59 coder quality auditor jobs found

Department Patient Accounting- Physicians Status Full Time Shift Remote Location Orlando, FL Title Physician Coding Auditor Summary The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding. "Orlando Health Is Your Best Place to Work" is not just something we say, it’s our promise to you. Orlando Health proudly embraces and honors the individuality of our team members. By sharing different ideas and perspectives and working together as a team, we are better able to relate to, care for and authentically serve our patients and families who make up the collective populations in our community. So, no matter who you are, what you believe or how you express yourself, you are welcome here. ORLANDO HEALTH...

Inpatient Hospital Billing Coding Auditor Performs quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS-DRG, APR-DRGs, and overall coding accuracy retrospectively and concurrently. Provides continuing education to individual coders and the coding staff concerning changes in the coding and reimbursement system and any weaknesses identified during the coding validation reviews. Reviews, analyzes, and interprets clinical documentation, seeking clarification from the physician when discrepancies exist, and effectively communicates with physicians and allied health personnel. Assists with writing compelling appeals to all DRG denials from outside agencies, referencing Official Coding Guidelines and Coding Clinic advice as appropriate to defend the DRG assignment and protect the organization's reimbursement. Serves as a resource to other departments in the Revenue Cycle to ensure business continuity and optimal revenue cycle management. Uses critical thinking and sound...

Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 26 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2025-2026 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 63 high-performing honors. What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

Physician Practice E&M Auditor Educator Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 26 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2025-2026 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 63 high-performing honors. What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful...

Coding Auditor - Professional Coder Auditor-Professionals are responsible for auditing of coding assignment with providers and coders, training of coding professional staff, pro-fee based coding includes the assignment of Assigns ICD-CM, CPT, HCPCS codes, E&M assignment, modifiers, and charge posting. Interacts with medical staff, nursing, ancillary departments, provider offices, and outside organizations. Department: Physician coding Hours: Full-Time, 40 hours a week required Required: High School Diploma, CPC, CEMA within 6 months of hire, CPMA within 1 year of hire Pay: Based one experience, starting at $23.87/hour Location: Remote or onsite: At this time, you must reside in one of the following locations: Alabama, Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, New Mexico, Ohio, Oklahoma, South Carolina, Tennessee, Texas Responsibilities: Assists coders with coding...

Looking for a way to make an impact and help people? PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths. The Risk Adjustment Coding Auditor reviews medical records to ensure accurate, compliant ICD 10 CM coding across Medicare Advantage, ACA/Commercial, and Medicaid programs. This role validates coding accuracy and specificity, audits external coding vendors, and provides...

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural...

Overview Baptist Health is the region’s largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 25 years, we’ve been named one of Fortune’s 100 Best Companies to Work For, and in the 2024-2025 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 45 high-performing honors. What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families...

Job Description Job Description Description: Position Overview The Professional Billing Coder – Vascular Surgery is responsible for accurate coding of professional services related to vascular procedures. This role supports compliant billing practices and contributes to revenue integrity and audit readiness. Requirements: Key Responsibilities Assign accurate CPT, HCPCS, and ICD-10-CM codes for vascular surgery procedures Review operative and procedural documentation for coding accuracy and completeness Apply appropriate modifiers and NCCI edits • Ensure adherence to CMS, AMA, and payer guidelines Maintain accuracy and productivity standards in a high-volume environment Support internal audits and quality improvement initiatives Required Qualifications Minimum 2+ years of professional billing coding experience Proven experience with vascular surgery coding Strong knowledge of CPT, ICD-10-CM, modifiers, and NCCI edits CPC or equivalent certification...

Summary: Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up. Seeks clarification from providers or other designated resources to ensure accurate and complete coding. Attends educational meetings and seminars to maintain certification and continuing education requirements. Reviews appropriate inpatient coding work queues daily to address coding edits and needed corrections...

Job Description Job Description Description: The Professional Fee (ProFee) Coder is responsible for reviewing provider documentation and assigning accurate CPT, HCPCS, and ICD-10-CM codes for physician services. This role supports compliant coding, accurate charge capture, and overall revenue integrity across a variety of specialties and client environments. Coders may support single-specialty or multi-specialty engagements depending on client needs and experience. Requirements: Core Responsibilities (Sage Standards) Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes Ensure documentation supports coded services and identify discrepancies Apply appropriate modifiers, NCCI edits, and payer-specific coding rules Ensure compliance with CMS, AMA, and payer guidelines Maintain =95% coding accuracy and meet established productivity standards Identify documentation gaps and escalate for clarification when needed Participate in quality...

Job Description Job Description Porter is hiring a Risk Adjustment Coder to join our Team!   Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter’s Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member’s specific needs, and directs Porter’s team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience.    Position Overview We are seeking a certified coder with expertise in risk adjustment coding and...

