30 coder auditor professional jobs found

Lakeshore Talent is in search of a Code Review Specialist – Medical Coding Methodology & Litigation Support Greenwood Village, CO (Denver Tech Center) Schedule: Monday–Friday, with Wednesdays remote and the remaining days in the office Lakeshore Talent is in search of a detail-oriented Code Review Specialist to join a growing team specializing in medical coding methodology, billing review, and litigation support. This role is ideal for an experienced medical coding professional who enjoys analytical work, takes pride in accuracy, and is interested in improving processes rather than simply following established procedures. In this position, you will review medical records and billing documentation, validate CPT and HCPCS procedure codes and modifiers, and ensure that coding decisions are accurate, consistent, and well-documented. Your work will support the development of transparent, defensible medical damage valuations used in litigation-related cases. Beyond day-to-day...

Lakeshore Talent is in search of a Code Review Specialist – Medical Coding Methodology & Litigation Support Location: Greenwood Village, CO (Denver Tech Center) Position Type: Direct Hire Salary: $75,000–$85,000 annually Schedule: Monday–Friday, with Wednesdays remote and the remaining days in the office Start Time: 7:00 AM or 8:00 AM Position Overview Lakeshore Talent is in search of a detail-oriented Code Review Specialist to join a growing team specializing in medical coding methodology, billing review, and litigation support. This role is ideal for an experienced medical coding professional who enjoys analytical work, takes pride in accuracy, and is interested in improving processes rather than simply following established procedures. In this position, you will review medical records and billing documentation, validate CPT and HCPCS procedure codes and modifiers, and ensure that coding decisions are accurate, consistent, and...

Revenue Cycle Coder Lead-Inpatient CodingInspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.As our Lead Inpatient Coder, you will be a cornerstone of our medical coding department, providing essential leadership and strategic direction for our inpatient coding team. You will be instrumental in driving coding accuracy, ensuring regulatory compliance, and optimizing revenue cycle performance for complex medical cases, making a direct impact on our healthcare data integrity and financial health.Every day you will provide expert technical guidance, conduct comprehensive quality...

Ready to make your application Please do read through the description at least once before clicking on Apply. Lakeshore Talent is in search of a Code Review Specialist – Medical Coding Methodology & Litigation Support Location: Greenwood Village, CO (Denver Tech Center) Position Type: Direct Hire Salary: $75,000–$85,000 annually Schedule: Monday–Friday, with Wednesdays remote and the remaining days in the office Start Time: 7:00 AM or 8:00 AM Position Overview Lakeshore Talent is in search of a detail-oriented Code Review Specialist to join a growing team specializing in medical coding methodology, billing review, and litigation support. This role is ideal for an experienced medical coding professional who enjoys analytical work, takes pride in accuracy, and is interested in improving processes rather than simply following established procedures. In this position, you will review medical records and billing documentation, validate CPT and HCPCS procedure codes 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: Benefits may vary based upon position type and/or level. Job...

Job Summary and Responsibilities As our Outpatient Coder Lead, you will code and abstract outpatient records for data retrieval, analysis, reimbursement, and research, ensuring complete charge capture, and providing expert guidance to coding and hospital staff. Every day you will direct Outpatient Coding Service Center operations including personnel management, training, education, productivity, work assignments, and quality reviews. You will assist with coding education, audits, denials, claim edits, and CHA data submissions, promoting standardization and managing DNB and coding compliance to achieve financial goals and improve the accuracy and integrity of patient data. To be successful in this role, you will possess expert-level outpatient coding proficiency, strong leadership and management skills, a deep understanding of coding regulations and reimbursement methodologies, and the ability to drive accuracy, quality, and standardization across coding operations, while...

Clinical Risk Adjustment Coder Alpine Physician Partners partners with independent physician groups to deliver coordinated, value-based care that improves outcomes and lowers the total cost of care. Our clinical and coding teams support providers with the accurate, compliant documentation and coding practices that make value-based care possible. The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding guidelines. Review medical records, encounter notes, and provider documentation to identify and validate diagnosis codes relevant to HCC and other risk adjustment models. Conduct in-home or virtual health assessments with patients, evaluating and...

