33 coder auditor professional jobs found

Job Description Job Description Hi, we're Oscar. We're hiring an Associate, SIU Coding Auditor to join our SIU. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Associate, Special Investigations Unit Coding Auditor executes on Oscar's anti-fraud initiatives by supporting operational and financial targets while adhering to legal and regulatory obligations. You will help execute on audit strategy by ensuring team productivity is met while ensuring quality remains high. The associate networks across all partners, and recommends enhancements to processes, policies, and procedures to support a best in class Fraud Waste and Abuse program. We ask that you have attention to detail, innovation, and ability to shift priorities to align...

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients. Job Summary Our client is looking for a Coding Auditor to join their team. The primary responsibilities include developing expertise in CPT, HCPCS, and ICD-10 coding guidelines, efficiently performing policy updates or audits on medical records or claims, and drafting written communications to providers. Key Responsibilities Develop and maintain expertise on CPT, HCPCS, and ICD-10 Coding guidelines and billing requirements. Perform thorough and complex policy updates or audits on medical records or claims. Document findings clearly for both clinical and non-clinical audiences. Create reports and reference guides for team communication and efficiency. Assist in drafting provider communication about audit findings. Participate in educational calls with providers. Train new team members. Develop and document team efficiency and...

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 Description Job Description PLEASE NOTE - This position may require temporarily relocation to other TONHC Facilities: Sells Hospital, Santa Rosa Health Center, San Simon Health Center, and San Xavier Health Center. Position Summary: The Lead Medical Coder serves as a certified professional coder and assists the Medical Coding Office Manager with oversight of daily coding operations. Performs the full range of coding, assigns ICD, CPT, HCPCS, and medical inpatient codes; abstracts data from the record; performs chart analysis, research coding issues; peer reviews; and serves as a medical documentation and coding technical expert to TONHC providers. Scope of Work: This position is located within Tohono O'odham Nation Health Care (TONHC). The work involves performing specialized medical record tasks and resolving problems using established processes, coding conventions, and guidelines. Performance of duties reflects directly on patient care by recording services...

Healthcare Coder Essential Functions For This Position: Ensures that codes are assigned correctly and sequenced appropriately as per government and insurance regulations. Complies with all medical coding guidelines. Follows up and clarifies any information that is not clear with the rendering provider. Conducts ad-hoc audits to ensure fidelity to coding guidelines. Relevant expert for Southwest Network on accurate and efficient coding practices. Analyze medical records and identify documentation deficiencies. Nonessential Functions: Follows policies and procedures and adheres to the requirements of the Corporate Compliance Program. Ensures confidentiality of verbal and written information in accordance with HIPAA standards and Southwest Network policy, and adheres to the legal, ethical, and professional guidelines adopted by Southwest Network. Other duties as assigned. Education and/or Experience, Licensure and Certification: Associate degree in medical coding or successful...

Responsibilities Essential Functions For This Position: Ensures that codes are assigned correctly and sequenced appropriately as per government and insurance regulations. Essential Functions For This Position: Ensures that codes are assigned correctly and sequenced appropriately as per government and insurance regulations. Essential Functions For This Position: Complies with all medical coding guidelines. Essential Functions For This Position: Follows up and clarifies any information that is not clear with the rendering provider. Essential Functions For This Position: Conducts ad-hoc audits to ensure fidelity to coding guidelines. Essential Functions For This Position: Relevant expert for Southwest Network on accurate and efficient coding practices. Essential Functions For This Position: Analyze medical records and identify documentation deficiencies. Nonessential Functions: Follows policies and procedures and adheres to the requirements of the Corporate Compliance...

