68 coder quality auditor jobs found

Fully Remote | Professional Fee Coding Auditor | 3-Month Contract with Strong Extension Potential Openings: 6 The Patient Records Abstractor 4 fulfills a role as a Medical Coder for UCSF's physician practices. This position reviews patient records, discharge summaries, operative reports, and other clinical documentation to assign standardized codes for diagnoses, procedures, and services. The role applies national and international coding classifications to ensure records accurately reflect the care delivered, supporting compliant reimbursement and reliable clinical data. This position also serves as a Coding Educator responsible for providing education and training for physicians, staff, and other providers on professional fee coding and clinical documentation standards. Responsibilities include conducting coding quality reviews, analyzing findings, and providing follow-up education to coding staff and providers. The incumbent outlines and annotates applicable laws and...

Job Description Primary Duties And Responsibilities The Coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM, ICD-10-PCS, and CPT codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Abides by the standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to all official coding guidelines. Verifies that all ICD-10-CM and CPT codes are correctly captured. Verify that physician is correctly abstracted. Keeps abreast of coding guideline changes by self-study, assigned education, coding meeting attendance or related in-services. Participates in internal and external quality review meetings. Performs other duties as assigned. Medical Coding - Hoag Hospital Resolves billing related errors and assists with workflow changes and process improvement projects....

Coding Compliance Auditor Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive...

Hcc Risk Adjustment Auditor/Coder We are looking for HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities include the following: Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use...

A Brief Overview The Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs, including but not limited to Medicare Advantage Risk Adjustment. Locations Stanford Health Care - University Healthcare Alliance What you will do Risk Adjustment Review May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing Reviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses. Evaluating medical records to verify that M.E.A.T criteria support the submitted diagnosis codes. Inquire with clinicians the recommended HCC diagnosis for chart addendum. Collaborating with other departments to address...

We are looking for experienced Sr. HCC Risk Adjustment Auditors/Coders to join our team! Position Summary The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use of diagnosis and procedure codes. Interface...

Western Growers Health — a part of Western Growers Family of Companies — provides employer-sponsored health benefit plans to meet the needs of those working for the agriculture industry. The unmatched benefit options provided by Western Growers Health stem from the core mission of Western Growers Association (est. 1926) to support the business interests of employers in the agriculture industry. Our mission at Western Growers Health is to deliver value to employers by offering robust health plans that meet the needs of a diverse workforce. By working at Western Growers Health, you will join a dedicated team of employees who care about offering quality health benefits and excellent customer service to plan participants. If you want to start making a difference working in the health care industry, then apply to Western Growers Health today! Compensation: $46,669.19 - $65,668.50 with a rich benefits package that includes profit‑sharing. This is a remote position and can reside...

Salary : $105,597.80 - $145,114.92 Annually Location : Riverside Job Type: Regular Job Number: 26-74191-01 AL Department: RUHS-Medical Center Opening Date: 03/03/2026 Closing Date: Continuous For questions regarding this position, please contact the Recruiter listed in the Supplemental Information section. ABOUT THE POSITION Riverside University Health System (RUHS)is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to...

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Day - 08 Hour (United States of America)**This is a Stanford Health Care - University Healthcare Alliance job.** **A Brief Overview** The Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare Advantage Risk Adjustment. **Locations** Stanford Health Care - University Healthcare Alliance **What you will do****Education Qualifications*** High school diploma or GED equivalent.* Bachelor's Degree preferred.**Experience Qualifications*** 5+ years of work experience in a risk...

Job DescriptionJob DescriptionDescription :Facility Outpatient Coding AuditorJob Type :Full-Time or Part-Time Remote Medical Coding Audit Outpatient Coding Facility CodingGrow Your Career with a National Leader in Outpatient Medical Coding & Auditing - Work from Home!Are you a certified outpatient medical coding auditor with experience in surgical coding, emergency department (ED) coding, interventional radiology , or facility outpatient services ? Join GeBBS Healthcare Solutions , an award-winning provider of HIM (Health Information Management) and RCM (Revenue Cycle Management) services.We are expanding and seeking experienced Remote Outpatient Facility Coding Auditors to support our national client base.Position Summary :As a Remote Outpatient Coding Auditor , you'll conduct quality assurance audits on coded outpatient medical records.Your audits will focus on multiple service areas including :Outpatient SurgeriesObservationsInterventional RadiologyCardiac...

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding...

Calaim Medical Billing Specialist The CalAIM Medical Billing Specialist is responsible for managing the day-to-day administrative and billing operations related to Enhanced Care Management (ECM) and Community Supports (CS) services. This position supports the organization's CalAIM programming by ensuring accurate claims submission, authorization management, billing compliance, encounter tracking, and reimbursement optimization in accordance with DHCS, Managed Care Plan (MCP), Medi-Cal, and organizational requirements. The Billing Specialist works closely with care managers, housing support staff, leadership, and Managed Care Plans to ensure timely and compliant billing processes while maintaining accurate records within electronic medical records (EMR/EHR) and billing systems. Qualifications: High school diploma or equivalent required; Associate's degree in Medical Billing and Coding, Healthcare Administration, Business Administration, or related field preferred Minimum...

