Coder auditor professional jobs | Healthcare Careers

Plan Coder

Western Growers Irvine, CA, USA

Western Growers Health Western Growers Health provides employer-sponsored health benefit plans to meet the needs of those working in the agriculture industry. The unmatched benefit options provided by Western Growers Health stem from the core mission of Western Growers Association 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 anywhere in the U.S. Job Description...

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OP Coder Auditor Trainee

Prime Healthcare Management Inc Ontario, CA, USA

Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation’s leading health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team! Responsibilities The Outpatient Coder Auditor Trainee reviews and analyzes documentation present in the medical record for outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Outpatient Coder Auditor Trainee finalizes the coding and abstracting of the medical record upon ensuring the assignment of...

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OP Coder Auditor Trainee

Prime Healthcare Ontario, CA, USA

Outpatient Coder Auditor Trainee Prime Healthcare is actively seeking new members to join our corporate team! The Outpatient Coder Auditor Trainee reviews and analyzes documentation present in the medical record for outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Outpatient Coder Auditor Trainee finalizes the coding and abstracting of the medical record upon ensuring the assignment of International Classifications of Diseases, Ninth Revision (ICD-9-CM) or Tenth revision (ICD-10/PCS), Current Procedural Terminology (CPT), and Health Care Procedure Coding System (HCPCS), are accurate and supported by the clinical documentation of the respective medial record. Holding a senior coding position, assumes primary responsibility for DRG validation/accuracy, primary role in assisting CDS and medical staff members with improving quality of clinical...

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Compliance Auditor 1-Physician

Loma Linda Unv Shared Services San Bernardino, CA, USA

Shared Services: Compliance (Full-Time, Day Shift) - Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness. The Compliance Auditor 1-Physician monitors and audits established mechanisms and controls to ensure compliance with regulations. Audits the activities of various departments for compliance with plans, policies and procedures prescribed by management. Prepares and submits reports on the results of audits, recommending improvements in policies and procedures. Cooperates with outside auditors in any undertaking that may expedite their work. Performs other duties as needed. Bachelor's Degree required or an additional six years of experience required in lieu of degree. Minimum two years of experience in auditing within healthcare, compliance or regulatory oversight agency, quality management, quality assurance or business analysis required. Certification in...

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HCC Risk Adjustment Coder, Sr.

Regal Medical Group Los Angeles, CA, USA

We are looking for experienced 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 of diagnosis and...

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Healthcare Coding Compliance Auditor - RUHS

County of Riverside in Riverside, CA, USA

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, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience in an acute care hospital...

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Inpatient Coding Auditor

Cedars-Sinai Los Angeles, CA, USA

Job Description Align yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company's Workplace of the Year. We provide an outstanding benefit package that includes healthcare, paid time off and a 403(b). Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals. What Will I be Doing in this Role? Under the general direction of the HID Audit Supervisor, the role operates as a Coding Auditor and shall: Monitor coding compliance through prebill and retrospective reviews or audits of ICD and/or CPT codes assigned by coding staff. Monitor coding compliance by performing focused audits on high-risk areas identified by the Office of Inspector General (OIG) and the Centers of Medicare and Medicaid Services (CMS)....

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Compliance Auditor, MAPD

University of California Los Angeles, CA, USA

Description Support compliance excellence at UCLA Health by joining our team as a Compliance Auditor, MAPD, focused on Medicare Advantage (Part C) and Prescription Drug (Part D) programs. In this vital role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk-based audits, support external audit coordination, and ensure alignment with CMS and DMHC regulations across the organization. Reporting to the Compliance Manager, MAPD Audit, you will contribute to the organization's audit work plan, assess operational risk areas, and prepare audit findings that help guide regulatory readiness and operational improvement. This position calls for a strong foundation in CMS guidelines, managed care compliance, and effective collaboration with both internal teams and external partners. In this role, you will: * Conduct compliance audits related to operational functions, vendor performance, data validation, RADV, Triennial Review, pre-delegation reviews, and...

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HCC Coder

TEKsystems Los Angeles, CA, USA

*Description* The HCC Auditor/Coder's primary objective is to continually improve providers' reporting and documentation of chronic health care conditions. This is done through auditing providers' patient medical records and providing education on best coding practices. Code review super bills and patient medical records for proper use of diagnosis and procedure codes. 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 effectively with physicians and office staff on coding issues. Research coding questions as needed. Code review a wide variety of document types, i.e., Primary and specialty care medical records, mental health, substance abuse, in-patient, out-patient, non-submittals (lab), ancillary and pharmaceutical services for HCC values. Perform both provider office audits and on-line audits via reviewing patient medical records. Provide education to...

