137 coder auditor professional jobs found

Certified ER Medical Coding AuditorThe Certified ER Medical Coding Auditor is responsible for auditing emergency department medical records to ensure accurate coding, compliance, and optimal reimbursement. This role also includes training and mentoring offshore coding teams to maintain high-quality standards and consistency across operations.Key ResponsibilitiesAudit ER charts for accurate assignment of ICD-10-CM, CPT, and HCPCS codesValidate E/M level selection for emergency department visitsEnsure compliance with payer guidelines and regulatory standards (CMS, HIPAA)Identify under coding, over coding, and documentation deficienciesPrepare detailed audit reports with corrective recommendationsProvide education and feedback to coders and providersTrain and mentor offshore coding teams on ER coding guidelines and audit findingsConduct regular quality review sessions and calibration meetings with offshore staffDevelop and update training materials, Review SOPs, and coding...

We are hiring a part-time Medical Coder to assign procedure and diagnosis codes for insurance billing, review claims data, research and correspond with insurance companies in an effort to obtain accurate reimbursement for healthcare claims. Responsibilities Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims. Adhere to coding policies and procedures consistent with the industry standard guidelines for CPT, ICD-9 and ICD-10. Answer coding questions. Review clinical documentation to ensure it meets level of CPT codes and ICD-10 codes. Perform related duties, as requested. Uphold the Organization's...

Job Title: Inpatient Coder Location (city, state): Remote – Must reside in FL, TN, TX, GA, LA, or WA Industry: Healthcare / Health Information Management / Inpatient Coding Pay: $35 – $40 / hr Benefits: This role is eligible for medical, dental, vision and 401k. About Our Client: Our Client is a 900+ bed academic medical center offering highly complex patient care across numerous specialties, including cardiovascular, transplant, oncology, neurology, orthopedics, and digestive disorders. Job Description: Seeking an experienced Inpatient Coder with a strong background coding complex cases within a large academic hospital. This role requires excellent sequencing skills and experience across a broad range of inpatient specialties. Key Responsibilities: Code complex inpatient medical records with a strong focus on accurate sequencing Code Med/Surg, cardiac procedures, surgeries, OB/moms & babies, transplants, orthopedics, neurology, gastroenterology, and oncology Review...

Location: Dallas, Texas, United StatesCompany: Health Care Service CorporationPosted: 2026-10-06Job Summary (Par time-Potential for Fulltime)The Certified ER Medical Coding Auditor is responsible for auditing emergency department medical records to ensure accurate coding, compliance, and optimal reimbursement. This role also includes training and mentoring offshore coding teams to maintain high-quality standards and consistency across operations.Key ResponsibilitiesAudit ER charts for accurate assignment of ICD-10-CM, CPT, and HCPCS codesValidate E/M level selection for emergency department visitsEnsure compliance with payer guidelines and regulatory standards (CMS, HIPAA)Identify under coding, over coding, and documentation deficienciesPrepare detailed audit reports with corrective recommendationsProvide education and feedback to coders and providersTrain and mentor offshore coding teams on ER coding guidelines and audit findingsConduct regular quality review sessions and...

Job Summary The Medical Coder complies with all legal requirements regarding coding procedures and practices. Conducts audits and coding reviews to ensure all documentation is accurate and precise, assign and sequence all codes for services rendered and collaborate with the business office to ensure all bill are satisfied in a timely manner. This position will also communicate with insurance companies about coding issues, submit statistical data for analysis and research by other departments and contact physicians and other health care professionals with questions concerning coding. Able to work in our hospital on site and not remote. Essential Duties: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. Conduct medical records...

Addison Group is seeking an experienced Inpatient Coder to support a 900+ bed academic medical center. This remote role emphasizes accurate sequencing and audit-ready charts across diverse inpatient specialties. The ideal candidate will have 1+ year inpatient coding experience, AHIMA CCS/RHIT/RHIA credentials, and Epic or Dolbey CAC familiarity. Full-time, remote with flexible hours and opportunities for advancement; training includes chart reviews and auditor feedback. #J-18808-Ljbffr

Overview The US Oncology Network is looking for a Senior Medical Coding Auditor to join our team at Texas Oncology . This full-time position will support the Revenue Cycle Departmentat our 3001 E. President George Bush Hwy Suite 100 location in Richardson, Texas. Typical work week is Monday through Friday 8:00a - 5:00p. This position will be a Sr level position. As a part of The US Oncology Network, Texas Oncology delivers high-quality, evidence-based care to patients close to home. Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas, our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today-at Texas Oncology , we use leading-edge technology and research to deliver...

