22 coder auditor professional jobs found

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). Company Overview Savista partners with healthcare providers to improve their financial strength by implementing integrated revenue cycle solutions that help control cost, improve margins and cash flow, increase regulatory compliance, and optimize operational efficiency. Job Purpose The Audit Project Lead oversees a designated client’s audit, which is ongoing in nature and spans several hospital and/or clinic sites. This colleague coordinates project managing a designated client’s audit with a designated colleague(s) from the Audit...

Coder Reimbursement Specialist - Hospital Tech Tammina LLC The Coding and Reimbursement Specialist, CCS is responsible for coding and abstracting thoroughly, clinical data from the medical record. This includes both inpatient, outpatient, commercial, Medicare, Medicaid, and Illinois Public Aid, plus any other payor types. This accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis, grouped to the 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. Manages workload and assigns work to three inpatient and two outpatient coders and oversees the day to day workings of the coding/reimbursement area. Monitors various regulatory sources to keep HIM coding and other staff informed and trained on various coding rules, regulations and related issues. Works closely with patient financial...

Job Description Job Description 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 Heath 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...

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,...

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. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday. Preferred Skills and Experience: - At least 2 years of coding experience. - Experience with CPT modifiers and how they impact...

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 Heath 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...

Job Description Job Description Description: Why you’ll want to work at nimble! Interested in becoming a part of a dynamic Coding team? This is a great opportunity to join a well-established and market-leading brand serving a high-growth end market while gaining valuable experience working closely with Executive leadership. As an organization, we are in high-growth mode through acquisition with a laser focus on positive culture building! Who we are: nimble solutions is a leading provider of revenue cycle management solutions for ambulatory surgery centers (ASCs), surgical clinics, surgical hospitals, and anesthesia groups. Our tech-enabled solutions allow surgical organizations to streamline their revenue cycle processes, reduce administrative burden, and improve financial outcomes. Join more than 1,100 surgical organizations that trust nimble solutions and its advisors to bring deep insights and actionable intelligence to maximize their revenue cycle. The...

The Patient Account Representative Coder will be responsible for reviewing and coding from the medical record, already billed, or suggested from provider or computer generated applications for straight‑forward to complex coding, and any account receivable activities for the physician clinics within Saint Luke's Health System. Activities include, but are not limited to, coding, charging, troubleshooting charge related issues, responding to inbound and outbound billing calls from patients, resolving payment credits, identifying and correcting medical claim errors that may prevent payment and identifying, correcting, and resubmitting medical claims denied by insurance companies. Resolving claim edits, working denials and appeals. Evaluation and coding of ICD, CPT, HCPCS. All coding initiatives, NCCI edits, incidentals/inclusive, and bundling rules, etc. Demonstrate competency for invalid diagnosis, modifiers, coding related issues, and be able to have moderate decision making in...

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...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 58427 - MCS - 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...

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. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday. Preferred Skills and Experience: - At least 2 years of coding experience. - Experience with CPT modifiers and how they impact...

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...

POSITION TITLE: Compliance Auditor REPORTS TO: Director of Compliance CLASSIFICATION: Non-Exempt POSITION SUMMARY: The Compliance Auditor is responsible for developing and executing audit plans based on research and regulatory guidelines and conducting internal and external audits of departments and their policies. They review programs, records, and systems to ensure adherence to regulations and to support an effective compliance program that prevents illegal, unethical, or improper conduct at the health center. Additionally, they compile and present audit findings to department leadership, assist in implementing procedural changes to resolve compliance issues, and may be reassigned duties as needed for accommodation or staffing reasons. ESSENTIAL FUNCTIONS: The following information is considered the definition of essential functions, but does not restrict the tasks that may be assigned. The Compliance Auditor may be reassigned duties and responsibilities...

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...

Job Description​ The Patient Account Representative Coder will be responsible for reviewing and coding from the medical record, already billed, or suggested from provider or computer generated applications for straight-forward to complex coding, and any account receivable activities for the physician clinics within Saint Luke's Health System. Activities include, but are not limited to, coding, charging, troubleshooting charge related issues, responding to inbound and outbound billing calls from patients, resolving payment credits, identifying and correcting medical claim errors that may prevent payment and identifying, correcting, and resubmitting medical claims denied by insurance companies. Resolving claim edits, working denials and appeals. Evaluation and coding of ICD, CPT, HCPCS. All coding initiatives, NCCI edits, incidentals/inclusive, and bundling rules, etc. Demonstrate competency for invalid diagnosis, modifiers, coding related issues, and be able to have moderate...

Medical Billing Specialist (CPC) - Feb 2026 California Medical Billing Specialist (CPC) Remote, California residents only (Full Time) Compensation: $28- $32 per hour About Us Zócalo Health is the first tech-driven provider built specifically for Latinos, by Latinos. We are developing a new approach to care that is designed around our very own shared and lived experiences and brings care to our gente. Founded in 2021 on the idea that our communities deserve more than just safety nets, we are backed by leading healthcare and social impact investors in the country to bring our vision to life. Our mission is to improve the lives of our communities—communities that have dealt with generations of poor experiences. These experiences include waiting hours in waiting rooms, spending mere minutes with doctors who don’t speak their language, and depending on their youngest kids to help them navigate our complex healthcare system. At Zócalo Health, we meet our members where they are,...

Education LevelCertification## Description**Primary Purpose:** To provide customer service to both the internal and external customers of the Health Information Management Department in a timely fashion. Review all outpatient encounters, selecting appropriate ICD-10-CM\* and ICD-10-PCS\* codes to reflect the diagnoses and course of treatment. **Formal Policy-Setting Responsibilities:** No formal responsibility. The policies associated with the job’s purpose and essential responsibilities are set by others. **Routine Decision Making**: Selects ICD-10 CM\* diagnostic codes and CPT-4 procedure codes for outpatient procedures, and ICD-10-PCS codes for inpatient procedures to obtain appropriate reimbursement. Coders also verify the correct charges are on the chart in accordance to physicians’ orders. **Formal Supervisory Responsibility:** No formal supervisory...

Why you’ll want to work at nimble! Interested in becoming a part of a dynamic Coding team? This is a great opportunity to join a well-established and market-leading brand serving a high-growth end market while gaining valuable experience working closely with executive leadership. As an organization, we are in high-growth mode through acquisition with a laser focus on positive culture building! Job Type Full-time About nimble solutions nimble solutions is a leading provider of revenue cycle management solutions for ambulatory surgery centers (ASCs), surgical clinics, surgical hospitals, and anesthesia groups. Our tech‑enabled solutions allow surgical organizations to streamline their revenue cycle processes, reduce administrative burden, and improve financial outcomes. Join more than 1,100 surgical organizations that trust nimble solutions and its advisors to bring deep insights and actionable intelligence to maximize their revenue cycle. Preferred candidate skills The preferred...

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...

Position Summary Verifies and ensures the accuracy, completeness, specificity and appropriateness of diagnosis codes on services rendered. Completes appropriate paperwork/documentation/system entry regarding claim and encounter information. Supports and participates in process and quality improvement initiatives. Assists with clinician billing and documentation training. Education Requires an associate degree from an 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...

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...