27 coder auditor professional jobs found

Coding Auditor - Professional Coder Auditor-Professionals are responsible for auditing of coding assignment with providers and coders, training of coding professional staff, pro-fee based coding includes the assignment of Assigns ICD-CM, CPT, HCPCS codes, E&M assignment, modifiers, and charge posting. Interacts with medical staff, nursing, ancillary departments, provider offices, and outside organizations. Department: Physician coding Hours: Full-Time, 40 hours a week required Required: High School Diploma, CPC, CEMA within 6 months of hire, CPMA within 1 year of hire Pay: Based one experience, starting at $23.87/hour Location: Remote or onsite: At this time, you must reside in one of the following locations: Alabama, Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, New Mexico, Ohio, Oklahoma, South Carolina, Tennessee, Texas Responsibilities: Assists coders with coding...

COMPANY OVERVIEW Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG currently bidding on a contract with the Federal Government for several coding positions. You would be a W-2 employee for HPMG and NOT a government employee. SUMMARY Responsible for assignment of accurate ICD codes for diagnoses and procedures. Medical Severity - Diagnostic Related Group (MS-DRG) is automatically assigned by the grouper software for inpatient stays. Inpatient coders may also be responsible for the assignment of accurate ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities from medical record documentation (paper or electronic) for inpatient professional services (a.k.a., rounds or IBWA encounters). Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities. MANDATORY KNOWLEDGE AND SKILLS Position requires...

Company Overview Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast‑growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Job Summary Alignment Health is seeking a remote Risk Adjustment Compliance Auditor to support auditing and compliance activities related to risk adjustment data submitted to CMS. In this role, you will conduct provider and coder‑level audits, review medical record documentation and coding accuracy, identify compliance risks and...

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....

Job Type: Full-time Description The Certified Coder will play a key role in converting diagnoses and treatment procedures into ICD-10, CPT and HCPCS codes. The Coder will review and accurately code office and hospital procedures for reimbursement. Essential Functions Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Reviews and verifies documentation supports diagnoses, procedures, and treatment results. Identifies diagnostic and procedural information. Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes. Assigns codes for reimbursements, research and compliance with regulatory requirements...

Additional Information About the Role BJC is hiring for a Lead Inpatient Coder position. We are looking for a minimum of 2 years of Inpatient Coding experience. This is a remote position. Required certs: CCS, RHIA, or RHIT Remote Eligible states: Alabama Kentucky Oklahoma Arkansas Louisiana South Carolina Florida Mississippi Tennessee Georgia Louisiana Texas Indiana North Carolina Wisconsin Iowa Ohio Overview BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health,...

Certified Professional Coder, Outpatient Billing Full Time Corporate 3 days ago Requisition ID: 4107 Salary Range: $27.00 To $35.00 Hourly Position Summary This role is responsible for ensuring accurate, compliant, and complete coding of professional outpatient encounters in a high-volume urgent care environment. This role reviews provider documentation, validates and corrects CPT® and ICD-10-CM code selection, queries providers for missing or unclear documentation, and ensures all claims meet CCI, payer, and outpatient coding requirements prior to billing. This role also plays a key role in supporting provider coding and documentation audits and manual coding activities required during system downtime or special operational needs. Key Responsibilities Documentation Review & Coding Validation Review clinical documentation to confirm all services rendered are documented completely and accurately prior to billing. Validate provider-selected CPT® and ICD-10-CM codes to...

Job Description And Duties The Investigative Auditor IV (Supervisor) supervises, assigns and monitors work of Investigative Auditors who conduct investigations of charities, charitable trusts, and professional fundraisers, and review asset sales, mergers, conversions, and other transactions that are subject to the supervision of the Attorney General pursuant to the Supervision of Trustee s and Fund raisers for Charitable Purposes Act and other statutes. The Investigative Auditor (Supervisor) also investigates allegations of misuse or diversion of charitable assets and recommends corrective action to enforce compliance with law, and may be called to serve as an expert witness in court trials. The Investigative Auditor (Supervisor) is a resource for the attorneys and the Registry of Charities and Fundraisers for accounting, reporting and related issues and helps analyze complaints, referrals and filings to assess whether further investigation is appropriate. Job Description And...

