39 coder auditor professional jobs found

EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workers' Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes. By partnering with clients to supercharge the reimbursement process, EnableComp removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data-rich performance management. EnableComp is a multi-year recipient the...

Experienced Associate, Healthcare ForensicsThe Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients.Job Duties:Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance mattersContributes to forensic engagements related to medical coding and...

Galen Medical Group in Chattanooga is seeking a Risk Adjustment Coding Auditor II to review patient records and ensure accurate ICD-10-CM coding in accordance with CMS standards. You will collaborate with physicians and coding staff to improve documentation and reimbursement. The role emphasizes documentation improvement, compliance with HIPAA and CMS regulations, and data accuracy. Candidates should have CRC and CPC certifications and 3–5 years of coding experience, with CMS-HCC modeling #J-18808-Ljbffr

Risk Adjustment Coding Auditor II Galen Medical Group offers several medical specialties throughout the Chattanooga region. We provide quality care and patient-friendly services to adults and children of all ages. Our mission is to elevate the health of our community through multiple medical specialties providing excellent care delivered with wisdom, compassion, integrity, and a commitment to technology, education, and scientific inquiry. Galen is CHATTANOOGA'S Doctor! Summary/Objective: The Risk Adjustment Coding Auditor II is responsible for reviewing and analyzing patient medical records to ensure accurate coding and documentation of chronic conditions based on ICD-10-CM guidelines and CMS standards. This role supports accurate health status assessment to drive appropriate reimbursement and quality care. This position will interact with physicians, coding staff and other members of the health care team to ensure the accuracy and completeness of clinical documentation to support...

Job Type Full-time Description University Health Network is seeking a Full-Time Coding Auditor. This role requires normal business hours Monday-Friday and is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region. UHN Auditor provides superior customer experience by educating internally and externally of errors and opportunities for improvement discovered during routine auditing. This individual will work closely with management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. The UHN Auditor performs duties in a professional manner while exercising good judgment and ethical standards, interacts effectively and builds respectful working relationships across the organization, and demonstrates integrity by adhering to high standards of personal and professional conduct. This...

Risk Adjustment Coding Auditor II Galen Medical Group offers several medical specialties throughout the Chattanooga region. We provide quality care and patient-friendly services to adults and children of all ages. Our mission is to elevate the health of our community through multiple medical specialties providing excellent care delivered with wisdom, compassion, integrity, and a commitment to technology, education, and scientific inquiry. Galen is CHATTANOOGA'S Doctor! Summary/Objective: The Risk Adjustment Coding Auditor II is responsible for reviewing and analyzing patient medical records to ensure accurate coding and documentation of chronic conditions based on ICD-10-CM guidelines and CMS standards. This role supports accurate health status assessment to drive appropriate reimbursement and quality care. This position will interact with physicians, coding staff and other members of the health care team to ensure the accuracy and completeness of clinical...

About the role As a Medical Coding Quality Auditor, you will play a critical role in ensuring coding accuracy, compliance, and quality across healthcare records. You will collaborate with coding professionals and physicians to support accurate clinical documentation, regulatory compliance, and operational excellence while maintaining high quality and productivity standards in a remote work environment. In this role, you will: Review medical documentation to accurately assign diagnosis and procedure codes. Communicate with physicians and other healthcare providers to obtain or clarify diagnoses and procedures through the coding query process. Assign accurate codes using electronic encoder applications in accordance with company policies, coding guidelines, and regulatory requirements. Perform peer reviews and quality audits of Health Information Management coding auditors and coders. Prepare and complete reports, audit findings, and other deliverables as requested. Monitor...

Coding Specialist, Outpatient Facility Coder Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes "Best Employer" seven times. Position Summary: This individual provides leadership, direction, and training for the coding staff. Working directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.Job Summary**If you are located outside of the state of Texas -- you must be located in KANSAS, OKLAHOMA, TENNESSEE, LOUISIANA, GEORGIA, SOUTH CAROLINA, NORTH CAROLINA, or be willing to relocate to one of the eligible states (including Texas). **Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data integrity and...

Department: 10407 Enterprise Revenue Cycle - Coding Production Operations: Inpatient Coding Operations Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Will support : A mix of inpatient community and academic coding. Includes service lines such as cardiology, neurology, and oncology. Schedule : Full-time, Monday-Friday 40hrs with a standard schedule of Monday through Friday, 8 hours per day, totaling 40 hours each week. Certification required : Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA). Remote opportunity: Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY Pay Range: $33.05 - $49.60 Major...

Tennessee Orthopaedic Alliance Job Opportunity Work at Home Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state. There are a number of reasons why TOA is an employer of choice; here are a few of them: Stability - TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state! Impact - TOA's team members use our careers whether in our clinics or our business office to make a positive difference in the community by building relationships and helping patients live their best life. Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. Total Rewards - TOA offers a...