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Healthcare Coding Compliance Auditor - RUHS

Riverside County, CA Riverside, CA, USA

Salary : $101,536.34 - $139,533.58 Annually Location : Riverside Job Type: Regular Job Number: 26-74191-01 AL Department: RUHS-Medical Center Opening Date: 03/03/2026 Closing Date: Continuous 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 ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through...

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OP Coder Auditor Trainee

Prime Healthcare Ontario, CA, USA

Outpatient Coder Auditor Trainee Prime Healthcare is actively seeking new members to join our corporate team! The Outpatient Coder Auditor Trainee reviews and analyzes documentation present in the medical record for outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Outpatient Coder Auditor Trainee finalizes the coding and abstracting of the medical record upon ensuring the assignment of International Classifications of Diseases, Ninth Revision (ICD-9-CM) or Tenth revision (ICD-10/PCS), Current Procedural Terminology (CPT), and Health Care Procedure Coding System (HCPCS), are accurate and supported by the clinical documentation of the respective medial record. Holding a senior coding position, assumes primary responsibility for DRG validation/accuracy, primary role in assisting CDS and medical staff members with improving quality of clinical...

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Remote Health Plan Coder & Process Improver

Western Growers Irvine, CA, USA

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

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Sr Risk Adjustment Coder

Stanford Health Care - ValleyCare Stanford, CA, USA

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Day - 08 Hour (United States of America)**This is a Stanford Health Care - University Healthcare Alliance job.** **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****Education Qualifications*** High school diploma or GED equivalent.* Bachelor's Degree preferred.**Experience Qualifications*** 5+ years of work experience in a risk...

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Ambulatory Coding Compliance Auditor (CPC/CCS-P)

Sharp Healthcare San Diego, CA, USA

A healthcare provider in San Diego is seeking a Coding Auditor to conduct audits and ensure compliance with coding standards. The role requires strong knowledge of CPT and ICD-10 codes, exceptional communication skills, and the ability to train clinical staff. The ideal candidate has 3 years of experience in a healthcare setting and holds a CPC or CCS-P certification. Competitive hourly rate offered. #J-18808-Ljbffr

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Full Time

Healthcare Coding Compliance Auditor

Riverside University Health System Medical Center Hybrid (Riverside, CA, USA)

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, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience in an acute care hospital...

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Medical Biller II (Bilingual Spanish or Vietnamese Required)

Families Together of Orange County Tustin, CA, USA

Job Title: Medical Biller II Salary: $25hr-$28hr DOE Location: Tustin, CA Openings: 1 Position Purpose: The Medical Billing Specialist II supports the revenue cycle team by independently performing a broad range of billing functions with moderate complexity. This role is responsible for accurate insurance verification, charge entry, claim submission, payment posting, and resolution of routine denials to ensure compliance with payer requirements and timely reimbursement. Core Duties and responsibilities, include but are not limited to: Insurance & Eligibility Verification Verify complex insurance coverage (Medi-Cal, Medicare, Managed Care, Commercial, PPO/HMO). Research and resolve discrepancies in patient coverage or eligibility. Document eligibility outcomes in the EHR/PM system. Charge Entry & Coding Support Perform charge entry and apply CPT, ICD-10, and HCPCS codes. Review encounter forms for accuracy; flag missing or incorrect...

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Certified Coder

Red Oaks Medical Group, Inc. Red Bluff, CA, USA

Business Office Representative Are you compassionate, collaborative, respectful, and strive for excellence? If so, you share our core values and we invite you to join our team as a Business Office Representative. Certified Coder Job Description Reports to: Revenue Cycle Manager, Billing Office Supervisor Organizational Peers: Billing Specialist Direct Reports: None Job Details: Full time, 40 hours/week, Monday-Friday, Non-Exempt, Pay Range: $25.75-$33.99/hour Job Summary: A Certified Coder is a nonexempt position responsible for front office and general coding billing duties. Responsible for Coding Audits, Claim, Billing review and Compliance. Performance Requirements: Knowledge: 1. Knowledge of billing practices and clinic policies and procedures. 2. Knowledge of coding and clinic operating policies. 3. Knowledge of medical terminology. 4. Knowledge of health care insurance claim practices and compliance. 5. Knowledge of computer systems, programs, and applications....

