136 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 on 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 questions., Conducts the...

New York Oncology Hematology is seeking a Medical Coding Auditor in Clifton Park, NY. This position involves conducting coding audits for medical, radiation, and surgical oncology, ensuring compliance with guidelines. The ideal candidate must have a Bachelor's degree and a Certified Professional Coder (CPC) accreditation, along with five to seven years of relevant experience. Join our dedicated team in a role focused on enhancing revenue cycle processes and compliance. #J-18808-Ljbffr

Job Title: Inpatient Coder with Coding & Review Experience Location: Remote Work Arrangement: Remote (Must work fixed shift 8:00 AM – 5:00 PM EST) Employment Type: Contract Duration: 7+ Months Domain: Healthcare | Hospital & Health Systems Pay Rate: $ 33.68/Hourly Application Deadline: July 29, 2026 SKILLS REQUIRED Primary (Must-Have): Active AHIMA Credential (CCS, RHIT, or RHIA). Minimum 3 years of Inpatient (IP) coding experience specifically within an Academic or Level 1 Trauma medical facility. Hands-on proficiency with APR-DRG methodology and electronic encoder applications. Comprehensive knowledge across all inpatient clinical service types and complex medical admissions. Proven track record of maintaining a 98% or greater coding accuracy rate . Ability to pass a mandatory pre-employment Coding Assessment with a score of 80% or higher. Secondary (Good to Have): Prior experience conducting Peer Reviews and data auditing for health information management teams. Strong...

Lake Success, Nassau, United States Job Info Job Identification 181790 Job Category Revenue Cycle Audit Posting Date 06/18/2026, 07:14 PM Locations 1111 Marcus Ave, Lake Success, NY, 11042, US Job Schedule Full time Minimum Salary/Range* 66,300.0000 Maximum Salary/Range* 98,500.0000 Shift Days Shift Begin Time 8:30 AM Shift End Time 4:30 PM Schedule Full Time Requisition Primary Location Lake Success, NY, United States Job Description Required: Coding Auditor with inpatient hospital experience Experience coding and auditing ICD-10-PCS. Responsibilities Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. Demonstrates effective skills in validation; provides ad-hoc education to the coding staff. Able to communicate effectively with coders and CDI staff. Demonstrates knowledge of coding policy and procedures. Maintains knowledge of all current Federal and State coding guidelines; remains up-to-date on...

A healthcare technology firm is seeking a Nurse Coder DRG Auditor to validate coding accuracy and medical necessity of inpatient claims. The role involves applying industry standards and guidelines to perform DRG validations while collaborating within a team. Successful candidates will have an active RN license, relevant coding certifications, and experience in clinical practice. A competitive salary of $85,000 to $90,000 is offered, along with a comprehensive benefits package. #J-18808-Ljbffr

Trend Health Partners is seeking a Coder DRG Auditor to validate DRG assignments and accuracy of billing in a dynamic work environment. Key responsibilities include reviewing medical records and applying industry coding standards. The position requires a coding certification and relevant experience, offering a competitive salary of $65,000 - $85,000 per year along with health benefits, a 401(k) plan, and more support for professional development. #J-18808-Ljbffr

Overview At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions. The Outpatient Payment Integrity Coder Auditor is responsible for reviewing outpatient medical claims to ensure coding accuracy, compliance, and appropriate payment in accordance with CMS and payer-specific guidelines. This role supports the development and implementation of payment integrity initiatives by identifying coding and billing inaccuracies, trends, and potential cost savings opportunities across outpatient facility claims. The ideal candidate has advanced knowledge of outpatient coding, APC and EAPG payment methodologies, and clinical documentation requirements, with strong analytical and auditing skills. Salary Range: $100,000 - $102,500 Responsibilities Perform detailed coding audits on outpatient facility claims to validate appropriate CPT/HCPCS, revenue codes, modifiers, and ICD-10 coding...

