25 coder auditor professional jobs found

If you are an existing employee of South Shore Health then please apply through the internal career site. The coding & compliance auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, designs and delivers coding education training programs for clinical staff, coders and other key stakeholders. The auditor monitors external regulatory and internal process changes and supports colleagues in adhering to federal, state and local requirements. Compensation Pay Range : $73,000.00 – $104,400.00 Responsibilities Identify staff and management training and education needs and recommend appropriate interventions. Assess organization-wide compliance training needs through audits or other review techniques. Analyze data to identify deficiencies or weaknesses in the performance of job-related competencies. Recommend appropriate training programs to address identified needs. Design and develop training programs. Develop and...

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

At South Shore Health, we come together to improve the health of our family, friends and neighbors by bringing together people, caregivers and excellence in medicine. We are seeking a Coding and Compliance Auditor to evaluate medical record documentation and coding accuracy, identify opportunities for improvement, and design and deliver coding education and training programs for clinical staff, coders and other key stakeholders. In this role, you will monitor external regulatory and internal process changes and provide support to colleagues in adhering to Federal, State and local requirements. The annual pay range for this role is $73,000.00 - $104,400.00.   Responsibilities: ·        Establish, implement, and maintain a formalized process for coding compliance and a formal review (audit) process, and conduct routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPCs, PCS and ICD-10-CM codes ·        Perform prospective...

Coding & Compliance Auditor The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Compensation Pay Range: $73,000.00 - $104,400.00 Job Responsibilities Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process. Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC's, PCS and ICD-10-CM codes. Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection. Analyzes data to identify...

If you are an existing employee of South Shore Health then please apply through the internal career site. Requisition Number: R-22463 Facility: LOC0006 - 780 Main Street780 Main StreetWeymouth, MA 02190 Department Name: SHS Compliance Status: Full time Budgeted Hours: 40 Shift: Day (United States of America) The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Compensation Pay Range: $73,000.00 - $104,400.00 Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit)...

Department Description:The Critical Care Auditor/ Coder position will be working directly with the Department of Anesthesia, Critical Care and Pain Medicine and will have the opportunity to work remotely following an initial onsite training period. The incumbent will be required from time-to-time to attend billing onsite staff meetings and meetings with the physicians they support. AFS, LLC is located in Needham Heights, Massachusetts. Job Location:Virtual Job Summary:Performs professional certified coding and provides administrative and project support to the department. Analyzes surgical-medical documentation, provides the individual surgeon/physician with the application of appropriate ICD-10/CPT/HCPCS descriptor codes including the appropriate use of modifiers to ensure compliance for reimbursement. Essential Responsibilities:Analyzes evaluation and management, including critical care, procedures and other notes and documents to determine the scope and complexity of the...

Senior Medical Coding Analyst CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix's autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. Reporting to the Senior Manager, Medical Coding & Audit, as a Senior Medical Coding Analyst, this role will be a key member of the team responsible for ensuring that CodaMetrix meetsand exceedsour customers' coding quality expectations. They will leverage their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency of coding...

Datavant is seeking an Inpatient Auditing Specialist who will address consulting and educational needs related to coding quality and compliance. This role is crucial for shaping the future of healthcare from a fully remote workspace. Responsibilities include conducting audits, providing coder education, and maintaining high accuracy rates. Candidates should have at least 5 years of experience and relevant certifications, with attractive benefits available to support your professional development. #J-18808-Ljbffr

Who We Are SouthNewHampshireHealth has been a cornerstone of the region since 1893, delivering high‑quality, compassionate care close to home. Anchored by SouthernNewHampshireMedicalCenter—a 188‑bed, DNV‑accredited hospital in downtown Nashua with a LevelIII‑N trauma center, LevelII Special Care Nursery, and Magnet® designation for nursing excellence—we offer a full spectrum of services from primary care to advanced diagnostics and specialized treatments. Our medical staff includes over 500 providers from Foundation Medical Partners and local practices. Foundation Medical Partners, our multi‑specialty group, spans 70+ practices across southern New Hampshire and northern Massachusetts, providing coordinated, patient‑centered care to thousands each year. About The Job The Coding Specialist – Professional Based (PB) is responsible for analyzing professional (physician and advanced practice provider) encounters and related documentation to assign accurate ICD‑10‑CM, CPT, and HCPCS...

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Under the general supervision of the Outpatient (OP) Coding Manager and OP Coding Supervisor, the OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Job Description: Essential Duties & Responsibilities including but not limited to: Hospital Coding: Review the complete electronic and scanned...

Summary Reemployed annuitant: This vacancy does not meet the criteria for appointment of annuitants. Learn more about this agency Duties Help Serves as the Supervisory Auditor in a branch office responsible for the supervision, conduct, and accomplishment of a segment of the audit program. Leads a major segment of the total audit program plan. Serves as a team leader and member of a participative work team (PWT) consisting of professional auditors. Establishes annual goals complementary to directorate region/agency goals and objectives. Reviews audit programs, working papers, progress on the audit assignment, and draft audit reports. Ensures that quantitative methods and computerized auditing techniques are being utilized as appropriate in the audit process. Communicates DCAA audit services and maintains audit liaison with acquisition officials. Counsels and advises employees. Evaluates performance, recommends and approves training and development, recommends recognition and...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Under the general supervision of the Outpatient (OP) Coding Manager and OP Coding Supervisor, the OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Job Description: Essential Duties & Responsibilities including but not limited to: Hospital Coding: Review the complete electronic and scanned...

