34 coder auditor professional jobs found

Lead Medical Coder and Auditor ProSidian Consulting is looking for a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land dominance, across the full range of military operations and the spectrum of conflict, in support of combatant commanders". The Regional Health Command's Readiness Mission includes dental care of active duty Soldiers, public health services, veterinary services, and providing management and support to wounded, ill and injured Soldiers assigned to its seven warrior transition units. The ProSidian Engagement Team Members work to provide health...

Inpatient Drg Coding Auditor Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs...and more! Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. Reviews discrepancies...

Overview Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs...and more! Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition....

Description WHAT IT'S LIKE AT SGMC HEALTH Purpose . No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place. Excellence . We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service. Team Spirit. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. Award Winning Performance. We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides. WHY YOU WILL LOVE SGMC HEALTH SGMC has great benefit options, depending on the role that you are going into- including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities...

A consulting firm based in Hinesville, GA, seeks a Lead Medical Coder and Auditor to support U.S. Armed Forces health facilities. The successful candidate will ensure accurate coding of medical records and perform quality checks to comply with federal regulations. This full-time position demands a minimum of 2 years of coding experience and relevant certifications. The role offers competitive compensation, comprehensive benefits, and opportunities for professional development. #J-18808-Ljbffr

Lead Medical Coder and Auditor [PR0001D] Full‑time ProSidian is looking for “Great People Who Lead” at all levels in the organization. Are you a talented professional ready to deliver real value to clients in a fast‑paced, challenging environment? ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. Linking strategy to execution, ProSidian assists client leaders in maximizing company return on investment capital through design and execution of operations core to delivering value to customers. Visit www.ProSidian.com or follow the company on Twitter at www.twitter.com/prosidian for more information. ProSidian Seeks a Lead...

A healthcare organization based in Atlanta is seeking a Physician Compliance Auditor to conduct audits, report findings, and lead training sessions on coding and billing. The ideal candidate will possess at least five years of coding experience, with a strong organizational skill set and effective communication abilities. Preferred qualifications include a Certified Professional Coder certification and experience in auditing. Join a team committed to ensuring compliance and excellence in healthcare billing processes. #J-18808-Ljbffr

Job Description Job Description Description: Job Title: Certified Medical Coder/Biller Location: Richmond Hill, GA | Hybrid Remote Employment Type: Full-time Reports to: Billing Manager Department: Revenue Cycle Management Job Summary: The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key Responsibilities: 1. Claims Processing: · Prepare and submit accurate and timely insurance claims for services rendered. · Verify patient insurance coverage...

Job Description Job Description The Medical Coder / Coder PAR at Apex Spine and Neurosurgery is responsible for reviewing clinical documentation and assigning accurate CPT, ICD-10, and HCPCS codes for spine, neurosurgical, and interventional pain management services. This role ensures compliant, complete, and timely coding to support revenue integrity, authorization accuracy, and efficient claims processing in accordance with CMS and payer guidelines. Key Responsibilities Review operative reports, clinic notes, imaging, and diagnostic studies to accurately assign CPT, ICD-10, and HCPCS codes for spine and neurosurgical procedures. Code surgical and procedural services including (but not limited to): spine surgeries, decompressions, fusions, discectomies, laminectomies, injections, nerve blocks, ablations, and other interventional pain procedures. Ensure compliance with CMS guidelines, NCCI edits, payer-specific policies, and internal coding standards. Communicate directly...

Certified Medical Coder/Biller The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. 1. Claims Processing: Prepare and submit accurate and timely insurance claims for services rendered. Verify patient insurance coverage and ensure correct billing to the appropriate payer. Review and process Explanation of Benefits (EOBs) and insurance payments. 2. Billing and Coding: Ensure that all medical services are accurately coded according to current guidelines (CPT, ICD-10,...

Description Primary function: Reporting to the Manager, Compliance Audit and Analysis, develops and executes audit, monitoring, and education for professional billing, coding and documentation programs that confirm compliance, identifies reimbursement implications, and provides billing providers with relevant and timely information regarding audit results and risk areas. Serves as a resource for providers on professional billing and coding. Principal duties and responsibilities: Prepares and oversees professional billing and coding components of the Compliance work plan reflecting scheduled activities and target dates. Leads focused audits and reviews to assess adherence with professional billing compliance policies, legal and regulatory requirements, and to identify and evaluate risk areas. Assists in development of organizational compliance auditing and monitoring activities for professional billing and coding, including periodic reviews of the...

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...

Overview Be inspired. Be valued. Belong . At Emory Healthcare At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoingmentorshipand leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs And more Individuals with Orthopedic and Neuro surgery experience are encouraged to apply!!! Description This position ensures the accuracy, completeness, and compliance of medical coding and clinical documentation for professional coding services. The role supports accurate coding practices, appropriate reimbursement, and regulatory compliance by reviewing patient records and...

Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more Work Location: Atlanta, GA Description The Senior Compliance Auditor - Healthcare Provider provides expert leadership in evaluating and strengthening the organization's compliance program across clinical, billing, privacy, and operational domains. This role leads complex, risk-based compliance audits to ensure adherence to federal and state healthcare regulations and guidance from...

Compliance Audit And Analysis Primary function: Reporting to the Manager, Compliance Audit and Analysis, develops and executes audit, monitoring, and education for professional billing, coding and documentation programs that confirm compliance, identifies reimbursement implications, and provides billing providers with relevant and timely information regarding audit results and risk areas. Serves as a resource for providers on professional billing and coding. Principal duties and responsibilities: Prepares and oversees professional billing and coding components of the Compliance work plan reflecting scheduled activities and target dates. Leads focused audits and reviews to assess adherence with professional billing compliance policies, legal and regulatory requirements, and to identify and evaluate risk areas. Assists in development of organizational compliance auditing and monitoring activities for professional billing and coding, including periodic reviews of the individual...