Tennessee Orthopaedic Alliance (TOA) is the largest orthopaedic surgery group in Tennessee. We are seeking a Certified Coder to ensure accurate coding of charges and compliance with CPT-4, ICD-10, HCPCS in a busy practice. Responsibilities include reviewing records, abstracting diagnoses and procedures, and educating providers on audit results while maintaining professionalism. Must reside in Middle TN, Columbia, or Knoxville area and hold CPC or CCS-P certification. #J-18808-Ljbffr

Required Skills & Experience • Certified coder (CPC, CCS, CRC, CCA, or equivalent certification) • Strong ICD-10-CM coding experience and medical record review background • Knowledge of Risk Adjustment and HCC coding methodologies • Experience reviewing physician documentation and assigning accurate diagnosis codes • Strong understanding of medical terminology, anatomy, physiology, and disease processes • Ability to interpret complex clinical documentation with high accuracy and productivity • Familiarity with CMS guidelines and Medicare Advantage requirements Nice to Have Skills & Experience • Medicare Advantage Risk Adjustment experience • Experience working with CMS-HCC models • CRC (Certified Risk Adjustment Coder) certification • Experience with EMRs and coding software platforms • Background in a health plan, physician practice, hospital, or revenue cycle environment • Audit and quality assurance experience Job Description Insight Global is seeking Medical Coders...

Community Health Systems, Inc. is seeking a Remote Physician Pro Fee Coding Specialist-Anesthesia to review and assign CPT, HCPCS, and ICD-10 codes for professional services, ensuring proper sequencing, modifiers, and compliant billing. You will work with physicians and revenue cycle teams, conduct coding audits, resolve claim edits in Athena Collector, and support coding education to maintain accuracy and reimbursement. #J-18808-Ljbffr

Community Health Systems, Inc. seeks a Remote Physician Pro Fee Coder specializing in Cardiology to review, analyze, and assign CPT, HCPCS, and ICD-10 codes for professional services from provider documentation. You will ensure proper sequencing and modifiers, comply with NCCI edits and LCD/NCD guidelines, perform coding audits, and collaborate with physicians and revenue cycle teams to support accurate reimbursement. #J-18808-Ljbffr

Coder Analyst Specialist Full Time, Day Shift Covenant Medical Group Overview: Covenant Medical Group is the employed and managed medical practice organization of Covenant Health, providing comprehensive care across East Tennessee. With more than 300 physicians and advanced practice providers in 20 communities, our team delivers expertise across a broad spectrum of specialties from primary care and walk-in clinics to preventive medicine and advanced surgical and subspecialty services. We are committed to offering coordinated, patient-centered care that spans the continuum of health needs, ensuring access to exceptional providers close to home. Position Summary: Analyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding initiatives. Abstracts and enters data from the medical...

Possess a thorough working knowledge of the revenue cycle management process including; ICD-9, ICD-10, CPT-4, and HCPS Billing.Responsibilities include ensuring that reimbursement is maximized through accurate and appropriate coding.Accountable for staying abreast of government policies and procedures as it relates to coding to ensure that company conforms to applicable guidelines and regulations.Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion and safety.MinimumHigh School Diploma or GEDCertified Medical CoderStrong understanding of industry / technical terms and processesExceptional customer service skillsStrong analytical and problem-solving skillsStrong attention to detailExcellent oral / written communication skillsDesiredBachelor's Degree2years medical coding experience- Abstract clinical information from medical records to document, assign, and sequence ICD-9 and / or CPT-4 and HCPS coding where appropriateAudit, review, and correct...

Location: Nashville, Tennessee, United StatesCompany: OneOncologyPosted: 2026-10-12OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology's mission and vision. Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve. Job Description:Role Summary:The Medical Coding Specialist, under general supervision, performs daily charge review of visits, diagnosis, radiation oncology or...

Coding Specialist, Outpatient Facility CoderFull Time, 80 Hours Per Pay Period, Day ShiftCovenant Health Overview:Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes "Best Employer" seven times.Position Summary:This individual provides leadership, direction, and training for the coding staff. Working directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and medical staff...

***Work at Home*** Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state. There are a number of reasons why TOA is an employer of choice; here are a few of them: Stability - TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state! Impact - TOA's team members use our careers — whether in our clinics or our business office to make a positive difference in the community by building relationships and helping patients live their best life. Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. Total Rewards - TOA offers a comprehensive suite...

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...

At Virtua Health, we exist for one reason – to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between – we are your partner in health devoted to building a healthier community. If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment. In addition to five hospitals, seven emergency departments, seven urgent care...

Country-wide Remote US-Nationwide-FIELD Full time 20189391 What Ethics & Compliance contributes to Cardinal Health Ethics & Compliance promotes a culture that encourages ethical conduct and a commitment to compliance. This function implements strategies and processes to ensure adherence to policies, educates and trains employees across the organization, and conducts investigations to resolve ethics and compliance issues. Ethics & Compliance develops and implements strategies and standard operating procedures to promote adherence to internal ethics and compliance policies related to areas such as privacy, HIPAA and FCPA, among others. This job family resolves concerns from business unit leaders and employees and proactively provides guidance and trainings on policies. Job Summary The Compliance Auditor is responsible for conducting coding, documentation audits to ensure adherence to regulatory requirements, payer policies, and organizational...

Become a part of our caring community 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 Outpatient Behavioral Health Coding disputes and is part of the PPI Coding Disputes Team with Humana. The Outpatient Behavioral Health Coding Auditor 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 Behavioral Health coding disputes and expertise in CPT/HCPCS...