal and state coding guidelines. Responsibilities Reviews patient’s entire current medical record and assigns appropriate ICD-10-CM diagnosis and ICD-10- PCS procedure codes according to accepted coding guidelines and hospital’s policies and procedures. Assigns accurate DRG to patient’s record utilizing hospital encoding system. Accurately abstracts statistical data from records using hospital abstracting system in accordance with hospital policies and procedures. Attends hospital sponsored educational programs and department coding meetings. Issues...

Job Title Individual responsible for coding all hospital IP records for purposes of reimbursement, research, and compliance with federal regulations. Responsibilities Reviews patient's entire current medical record and assigns appropriate ICD-10-CM diagnosis and ICD-10-PCS procedure codes according to accepted coding guidelines and hospital's policies and procedures. Assigns accurate DRG to patient's record utilizing hospital encoding system. Accurately abstracts statistical data from records using hospital abstracting system in accordance with hospital policies and procedures. Attends hospital sponsored educational programs and department coding meetings. Issues queries or send charts for query to clarify diagnoses in the patient's medical record in compliance with hospital policies and guidelines. Participates in and practices lean management principles and processes. DCH Standards: Maintains performance, patient and employee satisfaction and financial standards as...

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. 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 documentation. Staying Updated: Keep...

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...

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

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. 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...

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,...

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...

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...