Clinical Risk Adjustment CoderAlpine Physician Partners partners with independent physician groups to deliver coordinated, value-based care that improves outcomes and lowers the total cost of care. Our clinical and coding teams support providers with the accurate, compliant documentation and coding practices that make value-based care possible.The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding guidelines.Review medical records, encounter notes, and provider documentation to identify and validate diagnosis codes relevant to HCC and other risk adjustment models.Conduct in-home or virtual health assessments with patients, evaluating and...

Are you looking to work for a company that has been recognized for over a decade as a Top Place to Work? Apply today to become a part of a company that continues to commit to putting our employees first. Job Description: About Alpine Physician Partners Alpine Physician Partners partners with independent physician groups to deliver coordinated, value-based care that improves outcomes and lowers the total cost of care. Our clinical and coding teams support providers with the accurate, compliant documentation and coding practices that make value-based care possible. Position Summary The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding...

Medical Coding Specialist Position Summary This position is responsible for the accurate coding and billing of inpatient and outpatient professional services provided to patients working from the appropriate documentation in the medical record. Classification systems include the current versions of CPT and ICD as well as other specialty systems as required by diagnostic category. All work is carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association, Centers for Medicare and Medicaid Services, and organizational coding guidelines. Essential Duties Reviews and audits documentation for verification of type and level of professional services rendered using the current version of the Evaluation and Management Guidelines and CPT coding rules and guidelines. Queries providers and/or appropriate staff when documentation is missing, inadequate, ambiguous or unclear for coding purposes. Utilizes proper written and verbal...

Become a part of our caring community 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 Outpatient Behavioral Health Coding disputes and is part of the PPI Coding Disputes Team with Humana. The Outpatient Behavioral Health Coding Auditor 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 Behavioral Health coding disputes and expertise in CPT/HCPCS code...

Clinical Risk Adjustment Coder Alpine Physician Partners partners with independent physician groups to deliver coordinated, value-based care that improves outcomes and lowers the total cost of care. Our clinical and coding teams support providers with the accurate, compliant documentation and coding practices that make value-based care possible. The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding guidelines. Review medical records, encounter notes, and provider documentation to identify and validate diagnosis codes relevant to HCC and other risk adjustment models. Conduct in-home or virtual health assessments with patients, evaluating and...

Outpatient Coder Lead Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings. As our Outpatient Coder Lead, you will code and abstract outpatient records for data retrieval, analysis, reimbursement, and research, ensuring complete charge capture, and providing expert guidance to coding and hospital staff. Every day you will direct Outpatient Coding Service Center operations including personnel management, training, education, productivity, work assignments, and quality reviews. You will assist with coding education, audits, denials, claim edits, and CHA data submissions,...

National Jewish Health in Colorado is seeking a Medical Coder with 1+ year physician coding experience to ensure accurate inpatient and outpatient billing using CPT/ICD guidelines. This full-time, 100% remote role requires attention to documentation quality and compliance with AHA, CMS, and internal coding guidelines.You will query providers, audit records, and support education to clinicians, contributing to proper reimbursement while maintaining professional standards.J-18808-Ljbffr

Outpatient Coder LeadInspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.As our Outpatient Coder Lead, you will code and abstract outpatient records for data retrieval, analysis, reimbursement, and research, ensuring complete charge capture, and providing expert guidance to coding and hospital staff.Every day you will direct Outpatient Coding Service Center operations including personnel management, training, education, productivity, work assignments, and quality reviews. You will assist with coding education, audits, denials, claim edits, and CHA data submissions, promoting...

Title: Medical Coding/ Education Specialist Location: Remote, preferably in Texas Compensation: $65,000 - $75,000 per year *Must have Post Acute Care Experience* We are seeking an accomplished Medical Coding and Education Specialist to join our healthcare team, focusing on enhancing coding accuracy and compliance within our post-acute care facilities. This role involves reviewing medical records, assessing for accurate provider cpt and ICD-10 codes, and developing educational materials. Additionally, the specialist will collaborate closely with our technology and revenue cycle teams to optimize EMR processes, streamline documentation, and reduce coding denials. Responsibilities: Conduct regular coding audits and reviews to ensure compliance with coding guidelines, regulatory requirements, and reimbursement policies. Develop and deliver educational materials, training modules, and resources on coding guidelines, regulatory updates, and documentation requirements specific to...

