27 coder auditor professional jobs found

## Physician Coding AuditorApplylocations: Remote - Nationwide: Work at Home - Virginia - Other: Work at Home - Memphis - TN: Work at Home - Pittsburgh - PAtime type: Full timeposted on: Posted Todayjob requisition id: R046656**Thank you for considering a career at Ensemble!**Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!O.N.E Purpose:* **Customer Obsession:** Consistently provide exceptional experiences for our clients,...

DRG auditor Location: Maplewood Mn Pay Rate: Negotiable Duration: 12 months potential for extension Summary We are seeking two experienced inpatient DRG Auditors for an as‑needed role offering flexible hours (8–40 hours per week). Candidates may already have full‑time jobs, and the position is open to applicants on either the East or West Coast. The role will likely include two interviews. Qualifications 5–7+ years of inpatient hospital coding/auditing experience Experience working in acute care hospitals, large hospital systems, or academic medical centers Strong expertise with ICD‑10‑CM/PCS, MS‑DRG and APR‑DRG methodologies Understanding of Elixhauser scoring, HACs, PSIs, and clinical validation Prior exposure to Clinical Documentation Improvement (CDI) preferred Ability to independently perform DRG audits with high accuracy Strong analytical, communication, and documentation skills Responsibilities Perform inpatient DRG audits to validate the accuracy of coded...

Responsibilities Participate in the inpatient coding training program, as needed, which is well-established. In times of light training responsibilities, this position will perform retrospective inpatient coding reviews for DRG validation and compliance reviews. If you are an inpatient coder with a proven track record of excellent quality, this is an opportunity to advance your career as a retrospective inpatient coding auditor, possibly to include coder training. Qualifications Requirements are at least three years of inpatient coding experience in a high complexity facility or organization, with a certification of a CCS (or CPC and CCS eligible), RHIT, or RHIA. #J-18808-Ljbffr

Risk Adjustment Coding Auditor Blue Cross and Blue Shield of Minnesota is hiring a Risk Adjustment Coding Auditor. The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. An ideal candidate has 5+ years of risk adjustment coding experience and an active CRC certification. This is a production-based role requiring comfort in a high-volume environment. Your Responsibilities Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit...

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....

DRG auditor Location: Maplewood Mn Pay Rate: Negotiable Duration: 12 months potential for extension Summary: We are seeking two experienced inpatient DRG Auditors for an asneeded role offering flexible hours (8-40 hours per week). Candidates may already have fulltime jobs, and the position is open to applicants on either the East or West Coast. The role will likely include two interviews . Ideal candidates will have: 5-7+ years of inpatient hospital coding/auditing experience Experience working in acute care hospitals, large hospital systems, or academic medical centers Strong expertise with ICD10CM/PCS , MSDRG and APRDRG methodologies Understanding of Elixhauser scoring , HACs , PSIs , and clinical validation Prior exposure to Clinical Documentation Improvement (CDI) preferred Ability to independently perform DRG audits with high accuracy Strong analytical, communication, and documentation skills Role Responsibilities: Perform...

Responsibilities Participate in the inpatient coding training program, as needed, which is well-established. In times of light training responsibilities, this position will perform retrospective inpatient coding reviews for DRG validation and compliance reviews. If you are an inpatient coder with a proven track record of excellent quality, this is an opportunity to advance your career as a retrospective inpatient coding auditor, possibly to include coder training. Qualifications Requirements are at least three years of inpatient coding experience in a high complexity facility or organization, with a certification of a CCS (or CPC and CCS eligible), RHIT, or RHIA. #J-18808-Ljbffr

About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You Will Have Blue Cross and Blue Shield of Minnesota is hiring a Risk Adjustment Coding Auditor. The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support...

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:...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Senior Medical Coder performs concurrent review of FFS coding rules, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. This position will support coding functions within charge review, claim edits, and denials and play a critical role in maintaining coding accuracy and supporting revenue cycle integrity. Schedule: Monday to Friday,...

Medical Coder The Medical Coder is responsible for reviewing medical documentation and assigning accurate diagnostic and procedural codes using ICD-10, CPT, and HCPCS coding systems. This role ensures correct billing and compliance with healthcare regulations, supporting the revenue cycle, and minimizing claim denials. The coder works closely with healthcare providers and billing staff to maintain accurate, complete, and up-to-date patient records. We are committed to providing wage ranges for all open positions. Please note that the specific compensation for this role will be determined based on experience, education and internal equity considerations. The hourly wage range for this position is $22.80-$32.18. This range reflects the base salary for this position. Key Accountabilities Reviews and analyzes medical records to identify pertinent diagnoses and procedures for accurate coding and reporting. Assigns accurate medical codes using ICD-10, CPT, and HCPCS coding systems...

Get started on an exciting career in health information management. We’re with you every step of the way. Starts out onsite, then transitions to REMOTE 4 days/week. Job Summary: Required Services provide single path medical coding services and related medical records functions. Single path coding combines facility coding and professional coding and allows one coder to code facility and professional codes for the same patient utilizing a single coding platform. perform technically complex professional services coding for medical conditions and assign the correct International Classification of Diseases, ICD-10-CM, Procedure Coding System (PCS) Current Procedural Terminology (CPT), Health Care Financing Administration Common Procedure Coding System (HCPCS), and Evaluation and Management (E&M) codes for diagnosis, acuity of care and procedures for a wide range of medical specialties to include coding of complicated cases identified as difficult to classify such as treatment of...

