82 coder auditor professional jobs found

Job Description Job Description Overview Opportunities for you! Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek Free Continuing Education and certification Tuition reimbursement, education programs and scholarships Vacation time starts building on Day 1, and builds with your seniority Free money toward retirement with a 403(b) and matching contributions Great food options with on-demand ordering Free parking and electric charging Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page. Responsibilities The Coding Compliance Auditor is a member of the Compliance Office and contributes to the Community Health System’s mission to better the lives of all those we serve. As a Coding Compliance...

Coding Compliance Auditor In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments and accuracy and completeness of all ICD-10-CM, CPT, and HCPCS codes assigned by professional revenue coders and providers. All assigned codes must be supported by professional documentation contained within the medical record and must be in compliance with federal coding compliance regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics Re: coding accuracy rates, compliance rates, denial analytics, etc. Recommend education topics based on audit findings and assist in the continuing education of professional coders and providers. Understands coding/billing computer systems...

A healthcare firm supporting agriculture seeks a Claims Auditor for remote work, ensuring compliance with health benefits plans. The role involves coding new business, verifying plans, and maintaining efficiency in processes. Candidates should have a BS/BA degree and at least two years in claims auditing. The position offers a salary range of $46,669.19 - $65,668.50 and a benefits package including profit-sharing. #J-18808-Ljbffr

Western Growers Health — a part of Western Growers Family of Companies — provides employer-sponsored health benefit plans to meet the needs of those working for the agriculture industry. The unmatched benefit options provided by Western Growers Health stem from the core mission of Western Growers Association (est. 1926) to support the business interests of employers in the agriculture industry. Our mission at Western Growers Health is to deliver value to employers by offering robust health plans that meet the needs of a diverse workforce. By working at Western Growers Health, you will join a dedicated team of employees who care about offering quality health benefits and excellent customer service to plan participants. If you want to start making a difference working in the health care industry, then apply to Western Growers Health today! Compensation: $46,669.19 - $65,668.50 with a rich benefits package that includes profit‑sharing. This is a remote position and can reside...

Position Summary Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivering coding presentations to diverse audiences including physicians and other staff. Schedule & Location Schedule: 9/80 work schedule - hybrid Location: 7898...

Hcc Coding Analyst Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. This position is hybrid-remote in Orange, CA. The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider partners, to successfully, monitor and implement HCC coding strategies. Audit all RAPS submissions to ensure accuracy in the data provided to Centers for Medicare and Medicaid...

Hcc Risk Adjustment Auditor/Coder We are looking for HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities include the following: Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use...

We are looking for experienced HCC Risk Adjustment Auditors/Coders, Sr. to join our team! Position Summary The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use of diagnosis and procedure codes. Interface...

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....

Senior Risk Adjustment Coder The Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare Advantage Risk Adjustment. What you will do: Risk Adjustment Review May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing Reviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses. Evaluating medical records to verify that M.E.A.T criteria support the submitted diagnosis codes. Inquire with clinicians the recommended HCC diagnosis for chart addendum. Collaborating with other departments to address coding updates and support risk...

Eisenhower Health is seeking a Revenue Cycle Auditor in Rancho Mirage, CA. The role involves auditing revenue cycle integrity and ensuring compliance with coding guidelines. Candidates should have a high school diploma and relevant certification within a year. Required experience includes two years in medical billing or auditing. The position offers full-time hours at a competitive salary range between $23.97 and $36.42 per hour, depending on experience. Join our team to contribute to our mission of improving financial accuracy in healthcare delivery. #J-18808-Ljbffr

Fully Remote | Professional Fee Coding Auditor | 3-Month Contract with Strong Extension Potential Openings: 6 The Patient Records Abstractor 4 fulfills a role as a Medical Coder for UCSF's physician practices. This position reviews patient records, discharge summaries, operative reports, and other clinical documentation to assign standardized codes for diagnoses, procedures, and services. The role applies national and international coding classifications to ensure records accurately reflect the care delivered, supporting compliant reimbursement and reliable clinical data. This position also serves as a Coding Educator responsible for providing education and training for physicians, staff, and other providers on professional fee coding and clinical documentation standards. Responsibilities include conducting coding quality reviews, analyzing findings, and providing follow-up education to coding staff and providers. The incumbent outlines and annotates applicable laws and...

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. This position is hybrid- remote in Orange, CA. The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider partners, to successfully, monitor and implement HCC coding strategies. Audit all RAPS submissions to ensure accuracy in the data provided to Centers for Medicare and Medicaid Services (CMS). Provide...