Coder 3 - Remote The Coder 3 electronically records, stores, and reports on reams of data. Responsible for coding the following service types based on department and assignments: Facility HIM: Inpatient, outpatient, emergency room, and outpatient clinical. Ambulatory: Coding and auditing professional, inpatient, outpatient, emergency, and clinic. Coders will need to apply a broad knowledge of procedure coding, diagnosis coding, medical terminology, and anatomy/physiology. Responsibilities: Communication: Works in collaboration with physicians in tracking un-coded charts and identifying opportunities to properly complete coding assignments. Works closely with Clinical Documentation Improvement (CDI) specialists, providers, and clinical staff to develop and maintain a comprehensive audit and management system to ensure proper charge capture, sufficient documentation, and proper code assignment across all service lines. Mentors and trains other coders in the department....

Job Description Unlock your potential for professional development! We are hiring a ED / Observation Coder (Full Time) to join our Imaging Services Team! Located in northwest Arizona, Kingman has a mild climate with stunning Arizona sunsets! In the shadows of beautiful mountain ranges and nearby lakes, Kingman is an outdoor enthusiasts' paradise with abundant sunshine and is a great community to live, work and play! Position Purpose: All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI's vision to be among the kindest, highest quality health systems in the country. The ED / Observation Coder oversees assigned departments' charging through software systems. Benefits ( Full Time Employees ) We offer you an excellent total compensation package, including a competitive salary, comprehensive benefits, and growth opportunities: Exceptional Colleagues Join us and you'll be a part of a culture where we...

Job Description Staff Position Description Position Title: Professional Services Certified Coding Reviewer Position Code: Coder-8125 Department: Health Information Management Safety Sensitive: YES Reports to: HIM Director/Manager Exempt Status: NO Position Purpose: All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI's vision to be among the kindest, highest quality health systems in the country. Key Responsibilities Ensures data quality in compliance with State, Federal and regulatory requirements. • Evaluates medical record documentation and charge reports to ensure completeness, accuracy and compliance with the Correct Coding Initiative Edits. • Codes all professional charges to ensure accurate and timely billing • Perform coding reviews and/or surgical coding for practices and providers. • Evaluates and report audit findings or reviews and reports on results to physicians and/or...

Summary This position is located in the Health Information Management (HIM) section at the Southern Arizona VA Health Care System (SAVAHS). MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. Duties Help Duties include, but are not limited to: Outpatient MRTs (Coder) at this level perform the full scope of outpatient coding including ambulatory surgical cases, diagnostic studies and procedures, outpatient encounters, and/or inpatient professional services. Outpatient duties consist of the performance of a comprehensive review of documentation within the health record to accurately assign ICD-10-CM codes for diagnoses, CPT/HCPCS codes for surgeries, procedures and evaluation and management services. They independently review and abstract clinical data from the record for documentation of...

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...

Join Datavant, a leading data collaboration platform in healthcare, as we strive to make health data secure, accessible, and actionable. Our mission empowers providers, health plans, researchers, and life sciences companies to transform the way data is utilized for better health outcomes. By becoming a part of our team, you will contribute to meaningful innovations in healthcare from the comfort of your own workspace. Exciting Opportunities Available: Full-Time and PRN Positions with up to $5,000 Sign-On Bonus! What We're Looking For As an experienced inpatient coder, you will play a vital role in our team. We seek candidates with meticulous attention to detail and an extensive knowledge of medical terminology. This fully remote position offers a flexible schedule to help you thrive. Your Responsibilities: Assign diagnostic and procedural codes using ICD-10-CM and ICD-10-PCS codes. Abstract and sequence medical codes accurately from patient records while...

Certified Professional Coder (AR & Denials) - Phoenix, AZ Direct Hire | $27-$32/hr | Monday-Friday, 8AM-5PM Confidential Employer - Third?Party Recruiter Posting Potential Remote Flexibility for Experienced Candidates About the Role We are seeking an experienced Certified Professional Coder to support Accounts Receivable (AR) and Denials Management for a specialty medical group based in Phoenix, AZ. This is a direct?hire opportunity offering stability, growth, and the potential for remote work for top?tier candidates. The ideal candidate brings strong coding accuracy, experience working denials end?to?end, and comfort working with specialty practices- Neurology experience is a major plus . Familiarity with Athena (Athenahealth) is also preferred. Key Responsibilities Perform accurate coding using ICD?10?CM, CPT, and HCPCS Audit and scrub claims to ensure high clean?claim rates Investigate and resolve payer denials; submit...

