26 coder auditor professional jobs found

Description Note: While this role is currently remote, we are prioritizing candidates within commuting distance of our Rossford, Dublin, or Brooklyn offices to accommodate a potential future shift to a hybrid schedule. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers...

At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Primary Function/General Purpose of Position Under the guidance of the Director, Compliance this position contributes to the Bon Secours Mercy Health mission and vision by serving as a senior auditor of provider revenue cycle compliance. This position provides compliance program-related audit activities relative to Bon Secours Mercy Health operations conducted at local and remote locations and supports provider compliance education and Leadership requests. Conducts specialized compliance investigative audits for Leadership and as part of due diligence to ensure the accuracy and completeness of provider documentation and coding that results in appropriate reimbursement and data integrity and validation of coded information. Essential Job Functions...

Note: While this role is currently remote, we are prioritizing candidates within commuting distance of our Rossford, Dublin, or Brooklyn offices to accommodate a potential future shift to a hybrid schedule. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers applicable Centers...

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:...

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: Benefits may vary based upon position type and/or level. Job...

Description Note: While this role is currently remote, we are prioritizing candidates within commuting distance of our Rossford, Dublin, or Brooklyn offices to accommodate a potential future shift to a hybrid schedule. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers...

Description Note: While this role is currently remote, we are prioritizing candidates within commuting distance of our Rossford, Dublin, or Brooklyn offices to accommodate a potential future shift to a hybrid schedule. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers...

Lead, Quality & Regulatory Compliance Auditor Req ID: 52076 Job Category: Regulatory Affairs Location: Mentor, OH, US, 44060 Workplace Type: Hybrid At STERIS, we help our Customers create a healthier and safer world by providing innovative healthcare and life science product and service solutions around the globe. Position Summary The mission of the STERIS Quality & Regulatory Compliance function is to implement repeatable and sustainable processes to ensure on-going compliance with domestic and international regulations and standards. This includes evaluating the relevance to all STERIS facilities and products and implementing efficient and effective processes to ensure adherence to applicable regulations and standards. This is a hybrid role based in STERIS' Corporate Offices in Mentor, Ohio. In order to support the business needs working a minimum of 3 days a week in the Mentor office is expected. 20% domestic and international...

Medical Coding Auditor The Medical Coding Auditor is responsible for performing internal QA audits on coding staff and supporting the quality of coding provided by coders. Minimum Requirements: Formal HIM education with national certification (RHIA or RHIT) or Bachelor's Degree required Additional coding certification (CCS, or CCS-P) preferred Minimum of three (3) years of inpatient and outpatient hospital experience (additional physician coding experience preferred) Minimum of three (3) years of inpatient and outpatient hospital coding/auditing experience preferred Must hold at least one of the following certifications: RHIA, RHIT, CCS, CCS-P, CPC, CPC-H (COC) or have a preferred minimum of 2 years relevant coding experience Must be at least 18 years of age Benefits At Amergis, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits: Competitive pay & weekly paychecks Health, dental, vision,...

Outpatient Surgery/IVR Medical Coder The Outpatient Surgery/IVR Medical Coder is responsible for assigning ICD-10-CM and/or CPT/HCPCS codes as appropriate and abstracts pertinent information from patient records. Essential Duties and Responsibilities: Assigns ICD-10-CM and/or CPT/HCPCS codes, as appropriate and abstracts pertinent information from OPS/OBS patient records Ensures optimal reimbursement of all cases in compliance with CMS policies and procedures and official coding guidelines Implements medical center's physician query process when code assignments are not straightforward or documentation in the medical record is inadequate, ambiguous or unclear for coding purposes Keeps abreast of coding guidelines and reimbursement reporting requirements Brings identified concerns to the Professional Recruiter who will direct as needed Abided by the Standards of Ethical Coding as set forth by the American Health Information Management Association Adheres to Official...

At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region's adult academic health system, we strive for innovation and provide world‑class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors. UC Health is committed to providing an inclusive, equitable and diverse place of employment. Using established policies and procedures; the Certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing. The Certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and...

Job Description At UC Health, we’re proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region’s adult academic health system, we strive for innovation and provide world‑class care for not only our community, but patients from all over the world. Join our team and you’ll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors. UC Health is committed to providing an inclusive, equitable and diverse place of employment. Using established policies and procedures, the Non‑certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing. The Non‑certified Coder may code all types of inpatient, observation and outpatient cases (including clinics, ancillary services, ambulatory surgery, series, and...

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. ***** FT and PRN Openings *** Up to $5,000 Sign On Bonus ***** 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...