Medical Assistant Supervisor We are recruiting for an exciting leadership opportunity as a Medical Assistant Supervisor for experienced or lead MA's at one of our state of the art facilities. This exempt position is a crucial part of the service delivery team responsible for quality patient care at the health center sites. This position supervises and directs Medical Assistant staff activities to ensure quality of care, patient flow, and compliance with regulations and governing bodies. Additionally, a member of the management team, the Medical Assistant Supervisor evaluates, coaches, and guides staff performances along with providing indirect and direct patient care within the scope of their respective scope. Responsibilities Works closely with the Clinic Manager and other members of the clinic management team to: Maintaining patient flow in clinic to a level that supports agency productivity standards and goals Communicates with appropriate personnel as necessary,...

Facility: Copley Drive City San Diego Department Job Status Regular Shift Day FTE 1 Shift Start Time Shift End Time Certified Coding Specialist--Physician-based (CCS-P) - The American Health Information Management Association (AHIMA); Certified Professional Coder (CPC) - AAPC Hours : Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Flex hours are 6:00-9:00 am to 14:30-17:30 pm Weekend Requirements: As Needed On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $34.170 - $44.090 - $49.370 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.? The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates,...

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding...

Clinical Informaticist / Clinical Coder Are you looking for a career that will make an impact? The Leidos Military and Veterans Health Solutions Operation has an opening for a Clinical Informaticist / Clinical Coder to join the Operational Readiness Directorate at the Naval Health Research Center in San Diego, CA. This position will provide support to the Epidemiology and Data Management Support Department and involves clinical coding and data abstraction to support research on the physical and mental health of military personnel to improve overall health and readiness. The person in this position will work closely with department professionals in records management, information technology, and research teams to ensure alignment of clinical coding with research needs. Are you ready for unique and exciting work? This is a full-time position in San Diego. The candidate for this position must be located within commuting distance of San Diego to work on-site at the Naval Health...

Drive Accuracy. Influence Outcomes. Protect Revenue. We are seeking a highly experienced Senior Risk Adjustment Coder to play a critical role in risk adjustment accuracy, audit readiness, provider education, and clinical documentation excellence. Job Title: Senior Risk Adjustment Coder Location: Newark, CA (Candidates must currently reside within approximately 100 miles of the Newark area due to onsite operational needs.) Employment Type: Full-Time (Direct Hire) Salary Range: $91,000 – $119,000 annually, based on experience, skills, and internal equity   About the Role: We are seeking a senior-level Risk Adjustment professional to support a leading healthcare organization focused on accurate HCC capture, audit readiness, documentation integrity, and provider engagement. This role is highly operational and collaborative in nature and is not a traditional production-only coding position. The ideal candidate will bring strong expertise across Risk...

Payment Integrity Nurse Coder RN III Salary Range: $102,183.00 (Min.) - $163,492.00 (Max.) L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Job Summary The Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management projects. The position serves as a subject matter expert (SME), performing medical records reviews to include quality audits as well as validation of accuracy and completeness of all coding elements. The position is also responsible for guidance related to Payment Integrity initiatives to...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Overview Coding Educator (Temp-to-Hire, 13 Weeks) – Location: Within *** Footprint (Hybrid – Mostly Remote with Local Travel). Type: Contingent / Temp-to-Hire. is seeking experienced Professional Fee (Pro Fee)–focused Coding Educators to support large-scale chart review, coding accuracy validation, physician education, and documentation improvement initiatives. These roles are high-visibility and require strong communication and presentation skills to engage directly with clinicians and support Sutter's revenue cycle, audit, and education functions. Candidates must live within the *** geographic footprint and be available for occasional on-site work and local travel. Positions are structured as 13-week temp-to-hire with conversion opportunities. Key Responsibilities Coding Education & Training: Deliver physician and coder education for assigned groups, with emphasis on Pro Fee (ASC, surgery, outpatient) environments. Facilitate individual and group training sessions; must...

Job Description Job Description Job Description Skilled Wound Care is looking for a Lead Medical Biller to join our rapidly growing company! We are a mobile surgical physician wound care group expanding into new markets of the United States. The Lead Medical Biller is a critical leader responsible for ensuring the financial health of our organization by overseeing the daily operations of the billing team. This role requires advanced expertise in the end-to-end claims lifecycle, ensuring maximum revenue capture through accurate, compliant, and timely submission of medical claims across all payer types (private, government, and third-party). You will be the primary subject matter expert, driving team performance, resolving complex billing issues, and upholding strict adherence to all federal, state, and FQHC-specific billing regulations. Position is hybrid at our office in Playa Vista, CA Responsibilities: Supervise & Train: Lead the training and mentorship of new...

Coder III Coder III is responsible conducting clinically based concurrent and retrospective reviews of inpatient medical records. This review is to evaluate that the clinical documentation is reflective of quality of care outcomes and reimbursement compliance for acute care services provided. The CDS will work closely with the medical staff to facilitate appropriate clinical documentation of patient care. The CDS/Coder III abstracts and codes the diagnostic and procedural information for Inpatient Services and Surgery medical records utilizing the current version of International Classifications of Diseases in accordance with regulatory agencies and hospital specific guidelines. The CDS/Coder III enters the coded data and other abstracted data from the medical record into the electronic information system. This position assumes primary responsibility for clarifying ambiguous documentation, DRG optimization with the primary role in assisting medical staff members with improving...