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for a Lead Associate, Itemized Bill Review Quality Auditor to perform reviews of medical records, healthcare claims, itemized medical bill, and UB-04 forms to ensure accuracy, compliance, and proper billing practices. This role is responsible for conducting quality assurance audits and oversight of itemized bill review activities to ensure accuracy, consistency, regulatory compliance, and...

Duties of this position include, but are not limited to, the following: Position purpose The Compliance Auditor will be responsible for researching and analyzing the medical records where there is a discrepancy in coding, validating the coding, and preparing reports that summarize audit findings and provide recommendations for corrective actions, if warranted. Responsibilities/Duties/Functions/Tasks Conducts physician chart audits to identify incorrect coding, prepares reports of findings and any compliance issues. Examine claims for compliance with relevant billing and processing guidelines and identify opportunities for fraud and abuse prevention and control. Reports coding patterns identified within the audit process to the Manager and identifies corrective measures for compliance problems. Responsible for researching errors or missing documentation from medical records to provide accurate coding processes. Provides second-level review of billing performance to ensure...

Medical Compliance AuditorWe are searching for a Medical Compliance Auditor - someone who works well in a fast-paced setting. In this position, you will review and approve or deny medical claim appeals and perform clinical audits of medical records submitted in support of services billed by providers. This process includes clinical judgment, utilization review, application of product benefits, understanding of regulatory requirements for Medicaid managed care and fraud and abuse, and verification of medical necessity utilizing nationally recognized criteria.Think you've got what it takes?Job Duties & ResponsibilitiesAssess the treatment plan, clinical information, and medical necessity of all requested servicesUtilizes established criteria to appropriately review billed services within established timeframe required.Consults with medical directors and clinical staff regarding patient's history and current care needs and whether services billed were appropriate.Refers case...

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...

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for a Lead Associate, Itemized Bill Review Quality Auditor to perform reviews of medical records, healthcare claims, itemized medical bill, and UB-04 forms to ensure accuracy, compliance, and proper billing practices. This role is responsible for conducting quality assurance audits and oversight of itemized bill review activities to ensure accuracy, consistency, regulatory compliance,...

Monday-Friday schedule. Job Title Professional Coding Auditor/ Educator Location REMOTE (preference for CST or EST) Industry Healthcare Revenue Cycle | Professional Fee Coding | Compliance & Education Compensation $62,400 - $87,000 / year Benefits This role is eligible for medical, dental, vision and 401k. About Our Client Addison Group is partnering with a leading healthcare organization seeking an experienced Professional Coding Auditor/Educator to support coding quality, provider education, and compliance initiatives. This fully remote role offers the opportunity to work with a growing team while serving as a subject matter expert in professional fee coding and surgical auditing. Job Description The Professional Coding Auditor/Educator will conduct professional fee coding audits, deliver provider and coder education, and support coding compliance efforts across multiple specialties. This position requires extensive experience with surgical and procedural coding , along with...

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...

Medical Coding Supervisor Centralized Coding Lbk Lubbock Nationally recognized as a Great College to Work For, TTUHSC provides much more than just a job! Enjoy excellent benefits, including paid leave, retirement plans, wellness programs, health insurance and so much more. Ready to start building a rewarding career in a positive environment where you can develop and thrive? Join us as we change the future of health care. Texas Tech University Health Sciences Center is enriching the lives of others by educating students, providing excellent patient care, and advancing knowledge through innovative research. TTUHSC graduates more health care professionals than any other health care institution in the state, conferring 24.2% of all degrees and certificates awarded from health-related institutions in Texas. By providing comprehensive clinical services to more than 10 million individuals across 121 counties, TTUHSC is dedicated to advancing the health of people throughout Texas...

Location: Dallas, Texas, United StatesSalary: $32.00 - $37.00/hrCompany: TEKsystemsPosted: DescriptionRisk Adjustment Coding AuditorThe Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise.Your ResponsibilitiesEvaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practicesProtects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirementsPerforms Retrospective and Prospective chart reviews to ensure accurate risk adjustment...

Medical Coding SupervisorCentralized Coding LbkLubbockNationally recognized as a Great College to Work For, TTUHSC provides much more than just a job! Enjoy excellent benefits, including paid leave, retirement plans, wellness programs, health insurance and so much more. Ready to start building a rewarding career in a positive environment where you can develop and thrive? Join us as we change the future of health care.Texas Tech University Health Sciences Center is enriching the lives of others by educating students, providing excellent patient care, and advancing knowledge through innovative research. TTUHSC graduates more health care professionals than any other health care institution in the state, conferring 24.2% of all degrees and certificates awarded from health-related institutions in Texas. By providing comprehensive clinical services to more than 10 million individuals across 121 counties, TTUHSC is dedicated to advancing the health of people throughout Texas and beyond....