Description Columbia Orthopaedic Group Fast-paced. Detail-driven. Team-focused. Every claim, code, and detail matters in delivering accurate, compliant, and timely patient care behind the scenes. If you take pride in precision and enjoy working in a collaborative healthcare environment, this role is for you. Why This Role Is Different This is not just a coding role-it is a key part of the revenue cycle that directly impacts the success of orthopaedic care delivery. Your work ensures providers are accurately represented, claims are clean, and reimbursement flows efficiently. You'll partner closely with physicians, billing, and administrative teams in a highly collaborative environment where accuracy, communication, and compliance are essential. About the Role The Medical Coder is responsible for accurately coding orthopaedic services to support timely and compliant claim submission. This role ensures documentation integrity, supports revenue cycle...

Additional Information About the Role BJC is hiring for a Lead Inpatient Coder position. We are looking for a minimum of 2 years of Inpatient Coding experience. This is a remote position. Required certs: CCS, RHIA, or RHIT Remote Eligible states: Alabama Kentucky Oklahoma Arkansas Louisiana South Carolina Florida Mississippi Tennessee Georgia Louisiana Texas Indiana North Carolina Wisconsin Iowa Ohio Overview BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health,...

Job Description Must Haves: Minimum of 2 years in medical coding Familiarity with ICD-10 codes and procedures Highly proficient at Excel Associate’s degree in medical coding or CPC Certification Plusses: Fertility billing background preferred Working knowledge of medical jargon and anatomy preferred Day to day: A client of Insight Global is seeking a full-time, competent and knowledgeable Medical Coder/Biller. The new hire will possess a strong knowledge base of revenue cycle management, insurance and cash based revenue and first-class customer service skills. Assign codes to diagnoses and procedures, using ICD (International Classification of Diseases) HCPCS (Healthcare Common Procedure Coding System) and CPT (Current Procedural Terminology) codes. Make judicious decisions on which codes to assign in each instance and function to a high level of accuracy Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations Follow up...

At Houston Methodist, the Lead Outpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to outpatient encounters based on documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. FLSA STATUS Non-exempt...

Position Summary Verifies and ensures the accuracy, completeness, specificity and appropriateness of diagnosis codes on services rendered. Complete appropriate paperwork/documentation/system entry regarding claim and encounter information. Support and participate in process and quality improvement initiatives. Assist with clinician billing and documentation training. Education Requires an associate degree from Accredited Health Information Technology program, Bachelor's degree preferred. Coding certificate with AHIMA approval status. RHIA, RHIT, CCS or CCS-P certification status required. Experience Three (3) years' experience as a Certified Medical Biller/Coder Experience at a Federally Qualified Health Center (FQHC) preferred. Lab coding experience required. Skills and Abilities Strong written and verbal communication skills, strong analytical skills, organizational and time management skills. Knowledge and experience in a healthcare environment of billing and reimbursement...

Opportunities At Change Healthcare Opportunities at Change Healthcare, part of the Optum family of businesses. We are transforming the health care system through innovative technology and analytics. Find opportunities to make a difference in a variety of career areas as we all play a role in accelerating health care transformation. Help us deliver cutting-edge solutions for patients, hospitals and insurance companies, resulting in healthier communities. Use your talents to improve the health outcomes of millions of people and discover the meaning behind: Caring. Connecting. Growing Together. Job Description: The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours:...

AAPC Certified Medical Coder - Remote Join a dedicated healthcare team serving a broad regional community in the Midwest. This role is perfect for a detail-oriented medical coder who thrives in a remote work environment and is passionate about accurate and ethical coding practices. General Summary The medical coder ensures that services are billed correctly according to the American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. This position involves insurance credentialing and educating providers and staff on coding and billing standards. Routine chart audits are conducted to maintain compliance and accuracy. Essential Duties and Responsibilities Assign ICD-10-CM, CPT, and HCPCS Level II codes to finalized medical documentation to create accurate medical claims. Abstract specific data from patient records to determine appropriate claim modifiers. Query providers for clarification when documentation is unclear or incomplete,...

Coder Reimbursement Specialist - Hospital Full‑time position. The Coding and Reimbursement Specialist (CCS) is responsible for coding and abstracting clinical data from the medical record, including inpatient, outpatient, commercial, Medicare, Medicaid, Illinois Public Aid, and all other payor types. Accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis and DRG in accordance with rules and regulations and coding methodologies, resulting in reimbursement and billing compliances as set forth by the Office of Inspector General. The CCS manages workload, assigns work to three inpatient and two outpatient coders, and oversees day‑to‑day operations of the coding/reimbursement area. The CCS monitors regulatory sources to keep HIM coding and other staff informed and trained on coding rules, regulations and related issues, works closely with patient financial services to resolve claim denials, assists in...