Position Summary TheMedical Coder/Audit Specialist position is an exempt salaried position thatensures that AAAI's coding, documentation, and billing practices are accurate,compliant, and aligned with payer regulations. This role reduces risk exposure,strengthens revenue capture, manages payer portals, and supports providersthrough education and proactive auditing. This position supports timelysubmission of insurance claims to a wide variety of payers and functions as anintermediary between healthcare providers, clients, patients and healthinsurance companies. Must be certified from an accredited organization such as AAPC (CPC) (CCS) is required in coding and / or billing. Reports To: Medical PracticeAdministrator Principal Duties andResponsibilities 1.Revenue Protection & Growth Accurate Coding = Correct Reimbursement: Ensures all CPT/ICD-10 codes and HCPCS are properly supported, reducing underpayments. Audit-Driven Optimization: Identifies missed...

Lakewood Surgery Center is hiring a full time Medical Biller Welcome to Lakewood Surgery Center At Lakewood Surgery Center, we provide first-class surgical services for local communities and recognize our employees as our number one assets. We focus on offering a high quality, ambulatory care alternative to a hospital for surgical procedures. Our facility is accredited by The Joint Commission. Medical Biller at Lakewood Surgery Center The Medical Biller is responsible for overseeing the entire billing process for patient accounts, from submitting all billings to insurance in a timely manner, to working with our coding specialist to ensure that all cases are coded correctly, leading monthly coding audits, and taking the lead role in driving insurance collections. Essential Job Duties and Responsibilities include the following: Electronically submit patient procedure bills to third party payers Perform timely and accurate postings of payments received from...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2675 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced knowledge...

Certified Professional Coder (AR & Denials) Phoenix, AZ Direct Hire | $27$32/hr | MondayFriday, 8AM5PM Confidential Employer Third-Party Recruiter Posting Potential Remote Flexibility for Experienced Candidates About the Role We are seeking an experienced Certified Professional Coder to support Accounts Receivable (AR) and Denials Management for a specialty medical group based in Phoenix, AZ. This is a direct-hire opportunity offering stability, growth, and the potential for remote work for top-tier candidates. The ideal candidate brings strong coding accuracy, experience working denials end-to-end, and comfort working with specialty practicesNeurology experience is a major plus. Familiarity with Athena (Athenahealth) is also preferred. Key Responsibilities Perform accurate coding using ICD-10-CM, CPT, and HCPCS Audit and scrub claims to ensure high clean-claim rates Investigate and resolve payer denials; submit corrected claims and appeals Monitor AR aging...

Sage Clinical RCM, LLC supports leading healthcare organizations nationwide, is collaborative with a quality-driven culture, and an excellent opportunity to contribute to audit accuracy and coding excellence without unrealistic productivity expectations. Come join our team! www.sageclinicalrcm.com Position Summary The Professional Billing Coder - Cardiothoracic / Special Surgical is responsible for accurate and compliant coding of physician professional services for complex surgical procedures. This role supports timely claim submission, regulatory compliance, and revenue integrity within a hospital-based professional billing environment. Key Responsibilities Assign accurate CPT, HCPCS, and ICD-10-CM codes for cardiothoracic and other special surgical services Review operative reports, clinic notes, and supporting documentation to ensure complete and compliant coding Apply appropriate modifiers, bundling rules, and NCCI edits Ensure compliance with CMS, AMA, and...