Remote Rn Certified Coder Pride Health is hiring a remote RN certified coder for a well-known client! (REMOTE) Schedule: Monday-Friday (9am-5pm EST) Contract: 12 months Pay Rate: 60-64/hour Job Responsibilities Determine which codes belong to the language in the benefit plans Review what peers have designated as correct coding Facilitate any discussions needed to get to a coding document Review audit results and make adjustments as necessary Participate in project meetings Requirements 3 + years' experience with coding and reimbursement methodologies (e.g. CPT, HCPCS, ICD-10, CMS), 3+ years Certified Professional Coder (AAPC or AHIMA) Active unrestricted RN license AAPC or AHIMA certification Pride Global offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an...

Overview Are you ready to take the next step in your professional journey? At Minnesota Oncology, we believe that our people are our greatest asset, and we are committed to fostering a diverse and inclusive workplace where everyone can thrive. We are constantly on the lookout for talented individuals who are passionate, driven, and eager to make a difference. Come join this dynamic team who is passionate about providing exceptional care to our patients. Why Work for Us? We offer a competitive benefits package that includes - Medical Dental Vision Free Life Insurance Generous Paid Time Off (PTO) Plan Free Short-term and Long-term Disability Coverage 401k plan with company contribution Wellness program that rewards your healthy lifestyle Tuition Reimbursement Employee Assistance Program and Discount Program to some of your favorite retailers Free Parking Career Growth and Development Supportive Team and Resources Responsibilities SCOPE: Under minimal supervision...

Who Are We Life Link III is a premier, nationally recognized air medical transport company, known for our clinical excellence, superior aviation program and reliable response in providing care to critically ill or injured patients. Our priority is to do everything possible to give every patient their best chance for the best possible outcome - demonstrated by our unwavering commitment to providing the highest level of care to our patients while on board safe, state-of-the-art aircraft. We continually focus on innovation and work to put cutting-edge technology and education in the hands of our flight medical crew, pilots, mechanics, operational control specialists and communication specialists so we can provide uncompromising care to the communities we serve. We do this work while living out our core values of safety, customer focus, excellence, integrity, innovation, and collaboration. As a Medical Billing Specialist, you will play an important role in ensuring accurate billing,...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

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 you to...

Overview Are you ready to take the next step in your professional journey? At Minnesota Oncology, we believe that our people are our greatest asset, and we are committed to fostering a diverse and inclusive workplace where everyone can thrive. We are constantly on the lookout for talented individuals who are passionate, driven, and eager to make a difference. Come join this dynamic team who is passionate about providing exceptional care to our patients. Why Work for Us? We offer a competitive benefits package that includes - Medical Dental Vision Free Life Insurance Generous Paid Time Off (PTO) Plan Free Short-term and Long-term Disability Coverage 401k plan with company contribution Wellness program that rewards your healthy lifestyle Tuition Reimbursement Employee Assistance Program and Discount Program to some of your favorite retailers Free Parking Career Growth and Development Supportive Team and Resources This...

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...

Job SummaryWe are seeking an experienced Certified RN Medical Coder to support a full-time COC / SPD project focused on building out coding for benefit plans.This role combines clinical knowledge with technical coding expertise to ensure accuracy, consistency, and compliance across plan documentation.You'll work closely with a team of certified coders and business analysts in a collaborative, fast-paced environment where precision and partnership drive success.Why this Opportunity?Top ranked company in Fortune's 2024 World's Most Admired Companies for over a decade consecutively.This healthcare client is ranked number one in key attributes of reputation :Innovation People management Social responsibility Quality of Management Financial soundness Long-term investment value Quality of products Services and global competitiveness.Job Responsibilities :Determine and assign appropriate codes to benefit plan language as part of the COC / SPD project.Review coding selections made by peers...

Join Senior CommUnity Care as a Medical Coder - Risk Adjustment Specialist and partner directly with physicians and Medical Directors to improve documentation, support CMS reporting, and strengthen value-based care for older adults in the PACE program. Medical Coder - Risk Adjustment Specialist- Remote Schedule: M-F 8:00 AM-5:00 PM Salary: $58,000-$66,000 (Based on Experience) Essentials: Collaboration for Risk Adjustment Integrity: Works closely with Medical Directors and PACE providers to uphold the integrity and accuracy of the risk adjustment reporting process. Engages in continuous dialogue with healthcare professionals to ensure that coding accurately reflects participant acuity. Medication Documentation Review and Diagnostic Coding: Reviews and interprets provider documentation to extract critical information. Assigns ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures from documented information in the medical record. Assures the final...

Hourly Range: $20.72 USD to $31.08 USD Description The Medical Coding Specialist will evaluate medical records and encounters to ensure completeness, accuracy, and compliance with the International Classification of Diseases Manual - Clinical Modification (ICD-10-CM), and the American Medical Associations Current Procedural Terminology Manual (CPT). The Specialist will also provide technical guidance and training on medical coding to physicians and staff. Essential FunctionsReasonable accommodations may be made to enable individuals with disabilities to perform these essential functions. Assign codes to diagnoses and procedures, using ICD-10 (International Classification of Diseases) and CPT (Current Procedural Terminology) codes Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations and meet current policy coding guidelines Communication and training with provider(s) on any documentation that is...

Medical Billing Specialist The Mary T Family of Companies is seeking a full-time Billing Specialist to join our Accounting and Finance team. The Billing Specialist is responsible for full-cycle billing, including processing claims, payments, and other related paperwork to various payors, and ensures the paperwork is submitted correctly and in a timely manner. This position is based in Coon Rapids, MN and will offer a hybrid remote work schedule of 3 days in-office and 2 days remote. Essential Job Duties: Coordinates billing cycle needs and due dates for billing. Collects census information on a periodic basis. Services and Room and Board are on a monthly basis. Coordinates client income and spend down, take-backs and Social Security RFI benefit verifications when applicable. Conducts client eligibility verifications. Reviews Service Contracts for authorization and verifies unit/hour/days rates. Prepares and sends private pay statements. Completes data entry of billing information...