QA Nurse / Coder (RN) As a QA Nurse / Coder, you will ensure the accuracy, completeness, and regulatory compliance of Home Health documentationparticularly OASIS assessments, the Home Health Plan of Care (485), and face-to-face encounter noteswhile properly sequencing diagnoses according to federal/state standards and agency policy. Core responsibilities include: Review OASIS forms and Plans of Care for appropriateness, completeness, and compliance. Assign and sequence ICD?10 codes in line with current home health coding guidelines. Ensure consistency and compliance of face-to-face encounter documentation with OASIS and care plans. Conduct additional clinical record audits and OASIS reviews as assigned. Stay current on Medicare reimbursement policies, home health regulations, and compliance requirements. Maintain relevant certifications (HCS?D, HCS?O or COS?C). Participate in quality assurance and performance-improvement efforts. Coordinate with physicians, facilities,...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 58429-MCS-C- University Physicians, and the department will be hiring for two positions Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of changes made...

Shift : 40 hours/week - Flexible Schedule, one weekend day required. Department : Coding & Data Management - Outpatient Team. Remote Compensation : • Base Pay Range: o Non-Certified: $19.15 - $30.23 per hour, based on experience o Certified: $22.00 - $34.74 per hour, based on experience ABOUT THE JOB MU Health Care is looking for a detail-oriented Medical Coding Specialist to join our team. As a crucial member of our healthcare family, the ideal candidate will possess a passion for precision and a commitment to maintaining the highest standards in medical coding. We value individuals who demonstrate a deep understanding of technical coding principles, coupled with a strong knowledge of ICD-10-CM, ICD-10-PCS, and CPT codes. Our ideal candidate advances their coding expertise through continuous education, ensuring accurate and compliant coding practices. We seek someone who thrives in a fast-paced environment, excels in problem-solving, and actively contributes...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 59698 - MCS-C and the department will be hiring for two positions. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of changes made to...

Job Posting We are dedicated to providing exceptional care to every patient, every time. St. Luke's Hospital is a value-driven award-winning health system that has been nationally recognized for its unmatched service and quality of patient care. Using talents and resources responsibly, we provide high quality, safe care with compassion, professional excellence, and respect for each other and those we serve. Committed to values of human dignity, compassion, justice, excellence, and stewardship St. Luke's Hospital for over a decade has been recognized for "Outstanding Patient Experience" by HealthGrades. Position Summary: Serves as a lead analyst for the St. Luke's Hospital 3M 360 Encompass coding system and other coding quality systems. Responsible for development, re-engineering, and system enhancement projects. Performs system and/or staff audits across inpatient hospital coding. Maintains databases, spreadsheets, computer and paper files related to coding...

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...

Medical Coding Specialist Full Time St. Louis, MO, US Join Us to Build Healing and Hope Together! As leaders in children's mental health and wellness, St. Louis Children's and KVC Health Systems Youth Mental Health Care have partnered to create one of the nation's most innovative and transformative youth mental health and wellness campuses. The partnership includes a 77-bed acute care hospital and outpatient programs. Located on the KVC Missouri Children's Mental Wellness Campus conveniently located in Webster Groves, Missouri, the peaceful environment and broad continuum of care allow children and families to access the appropriate level of treatment throughout their healing experience. The new campus is slated to open in late 2026. Learn more at stlouischildrenskvc.org. Join us and be a part of this journey of healing and hope for thousands of children and teens. Job Summary The Medical Coding Specialist is KVC's Hospitals subject matter expert on medical coding. They...

It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Qualifications: Ideal candidate has experience with inpatient coding and auditing. RHIT, RHIA, and CCS are preferred certifications. ? Remote work: This position is eligible for remote work in accordance with SSM policies. Note that remote work is not permissible in some states; Human Resources should be consulted for additional information and guidance. * Candidates to reside in MO, IL, OK, or WI (additional states my be considered) Job Summary: Performs periodic and ongoing audits of claims to ensure accuracy of coding and billing, and sufficiency of supporting documentation. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Audits specified number of records per coder as defined in the system coding audit plan. Prepares audit reports that are issued to key stakeholders, as appropriate. Develops corrective action plans to...