Specialist - Concurrent Coding / Inpatient Coder Accounting and Finance/Healthcare Job Description Specialist-Concurrent Coding/Inpatient Scottsdale Arizona 85258 Exp 2-5 Degree Associates Job Summary: The Concurrent Coding Specialist performs and facilitates concurrent inpatient coding in order to establish a working DRG. Ensures high quality documentation that is thorough, accurate and complete to ensure accurate reimbursement capture. He or she will concurrently reviews health records, identifies key clinical data elements within the record, and translate this data from verbal description of disease, injuries and procedures into numerical designations, applying ICD coding systems. Audits for documentation opportunities and queries clinical staff with CDI to fill in any gaps, clarify confusing, incomplete or conflicting information and obtain any needed additional documentation in real time. Ensures coding compliance and acts as technical resource, resolves issues,...

Surgery Him Coder Wickenburg Community Hospital is a beautiful and sophisticated rural-access hospital located in Wickenburg, Arizona. WCH is a 8-bed Emergency Department, 19-bed Acute department and many ancillary services. We also have 3 Primary Care Clinics. Here at WCH, we strive to maintain the highest standards of professionalism and care. Join us today and let us be part of your success story. We offer: Full Benefits PTO/Sick Leave Wellness Benefits Wickenburg Community Hospital is a non-profit organization and qualifies for the Public Service Loan Forgiveness (PSLF) program. General Description We are seeking a highly detail-oriented and experienced Surgery HIM Coder to join our Health Information Management team. This position is responsible for reviewing, analyzing, and accurately assigning ICD-10-CM, CPT, and HCPCS codes for surgical procedures based on clinical documentation in the patient medical record. The Surgery Coder ensures coding compliance with...

Optima Medical is an Arizona-based medical group consisting of 30 locations and 130+ medical providers, who care for more than 200,000 patients statewide. Our mission is to improve the quality of life throughout Arizona by helping communities “Live Better, Live Longer” through personalized healthcare, with a focus on preventing the nation’s top leading causes of death. We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in‑house lab testing, imaging, chronic disease management, and other specialty health services. We aspire to aid the growth of our company by welcoming the most qualified and dedicated professionals aboard. We are currently seeking a Medical Coding Specialist to join our team! This role will transition to a fully remote position after your first 60 days. To be eligible, you’ll need to complete your initial 60 days onsite at our Scottsdale office and remain in good...

About Optima Medical :Optima Medical is an Arizona-based medical group consisting of 30 locations and over 130medical providers, who care for more than 200,000 patients statewide.Our mission is to improve the quality of life throughout Arizona by helping communities Live Better, Live Longer through personalized healthcare, with a focus on preventing the nation's top leading causes of death.We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services.We aspire to aid the growth of our company by welcoming the most qualified and deserving candidates aboard.This position requires an initial 60-day training period at our corporate office in Scottsdale, Arizona.Upon successful completion of training, the position will transition to a fully remote role.Job Responsibilities :Audit Medical Records...

Become a part of our caring community and help us put health first Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Durable Medical Equipment (DME) auditing and is part of the PPI Coding Disputes Team with Humana. The Disputes Auditor - DME Outpatient Coding on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient DME coding disputes and expertise in...

OverviewNAH reserves the right to make hiring decisions based on applicants state of residence if outside the state of Arizona.NAH currently hires for remote positions in the following states :AlabamaArizonaFloridaGeorgiaIdahoIndianaKansasMichiganMissouriNorth CarolinaOhioOklahomaPennsylvaniaSouth CarolinaTennesseeTexasVirginiaThe Coder 3 electronically records stores and reports on reams of data.Responsible for coding the following service types based on department and assignments.Facility HIM :Inpatient outpatient emergency room and outpatient clinical.Ambulatory :Coding and auditing professional inpatient outpatient emergency and clinic.Coders will need to apply a broad knowledge of procedure coding diagnosis coding medical terminology and anatomy / physiology.Hospital Coder Proficiency :ICD-10 PCS / DRG / CPT / HCPCS / ICD-10 CM.Professional Coder Proficiency :CPT / HCPCS / ICD-10 / CM.ResponsibilitiesCommunicationWorks in collaboration with physicians in tracking un-coded...