Revenue Cycle Audit Coding Auditor Coding Auditor with inpatient hospital experience Experience coding and auditing ICD-10-PCS. Conducts coding audits to optimize diagnosis related groupings. Develops and implements coding instruction classes. Prepares coding guidelines; implements coding changes. Job Responsibility 1. Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. 2. Demonstrates effective skills in validation; provides ad-hoc education to the coding staff. 3. Able to communicate effectively with coders and CDI staff. 4. Demonstrates knowledge of coding policy and procedures. 5. Maintains knowledge of all current Federal and State coding guidelines; remains up-to-date on system literature from all agencies. 6. Monitors and evaluates case mix index; demonstrates comprehensive knowledge of case mix indexing. 7. Reviews potential reassignments; demonstrates accurate and timely review of all...

Location Miramar, Florida Summary Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments. For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding. Submits daily productivity report to HIM manager by defined deadline....

Req Number 181790 Required: Coding Auditor with inpatient hospital experience Experience coding and auditing ICD-10-PCS. Job Description Conducts coding audits to optimize diagnosis related groupings. Develops and implements coding instruction classes. Prepares coding guidelines; implements coding changes. Job Responsibility 1.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. 2.Demonstrates effective skills in validation; provides ad-hoc education to the coding staff. 3.Able to communicate effectively with coders and CDI staff. 4.Demonstrates knowledge of coding policy and procedures. 5.Maintains knowledge of all current Federal and State coding guidelines; remains up-to-date on system literature from all agencies. 6.Monitors and evaluates case mix index; demonstrates comprehensive knowledge of case mix indexing. 7.Reviews potential reassignments; demonstrates accurate and timely review of...

Working remotely from anywhere in the U.S., the full-time Outpatient Coding Compliance Auditor will perform audits of outpatient facility coding to ensure compliance with ICD-10-CM diagnoses, CPT/HCPCS codes, and billing standards while effectively communicating findings to stakeholders. Key responsibilities: Perform coding compliance and quality audits in support of the Compliance Program and client expectations Independently analyze clinical documentation from medical records and validate coding accuracy for outpatient facilities Identify audit findings and calculate billing error rates, providing follow-up validation for corrective action plans Required qualifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Outpatient Coder (COC) 5+ years of Outpatient Facility coding experience, including knowledge of NCCI/OCE billing edits 5+ years of Outpatient Facility audit experience, including familiarity with Medicare regulations and OPPS...

Providing expert analysis and education, the full-time remote Certified Coding Auditor and Educator will conduct comprehensive audits, deliver targeted training, and ensure compliance with coding standards in professional services. Key responsibilities Conduct comprehensive audits of coding and documentation for accuracy and compliance with regulatory guidelines Provide actionable feedback to improve documentation quality and coding accuracy for providers and coders Develop and deliver education and training programs based on audit findings and regulatory updates Required qualifications Associate degree in Health Information Management or a related field, or equivalent education and experience Comprehensive knowledge of ICD-10, HCPCS, CPT, and HCC guidelines, as well as medical terminology and regulatory guidelines Three to five years of professional coding or auditing experience Certification as a Registered Health Information Technician (RHIT), Registered Health Information...

Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 26 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2025-2026 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 63 high-performing honors. What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that...

At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.Summary:Responsible for auditing physician evaluation and management and procedures coding and billing to ensure they meet the official coding guidelines, medical necessity and compliance with regulatory requirements.Responsibilities:Prepare formal audit report of audit background, steps and findings to presentation to executive leadership and the Board of Commissioners.Participates in investigations and responds to questions, issues, reports and formal inquiries by federal and state agencies of possible violations or non- compliance matters raised by employees, patients, physicians and the public.Monitor and assess compliance with state and federal laws and the System's policies and procedures to identify deviations and...

American Oncology Network is seeking an experienced Auditor for E/M coding who is proficient in MS Office and possesses strong critical thinking and communication skills. The role entails performing audits, providing coding support, and maintaining patient confidentiality. Applicants should have a minimum of 2 years of coding experience and relevant certifications. This remote position offers opportunities for professional development and necessitates effective time management skills. #J-18808-Ljbffr

MetroPlus is seeking a Clinical Coder to join its Special Investigations Unit in New York City. The candidate will review medical records and claims for compliance, conduct audits, and participate in investigations of suspected fraud. A Bachelor's degree in Nursing and AAPC Coding certification are required, along with 5+ years of relevant experience. Strong analytical skills and attention to detail are essential for success in this role. The position allows for hybrid work arrangements, promoting both collaboration and work-life balance. #J-18808-Ljbffr

1 day ago Be among the first 25 applicants This range is provided by TalentPlug LLC. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $55,100.00/yr - $99,000.00/yr Direct message the job poster from TalentPlug LLC The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Position Purpose: Responsible for developing and conducting training and quality auditing programs for the Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care. The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Responsibilities: Conducts auditing of work performed by staff and present...