Professional Fee Neuro/Ortho Coder (Remote) - Cambridge, MA | Medical Coding Job Professional Fee Neuro/Ortho Coder supporting the revenue cycle for experienced Orthopedic and Neurosurgery coders. This fully remote medical coding opportunity allows you to work from anywhere while contributing to a dynamic healthcare team serving the Cambridge/Boston area. Advance your career in physician coding and clinical documentation improvement with flexibility and autonomy. Job Details Location: Remote - serve the Cambridge, MA (02138) / Boston area healthcare market from anywhere in the U.S. Hours per Week: 40 Shifts per Week: 5 Shift Duration: 8 hours Weekly Estimated Pay: $1,310 - $1,410 Start Date: June 3, 2026 Contract Duration: 52 weeks Job Requirements / Qualifications Minimum 1 year of professional fee medical coding experience, preferably in Orthopedic and/or Neurosurgical specialties Active coding certification required (CPC, CCS, RHIT, RHIA, or equivalent) Advanced understanding...

Medical Office Coder Shift details: Per diem Job Summary: The Medical Coder complies with all legal requirements regarding coding procedures and practices. Conducts audits and coding reviews to ensure all documentation is accurate and precise, assign and sequence all codes for services rendered and collaborate with the business office to ensure all bill are satisfied in a timely manner. Essential Duties: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims. Adhere to coding policies and procedures consistent with the industry standard guidelines for CPT, ICD-9 and ICD-10....

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...

Senior Medical Coding Analyst CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix's autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. Reporting to the Senior Manager, Medical Coding & Audit, as a Senior Medical Coding Analyst, this role will be a key member of the team responsible for ensuring that CodaMetrix meets—and exceeds—our customers' coding quality expectations. They will leverage their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency of coding...

Title: Certified Risk Coder Reports to: Manager, Risk Coding Classification: Individual Contributor Location: Boston (Remote) Job description revision number and date: 2.0, 01.06.2025 Organization Summary: Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Quality Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary: The Certified Risk Coder will be a part of an emerging coding team and coding service that...

Medical Office Coder Shift details: Per diem Job Summary: The Medical Coder complies with all legal requirements regarding coding procedures and practices. Conducts audits and coding reviews to ensure all documentation is accurate and precise, assign and sequence all codes for services rendered and collaborate with the business office to ensure all bills are satisfied in a timely manner. Essential Duties: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims. Adhere to coding policies and procedures consistent with the industry standard guidelines for CPT, ICD-9 and ICD-10. Westborough...

Ambulatory Surgery Outpatient Coder - On-Site (Boston, MA) Experienced Ambulatory Surgery Outpatient Coder needed in Boston, MA - on-site role for certified medical coders (CPC/CCS) with Epic and 3M experience. Join a dynamic healthcare team in the heart of Boston, Massachusetts (zip code 02215). This on-site outpatient coder opportunity is ideal for medical coders focused on ambulatory surgery, outpatient surgical coding, and revenue cycle integrity at a leading Boston medical facility. Job Details Position Type: Full-Time, On-Site (Ambulatory Surgery Coder / Outpatient Coder) Number of Openings: 3 Contract Duration: 13 weeks Start Date: June 1, 2026 Shifts Per Week: 5 Shift Duration: 8 hours Weekly Estimated Pay: $1,310 - $1,560 Location: 330 Brookline Boston Ave, Boston, MA 02215 (Boston medical coding jobs) Required Qualifications Minimum 3+ years of ambulatory surgery / outpatient coding experience Strong...

Oncology Coder I - Outpatient Oncology Coding (Remote) Remote outpatient oncology coding opportunity for a certified outpatient coder with 3+ years of experience, CPC/CCS-P credentials, and Epic/3M skills. This role supports outpatient oncology coding operations, including injection and infusion services, in a high-acuity, detail-driven environment where accuracy, compliance, and efficient revenue cycle performance are essential. Based in Boston, MA, this position offers the opportunity to support a respected healthcare market known for its strong medical community and historic charm while working from home. Job Details Weekly Estimated Pay: $1,310-$1,560 Employment Type: Remote Schedule: 5 shifts per week Shift Duration: 8-hour day shifts Hours Per Week: 40 Start Date: 6/23/2026 Duration: 13-week assignment Specialty: Outpatient Oncology Coding Systems Used: Epic and 3M Location: Remote / Work from Home Job...

This is a remote based position. Applicants can be located nationwide Back 1d Outpatient Coding Auditor #2814 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...

Westboroughbehavioral is seeking a Medical Office Coder to join their team in Westborough, Massachusetts. This per diem position requires the coder to accurately assign medical codes for billing purposes, perform audits, and ensure compliance with coding regulations. Applicants should have a High School degree and an Associate's Degree or Certificate in Medical Coding/CPC, alongside at least one year of coding experience, preferably in psychiatric services. The role offers benefits like 401K, medical, dental, and vision coverage. #J-18808-Ljbffr

Title: Certified Risk Coder Reports to: Manager, Risk Coding Classification: Individual Contributor Location: Boston (Remote) Job description revision number and date: 2.0, 01.06.2025 Organization Summary Community Care Cooperative (C3) is a 501(c)(3) non‑profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast‑growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary The Certified Risk Coder will be a part of an emerging coding team and coding service that performs...