Overview Using established policies and procedures; the Certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing. The Certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and may be called upon to code highly complex inpatient records (to include trauma, burns, open heart and transplant cases) based on experience and skill set. Qualifications High school graduate required. Associate Degree preferred | Registered Health Information Technician (RHIT) preferred, (or RHIT eligible) | 2 years experience in Health Information Management or related health care/office experience . Responsibilities Coding quality - 40% - Reviews inpatients, ambulatory, observation, emergency and outpatient accounts to assign accurate ICD-10 and/or CPT codes and DRGs. Interprets...

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 is essential. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday required. Additional Skills and Experience: - Familiarity with retrospective payment reimbursement highly preferred....

Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process. Department: Health Information Management Shift/Schedule: Full Time (40 hrs/wk), Remote GENERAL SUMMARY Works under the supervision of the Health Information Reimbursement Manager. The primary job function of the HIM Coder Level I are to assign correct, ICD-10 and CPT codes to established diagnoses and procedures to outpatient (emergency room, same-day surgery, interventional radiology, observation and/or Urgent Care Center) and/or limited inpatient records. In some instances, may audit OP and /or IP records for charging accuracy. May be asked to add or delete charges for optimal reimbursement as well as compliance following coding and governmental guidelines. The level one coder has mastered a maximum of 2 work types. Performs other duties as assigned. QUALIFICATIONS Education: High School Diploma or successful completion of an...

Anderson Hills Pediatrics' Expectations of all Employees: Adhere to all Anderson Hills Pediatrics' Policies and Procedures Conduct self in a manner that represents Anderson Hills Pediatrics' core values at all times Maintain a positive and respectful attitude with all work-related contacts Consistently reports to work prepared to perform the duties of the position Meets productivity standards and performs duties as workload necessitates Primary Function : Assists the Billing Manager with the claims submission and revenue cycle of the practice. Major Duties and Responsibilities : • Adherence to current HIPAA regulations and federal/state laws for patient protected health information (PHI) and/or medical records; adherence to all AHP policies/procedures as they pertain to patient PHI and the medical record; maintain strict confidentiality of all patient information • Update patient demographic information including insurance coverage; make changes/corrections as...

Job Description At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors. UC Health is committed to providing an inclusive, equitable and diverse place of employment. Using established policies and procedures; the Non-certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing. The Non-certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series,...

Job Description: Title: Medical Billing Specialist Job Code: 64305OH Division: Senior Living Corporate Status: Non-Exempt Reports to: Lead Medical Billing Specialist Revision date: April 2019 Supervises: n/a PURPOSE According to prescribed policies and procedures of the organization including all applicable state, federal and accreditation regulations and under the general supervision of the Lead Medical Billing Specialist assumes responsibility for performing all general accounting, billings, and bookkeeping functions for the Senior Living Division's Facilities. ESSENTIAL FUNCTIONS Manage accounts receivable for medical billing for the Senior Living Division including, but not limited to: Part A and B Medicare, Medicaid, Home Health, Hospice, Part B, Outpatient, Managed Care, Insurance, and Co-Insurance Billing. Communicates with different insurance carriers for timely payment of our services. Prepares and files insurance claims. Performs...

Become a part of our caring community and help us put health first Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Durable Medical Equipment (DME) auditing and is part of the PPI Coding Disputes Team with Humana. The Disputes Auditor - DME Outpatient Coding on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient DME coding disputes and expertise in...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2675 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 knowledge...

Internal Posting Dates: April 30, 2025-May 6, 2025 Medical Records - Medical Records Coder - Full Time-Day Shift - 7am- 4pm- Req 8527 Pay Range: $24.16-$27.52* Under general supervision and according to established procedures, assigns diagnostic codes to medical record information. Codes charts under the ICD-10-CM and HCPCS System for statistical and DRG assignment purposes. Abstracts required data into hospital abstracting system. The outcome of information gathered is used to determine the hospital database and reimbursement of hospital claims. EDUCATION: Required: High school diploma or equivalent Preferred: Three to five years of post-secondary education related to an Associate’s Degree in Medical Record Technology LICENSES AND CERTIFICATIONS: Required: CCS/CCA TRAINING and EXPERIENCE: Required: Three to five years of medical records coding experience Successfully completion of coding assessment tool Proficiency in coding with ICD-10-CM Knowledge of medical terminology,...

Based in Akron, Ohio, SummaCare provides Medicare Advantage, individual, family, and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5‑Star rating for 2025 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits. Position Summary Performs chart retrieval, medical record review, HCC identification and data quality oversight for risk mitigation and revenue recovery for both Medicare and ACA services. Assists in the development and management of activities in support of HCC coding while ensuring compliant practices for revenue management and reducing risk. Helps in the preparation with all Risk Adjustment Data Validations (RADV) audits as well as serving as the CMS liaison for coding questions/issues. Determines...