24 coder auditor professional jobs found

A healthcare solutions provider is seeking a DRG Quality Auditor to perform quality assurance audits for clinical and coding staff. Responsibilities include reviewing medical records, validating DRG assignments, and ensuring compliance with coding guidelines. The ideal candidate should have an active RN license, coding certification, and extensive clinical experience. This remote position offers flexible hours and requires a strong knowledge of DRG reimbursement methodologies. #J-18808-Ljbffr

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:...

A leading health services organization is seeking a DME Outpatient Medical Coding Auditor. This remote role involves handling coding disputes with a focus on accuracy and compliance in DME coding. Candidates should possess CPC or CCS certification and extensive experience in CPT/HCPCS auditing. The company offers competitive benefits starting from day one, including health benefits, paid time off, and a 401(k) plan with employer match, ensuring well-being for both employees and their families. #J-18808-Ljbffr

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world. At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you're interested in joining a health care system that is changing the face of care and well-being in our community, we...

Risk Adjustment Coding Auditor, Sr page is loaded## Risk Adjustment Coding Auditor, Srremote type: Remotelocations: Remote Oregon: Remote Utah: Remote Texas: Remote Idaho: Remote Wisconsintime type: Full timeposted on: Posted 2 Days Agojob requisition id: JR100739Risk Adjustment Coding Auditor, Sr---------------------------------------------------------------The Coding Auditor, Senior performs code audits and is responsible for chart auditing processes as well as contributing to the education of providers and internal stakeholders on coding topics. The position is responsible for keeping up to date on the newest coding guidelines and best practices while promoting compliance with existing American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. Specific approaches to job duties vary depending on the department.**Estimated Hiring Range:**$81,000.00 - $99,000.00**Bonus Target:**Bonus - SIP Target, 5% AnnualCurrent...

Working Conditions Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure The Coding Auditor, Senior performs code audits and is responsible for chart auditing processes as well as contributing to the education of providers and internal stakeholders on coding topics. The position is responsible for keeping up to date on the newest coding guidelines and best practices while promoting compliance with existing American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. Specific approaches to job duties vary depending on the department. Estimated Hiring Range $81,000.00 - $99,000.00 Bonus Target Bonus - SIP Target, 5% Annual Current CareOregon Employees: Please use the internal Workday site to submit an application for this job. Essential Responsibilities Perform and lead a variety of coding-related audits for providers and other entities. Review medical records to verify that complete and accurate...

A healthcare organization is seeking a Senior Coding Auditor to lead coding audits, ensure compliance with regulations, and educate internal stakeholders. The ideal candidate will have over 5 years of experience as a certified coder, with strong knowledge of diagnosis coding conventions. The role requires maintaining active coding certification and engaging in continuous education on coding topics. Benefits include competitive pay and a comprehensive rewards program, along with opportunities for professional development. #J-18808-Ljbffr

*Location:* *Remote (WI/IL preferred).* Candidates must reside in the U.S. *Schedule:* Full-time, remote | Flexible hours after training *Work Setup:* Private, dedicated workspace with a door required *About the Role* We're seeking a detail-oriented and experienced *Inpatient Coder (Coder Inpatient II)* to join our Health Information Management team. In this remote role, you will accurately assign *ICD diagnosis/procedure codes* and *MS-DRGs* for inpatient hospital services at an academic, Level I Trauma environment. You'll code across complex specialties (e.g., Neurology, Oncology, Urology, Transplant, OB/Newborn, Orthopedics, Cardiology, Critical Care), collaborate with providers via compliant queries, and partner closely with CDI to ensure documentation supports the most appropriate DRG assignment. This is an advanced, independent role where accuracy, communication, and sound judgment are essential. *What You'll Do* * *Code inpatient charts* across medical/surgical...