A healthcare provider is seeking a Clinical Coding Auditor & Trainer to develop training and quality auditing programs. The role primarily offers remote work with some travel to New York expected annually. Candidates should have a valid clinical license and experience in DRG and Medical Record Audits. This full-time position focuses on training, quality assurance, and compliance in a hospital environment. #J-18808-Ljbffr

Kids for the Future is seeking a Full-Time Facility Outpatient Coding Auditor to work remotely. This role involves abstracting codes from medical records, ensuring compliance with health standards, and performing quality reviews. The ideal candidate will possess relevant coding credentials and have at least five years of experience in coding assignments. The position offers various benefits including health insurance, a 401(k) with company match, and learning opportunities, making it an excellent opportunity for experienced coders. #J-18808-Ljbffr

The Medical Coding Auditor is responsible for conducting prospective and retrospective compliance reviews of documentation supporting codes reported by providers or facility coding to ensure accuracy in billing, maximize charge capture, and comply with Federal, State, payer, and institutional requirements. This role involves analyzing medical records, ensuring the accuracy of ICD-10-CM diagnosis coding and CPT/HCPCS coding, and compliance with regulations. The specialist communicates results, makes recommendations, and provides training and education to staff on appropriate documentation, coding, and billing practices. Essential Job Responsibilities Conduct coding and auditing of technical and professional components of services and procedures to ensure accuracy. Perform audits of new physicians on coding and documentation requirements for E/M services and procedures. Track coding issues by provider and present necessary education and training to improve coding. Demonstrate...

Job Description Job Schedule This role offers a hybrid schedule. You will need to visit two centers twice a week: one day at the Ocoee center and one day at the East Colonial center. These onsite visits are mandatory and non-negotiable. The remaining days of the week will be remote work. Job Summary The Medicare Coder Specialist facilitates modifications to clinical documentation through pre‑visit and post‑visit interaction with providers and other members of the healthcare team. She or he promotes capture of clinical severity (later translated into coded data) to support the level of service rendered to relevant patient populations, enhance evidence‑based medicine, promote continuity of care, and improve capturing chronic conditions. Responsible for coding all medical services procedures CPT and HCPCS codes, pharmaceuticals supplies, patients’ ICD‑10 diagnoses, signs, and symptoms when applicable, ensuring that all assigned ICD‑10‑CM codes are supported by proper clinical...

3 days ago Be among the first 25 applicants About Performant At Performant, we’re focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Our mission is to offer innovative payment accuracy solutions that allow our clients to focus on quality of care and healthier lives for all. Medical Coding Auditor – Inpatient (Remote) Location: Remote. Full‑time. Salary: $70,000 – $85,000 per year. Key Responsibilities Audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD‑10, CPT, and HCPCS codes. Ensure coding practices comply with federal, state, and payer‑specific regulations and guidelines, including HIPAA and CMS standards. Detect discrepancies...

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:...

Managing multiple projects remotely, the full-time Medical Auditor Project Lead will oversee client needs, perform production work, maintain audit standards, and provide feedback to auditors while ensuring high-quality deliverables. Key responsibilities Oversee project management and client expectations to ensure timely and quality deliverables Audit medical records and validate clinical documentation to meet quality standards Prepare audit findings and provide recommendations based on detailed analysis Required qualifications CPC certification required; CPMATM or RHIT preferred Extensive experience in coding, billing, auditing, and compliance within the healthcare industry Proficient knowledge of AMA, OIG, CMS, and national coding guidelines Experience in developing training materials and delivering presentations Demonstrated ability to manage multiple projects simultaneously