Country-wide Remote US-Nationwide-FIELD Full time 20189391 What Ethics & Compliance contributes to Cardinal Health Ethics & Compliance promotes a culture that encourages ethical conduct and a commitment to compliance. This function implements strategies and processes to ensure adherence to policies, educates and trains employees across the organization, and conducts investigations to resolve ethics and compliance issues. Ethics & Compliance develops and implements strategies and standard operating procedures to promote adherence to internal ethics and compliance policies related to areas such as privacy, HIPAA and FCPA, among others. This job family resolves concerns from business unit leaders and employees and proactively provides guidance and trainings on policies. Job Summary The Compliance Auditor is responsible for conducting coding, documentation audits to ensure adherence to regulatory requirements, payer policies, and organizational...

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. 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 terminology. This role is fully remote with a flexible schedule, allowing...

Description Join Our Team and Make a Difference in Healthcare! Are you a detail-oriented coding professional with a passion for accuracy, compliance, and quality patient care? We’re looking for a knowledgeable and motivated Medical Coder to join our Revenue Cycle team! Under the guidance of the Revenue Cycle Director, the Medical Coder plays a vital role in ensuring accurate clinical coding, complete medical record documentation, regulatory compliance, and appropriate reimbursement for hospital and clinic services. This position offers the opportunity to collaborate with providers, clinical staff, and fellow coding professionals while helping maintain the highest standards of coding accuracy and integrity. Pay Range: $26.38-$36.98 per hour based on experience and qualifications. FLSA Status: Non-Exempt Schedule: 40 Hours per week - remote position As a Medical Coder, you will be responsible for reviewing clinical documentation, assigning accurate codes, identifying...

Spanish Peaks Regional Health Center is seeking a meticulous Medical Coder to join our Revenue Cycle team in a remote role. You will review clinical documentation, assign accurate codes, and ensure compliant coding for hospital and clinic services to support appropriate reimbursement. Under the Revenue Cycle Director, you’ll collaborate with providers and staff, participate in audits, and drive continuous improvement while upholding confidentiality and regulatory standards. #J-18808-Ljbffr

Required Skills & Experience • Certified coder (CPC, CCS, CRC, CCA, or equivalent certification) • Strong ICD-10-CM coding experience and medical record review background • Knowledge of Risk Adjustment and HCC coding methodologies • Experience reviewing physician documentation and assigning accurate diagnosis codes • Strong understanding of medical terminology, anatomy, physiology, and disease processes • Ability to interpret complex clinical documentation with high accuracy and productivity • Familiarity with CMS guidelines and Medicare Advantage requirements Nice to Have Skills & Experience • Medicare Advantage Risk Adjustment experience • Experience working with CMS-HCC models • CRC (Certified Risk Adjustment Coder) certification • Experience with EMRs and coding software platforms • Background in a health plan, physician practice, hospital, or revenue cycle environment • Audit and quality assurance experience Job Description Insight Global is seeking Medical Coders...

National Jewish Health in Colorado is seeking a Medical Coder with 1+ year physician coding experience to ensure accurate inpatient and outpatient billing using CPT/ICD guidelines. This full-time, 100% remote role requires attention to documentation quality and compliance with AHA, CMS, and internal coding guidelines. You will query providers, audit records, and support education to clinicians, contributing to proper reimbursement while maintaining professional standards. #J-18808-Ljbffr

Certified Professional Coder OnPoint Medical Group is searching for an outstanding Certified Professional Coder to join our team! This is a full-time position, and after the training period, the role may be remote for candidates who reside in Colorado, must be able to complete training onsite in Highlands Ranch, CO prior to working remotely. Come join a great group of medical professionals as our network continues to grow!OnPoint Medical Group is a physician-led network of skilled Primary and Urgent care providers who are committed to expanding access to quality healthcare in the most effective and affordable manner possible. About the Role The Certified Professional Coder (CPC) plays a critical role in the healthcare industry by accurately translating medical diagnoses, procedures, and services into standardized codes used for billing and record-keeping. This position ensures that healthcare providers receive proper reimbursement from insurance companies and government programs...

Alpine Physician Partners is seeking a Clinical Risk Adjustment Coder to review medical records, identify and code diagnoses for HCC risk adjustment, ensuring CMS and payer compliance. This role supports provider education and works to maintain accurate risk scoring in a remote or hybrid setting around Denver and Colorado Springs area. Responsibilities include reviewing encounter notes, assigning ICD-10-CM codes, conducting chart reviews, coordinating with clinicians, performing audits, and #J-18808-Ljbffr