We are seeking a *detailoriented and experienced Inpatient Coder* to join our Health Information Management team. This role focuses on qualitydriven inpatient coding within a collaborative, highperformance environment. The ideal candidate values accuracy over volume and is comfortable managing a focused inpatient workload while maintaining compliance with MSDRG standards. *Key Responsibilities* * Review and analyze *inpatient medical records* to assign accurate *ICD10CM, ICD10PCS, and CPT codes* * *Ensure compliance with MSDRG classification* and coding guidelines * Work from a designated *Work Queue*, receiving one inpatient chart at a time * Average *4-5 inpatient accounts per day*, prioritizing quality and accuracy * Utilize *Epic EHR*, *3M Encoder*, and *Viziant (REM score calculator)* to support compliant coding * Maintain high coding quality standards, including participation in *monthly audits (10% of charts)* * *Engage in coaching, feedback, and quality improvement...

Coder Major Responsibilities: This role will have all responsibilities of coder I, II and III in addition to: Reviews complex inpatient documentation at a highly skilled and proficient level to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software. Adhere to organizational and internal department policies and procedures to ensure efficient work processes. Responsible for coding high dollar and long length of stay cases for all patient types. Expertise in query guidelines, and coding standards. Follow up and obtain clarification of inaccurate documentation as appropriate. Serves as a subject matter expert to Coding department leaders and peers. Recommends modifications to current policies and procedures as needed to coincide with government regulations....

Job Description Job Description Medical Billing Specialist Full-time • 80 hours per pay period • Monday–Friday • Benefited – 8th Street Campus Black River Health is seeking a detail-oriented, motivated professional to join our Finance & Revenue Cycle team as a Medical Billing Specialist. In this role, you will ensure accurate billing, timely claim submission, effective follow-up, and strong collaboration across departments to support the financial health of our organization. What You’ll Do As a Medical Billing Specialist, you will play a key role in ensuring claims are processed accurately and efficiently while supporting both patients and internal teams. Your responsibilities include: Essential Duties Correct, complete, and process claims for all payors according to established standards Perform follow‑up with payors on unpaid accounts identified through aging reports, denials, or payer rejections Demonstrate thorough knowledge of billing policies...

CSI Companies is seeking an experienced Professional Fee (ProFee) Coder with a strong background in Mental Health and/or Primary Care coding. This role is responsible for accurately reviewing, assigning, and validating CPT, ICD-10-CM, and HCPCS codes for outpatient provider services to ensure compliance with federal regulations and payer-specific guidelines. The ideal candidate brings strong knowledge of behavioral health documentation standards, E/M coding guidelines, and regulatory compliance within physician practice or outpatient settings. This role requires high accuracy, productivity, and the ability to work independently in a remote environment. Hours: 40 hours/week – Monday to Friday, standard business hours Location: Remote (CST) – Must reside in Texas Pay: Competitive Market Rate Work Authorization Visas are acceptable (any EAD). Candidates must be eligible to work on W2 and must not require sponsorship for at least 6–12 months. What you’ll do Review and assign...

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 terminology. This role is...

Overview 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. Responsibilities Will be an experienced medical coding auditor with in-depth experience in outpatient DME coding disputes...

POSITION PURPOSE Areas of emphasis will include inpatient and outpatient coding of provider charges as well as documentation reviews and audits. Secondary responsibilities will include assisting Physicians Billing staff and clinic staff with coding questions. SITE(S) Kenosha Campus Urgent Care Physicians Billing Service MINIMUM EDUCATION REQUIRED High School or Equivalent (GED) MINIMUM EXPERIENCE REQUIRED 1-3 years Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician (CCS-P) MINIMUM EXPERIENCE PREFERRED LICENSES / CERTIFICATIONS REQUIRED Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician (CCS-P). SUPERVISES N/A KNOWLEDGE, SKILLS & ABILITIES REQUIRED Knowledge of CPT and ICD-10 codes Ability to accurately audit provider documentation to ensure all CPT codes and ICD-10 codes are accurately assigned...