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Certified Biller & Coder Specialist

Bakersfield American Indian Health Project Bakersfield, CA, USA

Hours Per Week: 40 Job Type: Full-time, Non-Exempt Summary/Objectives of Position The Certified Biller & Coder Specialist's responsibility is to ensure the smooth facilitation of communication with funding sources, program partners, and insurance companies. This position will spend most of the time interpreting patient files and using established systems that make it easy for insurers to recognize the type of treatment covered under a patient’s plan. The day-to-day work of the Certified Biller & Coder Specialist includes proper coding of services, procedures, diagnoses, and treatments. Preparing and sending invoices or claims for payment. It is the responsibility of the position to gather documentation to validate the coding choices and argue against any wrongfully denied claims. They analyze all parts of a patient’s visit, including diagnostic tests, consultations, in-office procedures, and prescribed medication. Essential Duties, Functions &...

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Him Coder III

Cottage Health Goleta, CA, USA

Codes and abstracts inpatient and outpatient conditions, diseases, reason for encounters, social determinants of health and PCS/CPT procedures to report accurate administrative and clinical data, utilizing approved coding guidelines as set forth in Official Coding Guidelines, ICD Book, Coding Clinic for ICD-CM/PCS, AHA Coding Clinic for HCPCS and CPT Book. Assigns appropriate DRG/APC prospective payment systems and classifications, to reflect the appropriate severity and illness for inpatient and specialty cardiac, neurology, and vascular outpatient encounters. Collaborates closely with clinicians and CDI staff, not excluding inpatient rehab coordinators to obtain appropriate documentation, as needed. Assists with internal coding audit and training activities. About Us Cottage Health is a leading acute care hospital system, located on the central coast of California, widely known for our superior patient care, innovation, medical research and education. Our health system operates...

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Medical Biller

Ultimate Staffing Fresno, CA, USA

Medical Biller Overview This temp to hire role requires strong technical accuracy, experience with insurance processes, and the ability to work efficiently in a high-volume environment. Responsibilities Retrieve, manage, and post charge batches from multiple EHR platforms Group and organize charge batches for processing Sequence ICD-10 and CPT codes based on client requirements Apply appropriate modifiers and add-on codes Audit coding for accuracy and resolve any discrepancies Perform A/R functions, including follow-up on aging reports Communicate with insurance representatives by phone regarding claims and EOBs Maintain productivity expectations (70-100 accounts daily) across multiple medical specialties, including radiology, pathology, dermatology, family practice, wound care, and urology Qualifications 1+ years of medical billing experience with ICD-10, CPT, and EHR systems Experience with...

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Coder - SRS

Sharp Healthcare San Diego, CA, USA

Medical Coding Specialist Shift Start Time: 6 AM Shift End Time: 2:30 PM AWS Hours Requirement: 8/80 - 8 Hour Shift Additional Shift Information: 0600-0900 Start, 1430-1730 End Weekend Requirements: No Weekends On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $30.370 - $37.950 - $42.510 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do Ensure that all charges are submitted accurately, timely and meets department guidelines. Provides administrative and coding support to management, site support, staff and physicians. Identifies and reports documentation and coding opportunities...

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Medical Coder- West Hills

TEKsystems Los Angeles, CA, USA

This role is onsite in West Hills, CA NOT REMOTE Job Description As an HCC Coder, you will be responsible for supporting the organization's risk adjustment and revenue integrity efforts through retrospective chart review. This team is currently working through a backlog of ~30,000 encounters, so accuracy and productivity are essential. Key Responsibilities Review 2025 PCP office visit notes Perform retrospective HCC coding for all documented diagnoses Close encounters after coding completion Ensure accurate capture of Medicare Risk Adjustment diagnoses Work exclusively with PCP office visits Productivity Expectations Minimum: 65 charts/day Typical: 75-80 charts/day Quality & Auditing 100% audit for first two weeks post-training Audit percentage decreases with accuracy (70% ? 50% ? 30%) Experienced coders may be audited at ~10% Systems & Tools No billing performed directly in...

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DME/Outpatient Medical Coding Auditor

Humana Sacramento, CA, USA

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...

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Sr. Certified Coder, Acute SDS-OBSV

Adventist Health Roseville, CA, USA

Job Description Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work. Job Summary: Reviews SDS and OBV records to identify the diagnosis and procedure codes performed during the patients stay are valid and in accordance with coding conventions and guidelines. Records types including same day surgery and observation encounter types. Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work. Job Requirements: Education and Work Experience: High School...

85 coder auditor professional jobs found