Salary : $105,597.80 - $145,114.92 Annually Location : Riverside Job Type: Regular Job Number: 26-74191-01 AL Department: RUHS-Medical Center Opening Date: 03/03/2026 Closing Date: Continuous For questions regarding this position, please contact the Recruiter listed in the Supplemental Information section. ABOUT THE POSITION Riverside University Health System (RUHS)is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to...

A Brief Overview The Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs, including but not limited to Medicare Advantage Risk Adjustment. Locations Stanford Health Care - University Healthcare Alliance What you will do Risk Adjustment Review May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing Reviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses. Evaluating medical records to verify that M.E.A.T criteria support the submitted diagnosis codes. Inquire with clinicians the recommended HCC diagnosis for chart addendum. Collaborating with other departments to address...

Pinnacle Claims Management Job Opportunity If you're looking for a career that provides affordable health benefit solutions to the people who support some of the most vital industries, we're looking for you. At Pinnacle Claims Management, we are an innovative third-party administrator (TPA) that provides a full suite of comprehensive and customized health benefits administration services for self-funded companies, including health management and wellness solutions, and pharmacy benefit management. As part of the Western Growers Family of Companies, we are committed to providing our employees with everything they need to succeed and grow. We know that taking care of our clients starts with taking care of our employees. As a keystone of our philosophy, we recognize that every person on our team comes to us with a unique background, history and story that adds strength to our organization. Additionally, employees are encouraged to recognize that there isn't a work life and a home...

Job Details Job Location: Burlingame, CA 94010 Salary Range: $42.79 - $48.75 Hourly ESSENTIAL JOB FUNCTIONS HCC Coding and Risk Adjustment (RA) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines. Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance. Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy. Provider Training and Clinical Documentation Improvement (CDI) Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding. Provide one‑on‑one and group training to providers and clinical staff to improve documentation quality and accuracy. Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards. Data Analysis and Reporting Analyze coding data to identify trends, documentation...

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding credential required...

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding credential required...

Medical Billing Specialist I/II - Behavioral Health Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5369990) Apply  Medical Billing Specialist I/II - Behavioral Health Salary $47,840.00 - $69,546.52 Annually Location Oxnard, CA Job Type Full-Time Regular Job Number 0838HCA-26AA (VM) Department Health Care Agency Division Behavioral/Mental Health Opening Date 06/15/2026 Closing Date 6/29/2026 5:00 PM Pacific Description Benefits Questions Description How to Submit a Successful Application video: https://hr.venturacounty.gov/how-to-apply/application THE DEPARTMENT: As a vital department of Ventura County Health Care Agency (HCA), Ventura County Behavioral Health (VCBH) provides comprehensive mental health and substance use treatment services tailored to meet the needs of our community. From mobile crisis response to outpatient treatment, our array of programs ensures individuals receive the...

Medical Billing Specialist I/II The Department: As a vital department of Ventura County Health Care Agency (HCA), Ventura County Behavioral Health (VCBH) provides comprehensive mental health and substance use treatment services tailored to meet the needs of our community. From mobile crisis response to outpatient treatment, our array of programs ensures individuals receive the support they need at every stage of their journey. The Position: Under general supervision at the (I) level, or direction at the (II) level, the incumbent is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance reimbursement requirements. What We Offer: The County of Ventura offers an attractive compensation and benefits package. Aside from our base salary range, an employee within this position will also be eligible for the following: Educational Incentive - An educational incentive of 2.5%...

The University of California in San Francisco is looking for a Health Information Coder III, Per Diem. This senior-level position involves coding inpatient cases accurately using ICD-10-CM and ICD-10-PCS systems. Key responsibilities include evaluating clinical data, maintaining compliance with guidelines, and participating in coding audits. A successful candidate must have relevant certifications and experience in DRG coding. The role requires strong analytical and communication skills. This position offers a variable work shift and a competitive salary. #J-18808-Ljbffr

Job Description Job Description Lead Medical Biller Los Angeles, CA Job Description Skilled Wound Care is looking for a Lead Medical Biller to join our rapidly growing company! We are a mobile surgical physician wound care group expanding into new markets of the United States. The Lead Medical Biller is a critical leader responsible for ensuring the financial health of our organization by overseeing the daily operations of the billing team. This role requires advanced expertise in the end-to-end claims lifecycle, ensuring maximum revenue capture through accurate, compliant, and timely submission of medical claims across all payer types (private, government, and third-party). You will be the primary subject matter expert, driving team performance, resolving complex billing issues, and upholding strict adherence to all federal, state, and FQHC-specific billing regulations. Position is hybrid at our office in Playa Vista, CA Responsibilities: Supervise & Train: Lead...