A healthcare organization is seeking a Coder Inpatient III to manage coding for complex inpatient cases in a remote setting. The ideal candidate will have at least 3 years of coding experience, exceptional skills in anatomy and physiology, and be familiar with various software tools. Responsibilities include accurate coding assignments and performing audits. This position offers a competitive pay range and various employment benefits. #J-18808-Ljbffr

A healthcare solutions company seeks an experienced CPC certified medical coder to conduct medical coding audits and utilization reviews. The ideal candidate must reside in Texas and have at least 5 years of coding experience, with strong knowledge of Texas Medicaid policies. Responsibilities include performing audits, preparing reports, and providing litigation support. The position may be part-time, offering comprehensive benefits such as medical coverage, paid time off, and a 401k plan with a company match. #J-18808-Ljbffr

Medical Billing Specialist Full-time • 80 hours per pay period • Monday-Friday • Benefited - 8th Street Campus Black River Health is seeking a detail-oriented, motivated professional to join our Finance & Revenue Cycle team as a Medical Billing Specialist. In this role, you will ensure accurate billing, timely claim submission, effective follow-up, and strong collaboration across departments to support the financial health of our organization. What You'll Do As a Medical Billing Specialist, you will play a key role in ensuring claims are processed accurately and efficiently while supporting both patients and internal teams. Your responsibilities include: Essential Duties Correct, complete, and process claims for all payors according to established standards Perform follow-up with payors on unpaid accounts identified through aging reports, denials, or payer rejections Demonstrate thorough knowledge of billing policies and procedures, including editing,...

MUST RESIDE IN TEXAS AND HAVE CODING AND AUDITING EXPERIENCE. Counter Affidavit as well as Testimony experience is preferred. We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong Texas based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. Counter Affidavit experience is preferred. Responsibilities Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS) Conduct utilization reviews to determine medical necessity and documentation compliance Review and prepare demand packages and audit response materials Analyze records for payer disputes and recoupments Prepare written audit findings and defensible reports Provide expert support for depositions and testimony as needed Review...

A leading medical coding firm is seeking an experienced CPC certified medical coder in Texas to conduct coding audits and provide litigation support. Candidates should have a minimum of 5 years of coding experience, with at least 3 years in Texas. The role includes performing audits, conducting reviews for medical necessity, and preparing documentation. The firm offers a comprehensive benefits package, including medical, dental, vision coverage and a 401k plan with company match. #J-18808-Ljbffr

CODER INPATIENT III – Froedtert Health Location: Menomonee Falls, WI – Woodland Prime 400 facility (Remote) Sign-On Bonus: Eligible for a $2,000 sign‑on bonus. Job Summary This is a remote, high‑level coding position functioning under general supervision. The Coder III accurately assigns ICD diagnosis and procedure codes, MS‑DRGs, and APR‑DRGs for inpatient hospital services at Froedtert Health, which includes an academic Level I Trauma Center. The role focuses on highly complex trauma and acutely ill patients, including mortality, extended length of stay, and high‑dollar cases. A key responsibility is performing chart audits for levels I and II coders, applying official and departmental coding rules, regulations, and guidelines, and meeting or exceeding productivity and quality standards. Coding staff communicate directly with care providers to clarify information needed for complete and accurate coding and partner with clinical documentation improvement specialists....

Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) 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 anInpatient Coding Auditor, Senior Associatewho is responsible for performing coding reviews of inpatient medical records and/or other documentation to determine correct coding as defined by review methodologies specific to the contract for which review services are being provided. This involves accessing...

Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) Summary We are seeking a talented individual for an Outpatient Coding Auditor, Senior Associate who is responsible for performing coding reviews of medical records and/or other documentation to determine correct coding as defined by review methodologies specific to the contract for which review services are being provided. This involves accessing proprietary systems to audit medical records, accurately documenting findings and providing policy/regulatory support for determination. The candidate must have an extensive background in outpatient coding edits and a high level of understanding in reimbursement guidelines specifically an understanding of the EAPG, ASC and APC payment systems. What you will do Perform audits of medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCC & CC) and procedure codes. Adhere to official coding guidelines, coding clinics...

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings and...