Job Title Medical Coding Auditor Description This position ensures the accuracy, completeness, and compliance of medical coding and documentation for professional coding services. This role involves reviewing patient records, clinical documentation, and coded data to identify discrepancies and ensure adherence to coding guidelines. By working closely with healthcare providers, coders, and compliance teams, the auditor supports accurate professional coding, optimizing reimbursement, and mitigating compliance risks. Key responsibilities include conducting comprehensive chart reviews, evaluating provider documentation accuracy, and participating in regular audits to maintain high standards of coding accuracy and compliance. The role may involve providing training to healthcare professionals, analyzing coding data, and generating audit reports. Key Responsibilities Audit and Review: Conduct regular audits of medical coding to verify accuracy, completeness, and compliance with...

Career Opportunities At Northside Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today. Responsibilities Responsible for coding procedures and entering charges to comply with federal/state regulations and internal policies. Coordinate with Practice Coordinator and Revenue Integrity to assure all necessary documentation is present to support selected procedure codes or to code cases as needed. Participates in audits to evaluate if all selected codes are accurate and develops methodologies to improved coding issues identified. Qualifications Must have a coding credential (RHIA, RHIT, CPC, CCS, RN). Minimum of 3 years of specialty and or surgical coding experience Familiarity with data processing applications in a...

Risk Adjustment Coder Specialist 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 ourselvesone that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for...

Location: Fully Remote Schedule: Flexible Daytime Hours (Must Work Full-Time) Pay Rate: $35-40/hour Benefits: LaSalle Network contractors have the opportunity to enroll in benefits including medical, dental, and vision insurance. Job Description: My client is hiring for an experienced Inpatient Facility Coder to support hospital-based coding operations within a Trauma Level I teaching facility. This is a fully remote opportunity offering flexible daytime hours, with the expectation that candidates are available to work full-time (40 hours per week). Key Responsibilities: Assign accurate ICD-10-CM and ICD-10-PCS codes for inpatient facility encounters Review clinical documentation to ensure compliant and complete coding Apply inpatient coding guidelines in accordance with CMS, UHDDS, and facility standards Support DRG assignment and coding quality initiatives Collaborate with CDI, physicians, and revenue cycle teams as needed Meet...

Essential Duties and Responsibilities: - Abstract and code clinical data. - Audit medical records to ensure compliance with the organization's coding procedures and standards. - Accurately enter coded data in a system and validate data entered. - Research correct coding practices, clearly document and share findings with others. - Review denials and recommend billing corrections. - Train staff members on the coding process. Minimum Requirements - High School diploma or equivalent with 0 - 2 years of experience. - Additional clinical licensure may be required based on project. - Must be a Certified Medical Coder, Certified Professional Coder, or a Certified Coding Specialist. - Knowledge of Medical Billing and Coding Systems such as CPT and HCPCS is essential. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday required. Additional Skills and Experience: - Familiarity with retrospective payment reimbursement highly preferred....

Join Datavant, the trusted data collaboration platform for healthcare. Our mission is to make health data secure, accessible, and actionable. We provide vital data solutions for healthcare providers, health plans, researchers, and life sciences companies. From assisting with individual patient requests to advancing AI in healthcare, our team is dedicated to shaping the future of health data. By becoming a Datavanter, you will be part of a dynamic and collaborative team committed to transformative change in the healthcare landscape. What We’re Looking For We are seeking experienced and certified inpatient coders to join our team. The ideal candidate will have exceptional attention to detail and a solid understanding of medical terminology. This fully remote position offers a flexible schedule, allowing you to influence the future of healthcare from wherever you work best! Key Responsibilities: Assign diagnostic and procedural codes using ICD-10-CM and ICD-10-PCS...

Essential Duties and Responsibilities: - Abstract and code clinical data. - Audit medical records to ensure compliance with the organization's coding procedures and standards. - Accurately enter coded data in a system and validate data entered. - Research correct coding practices, clearly document and share findings with others. - Review denials and recommend billing corrections. - Train staff members on the coding process. Minimum Requirements - High School diploma or equivalent with 0 - 2 years of experience. - Additional clinical licensure may be required based on project. - Must be a Certified Medical Coder, Certified Professional Coder, or a Certified Coding Specialist. - Knowledge of Medical Billing and Coding Systems such as CPT and HCPCS is essential. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday required. Additional Skills and Experience: - Familiarity with retrospective payment reimbursement highly preferred....

A leading health services company seeks a professional for auditing and abstraction of medical records, ensuring ICD codes align with regulations. The ideal candidate will have at least 1 year of experience, a CPC or CCS-P certification, and strong proficiency in Microsoft Office. Responsibilities include compliance audits and accurate coding. This full-time position in Atlanta offers a pay range of $18.50 to $38.82 per hour and a comprehensive benefits package. #J-18808-Ljbffr

Job Title: Certified Medical Coder/Biller Location: Richmond Hill, GA | Hybrid Remote Employment Type: Full-time Reports to: Billing Manager Department: Revenue Cycle Management Job Summary: The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key Responsibilities: 1. Claims Processing: • Prepare and submit accurate and timely insurance claims for services rendered. • Verify patient insurance coverage and ensure correct billing to the appropriate...