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.Under the general supervision of the Outpatient (OP) Coding Manager and OP Coding Supervisor, the OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing.Job Description:Essential Duties & Responsibilities including but not limited to:Professional Coding Coding Responsibilities:· Provides review and/or...

Medical Coding Specialist Key Responsibilities: Analyze patient charts, physician notes and discharge summaries Ensure documentation is complete and accurate before coding Translate diagnoses and procedures into standardized codes using: ICD-10-CM (diagnoses) CPT (procedures) HCPCS (supplies/services) Make sure codes correctly represent services provided Follow healthcare laws and regulations (HIPAA, Medicare/Medicaid guidelines) Company Policies Prevent coding errors that could lead to claim denials or audits Stay updated on coding changes and updates Work with billing teams to submit coded claims to insurance companies Verify claim accuracy to ensure proper reimbursement Fix rejected or denied claims by reviewing and correcting codes Communicate with healthcare providers and insurance companies Protect sensitive patient information Follow strict privacy and data security standards Clarify documentation with physicians when needed Collaborate with billing...

Citizens Medical Center is a not-for-profit hospital known for compassionate patient care, clinical expertise, and bringing advanced medical services to the South Texas region since 1956. Today, Citizens is a 338-bed acute care hospital with over 1,000 dedicated employees. Citizens offers a generous benefit package that includes retirement plans upon hire, and an excellent medical plan with optional insurance plans to choose from. If you are interested in pursuing a career with an award-winning hospital, welcome home. The Physician Coder I performs evaluation/management coding for clinic, inpatient, and outpatient encounters as well as coding for in-office ancillary services and minor procedures. Assigns and sequences all codes for services rendered. Collaborates with coders, billers, clinical staff, managers, and healthcare professionals to ensure accurate coding assignment and to resolve any coding-related claim denials. JOB DUTIES AND RESPONSIBILITIES Job Specific Assigns...

Posted 2 days ago Description Summary POSITION SUMMARY The Inpatient coder reviews and analyzes documentation in the medical record for inpatient visits to ensure accuracy of diagnosis and procedure codes. Coder finalizes the coding and abstracting of the medical record according to ICD-10-CM/PCS, CPT, and HCPCS coding conventions and guidelines supported by the clinical documentation in the medical record. Coder analyzes diagnosis and procedure codes concurrently assigned by Clinical Documentation Specialists. The Inpatient Coder assumes primary responsibility for DRG validation/accuracy, primary role in assisting CDS and medical staff members with improving quality of clinical documentation. Sequence the diagnoses and procedures using official coding guidelines. Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges. Resolve Inpatient billing edits. Abide by the Standards of Ethical Coding as set forth by...

Coder III, CodingUS:TX:McAllen | Health Information Management | Full Time POSITION EDUCATION/QUALIFICATIONS RHIA, RHIT, CCS or CIC required. Three to five years hospital experience required. Experience and/or advanced training in medical coding (MS/APR DRG's, ICD-10-CM, CPT, HCPCS, etc.). Must have extensive knowledge of medical terminology, anatomy and physiology, knowledge of pharmacology and all major diseases. Requires reasoning ability and good independent judgment. Critical thinking skills are a must. Must have strong interpersonal skills and the ability to multi-task. 3M CRS software experienced preferred. Requires good communication and organizational skills. Must have an understanding of laws and ethics related to health insurance, medical billing and the Health Insurance Portability and Accountability Act (HIPAA). Requires working with minimal to moderate interruptions. Must complete CE hours annually, according to certification requirements. Professional coding and...

Coder Lll - FT Days - Coding DHR Health - US:TX:McAllen - Days Summary: POSITION SUMMARY: The Inpatient coder reviews and analyzes documentation in the medical record for inpatient visits to ensure accuracy of diagnosis and procedure codes. Coder finalizes the coding and abstracting of the medical record according to ICD-10-CM/PCS, CPT, and HCPCS coding conventions and guidelines supported by the clinical documentation in the medical record. Coder analyzes diagnosis and procedure codes concurrently assigned by Clinical Documentation Specialists. The Inpatient Coder assumes primary responsibility for DRG validation/accuracy, primary role in assisting CDS and medical staff members with improving quality of clinical documentation. Sequence the diagnoses and procedures using official coding guidelines. Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges. Resolve Inpatient billing edits. Abide by the...

Become a part of our caring community Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities: You will deliver coding and documentation education to providers and clinic staff within IPA clinics. You will be a consultative resource and ongoing support for providers in assigned clinics. You will conduct documentation audits to identify gaps, trends, and opportunities for improvement. You will...