Medical Clinic Biller/Coder Northwest Florida Community Hospital is seeking a detail-oriented and experienced Medical Clinic Biller/Coder to join our team. This position is responsible for accurate coding, billing, and claims processing for clinic services to ensure timely reimbursement and compliance with federal regulations and payer requirements. The ideal candidate will have strong knowledge of medical terminology, coding systems, and insurance billing procedures. Responsible for all activities in the Clinic accounts receivable function. Manages billing and collection activities such as sending follow-up inquiries, negotiating with past due accounts, and referring accounts to collection agencies. Codes and sequences all diagnoses and procedures using established ICD-10-CM coding rules for each patient encounter; coding will be subject to accuracy and productivity rates as determined by department manager. Maintains accurate records. Audits methods and procedures of accounts...

FORT WALTON BEACH, Ft Walton Bch, FL, US 8 days ago Requisition ID: 2150 Position Summary The Clinical Technical Supervisor is responsible for the technical and scientific oversight of the laboratory’s daily operations to ensure accurate, reliable, and timely patient test results in accordance with COLA, CLIA, and all applicable federal and state regulations. This position provides direct supervision of testing personnel, ensures compliance with quality assurance and quality control policies, and supports the laboratory’s mission to deliver high‑quality, patient‑centered diagnostic services. The supervisor will also perform occasional bench work as needed or when short‑staffed. Essential Duties and Responsibilities Technical Oversight & Quality Assurance Provide day‑to‑day technical supervision of all laboratory testing in compliance with COLA and CLIA requirements. Ensure that testing systems are properly functioning and providing accurate and timely results. Oversee...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

Summary: Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up. Seeks clarification from providers or other designated resources to ensure accurate and complete coding. Attends educational meetings and seminars to maintain certification and continuing education requirements. Reviews appropriate inpatient coding work queues daily to address coding edits and needed corrections...

Summary: Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up. Seeks clarification from providers or other designated resources to ensure accurate and complete coding. Attends educational meetings and seminars to maintain certification and continuing education requirements. Reviews appropriate inpatient coding work queues daily to address coding edits and needed corrections...

Remote Health Information Management Coding Specialist Work remotely as part of a collaborative HIM team focused on coding accuracy, compliance, and quality outcomes. Work Style: Remote Location Requirement: Must reside in an approved state (FL, GA, MO, PA, SC, NC, TN, or TX) FTE: Full-Time (1.0 FTE) Reviews and analyzes medical records to assign appropriate diagnostic and procedural codes in compliance with established coding guidelines and organizational policies. Collaborates with healthcare providers to clarify documentation, resolve coding discrepancies, and ensure the integrity of coded data for billing and reporting purposes. Maintains current knowledge of coding standards, including ICD, CPT, and HCPCS, and supports the billing process by providing accurate coded data for claims submission. Participates in auditing activities, supports staff training on coding procedures, and monitors productivity and quality metrics to drive continuous improvement and enhance...

Job Description Job Description This is not a remote position. This position is on Site. Become a part of our caring community As Certified Medical Coder you will be accountable for timely, accurately coding and filing claims to minimize the number of claim rejections and denials. Location : CenterWell Senior Primary Care office address: Multiple locations, The Villages, FL  Certified Medical Coder Role Overview: Review medical records, provider notes, dictation and other documentation and compare to the actual codes selected by the provider.  In accordance with correct coding guidelines, correct codes and notify provider as needed. Utilize ICD9/ICD10 to code diagnosis and determine principal and significant secondary diagnoses.  Utilize CPT/HPCS to assign and sequence all codes for services rendered. Provide education and teaching to providers and clinical assistants as needed related to properly coding encounters (CPT, ICD-10 and HCC) and compliance with...

Company Overview :Read on to fully understand what this job requires in terms of skills and experience If you are a good match, make an application.Upward Health is an in-home, multidisciplinary medical group providing 24 / 7 whole-person care.Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help.Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients.We are able to treat a wide range of needs - everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals - because we know that health requires care for the whole person.It's no wonder 98% of patients report being fully satisfied with Upward Health!Job Title & Role Description :The Certified Medical Coder is responsible for analyzing provider documentation to accurately select ICD-10 and CPT / HCPCS...

Summary: Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up. Seeks clarification from providers or other designated resources to ensure accurate and complete coding. Attends educational meetings and seminars to maintain certification and continuing education requirements. Reviews appropriate inpatient coding work queues daily to address coding edits and needed corrections...

Job Description Job Description Description: Coding & Documentation • Accurately code radiation oncology diagnoses and procedures using ICD-10-CM, CPT, and HCPCS coding systems • Code all radiation therapy modalities including IMRT, IGRT, 3D-CRT, brachytherapy, stereotactic radiosurgery, and other specialized treatments • Review and analyze clinical documentation to ensure accuracy and completeness for coding purposes • Assign appropriate evaluation and management (E/M) codes for physician services • Code both professional and technical components for radiation oncology services • Perform daily charge reconciliation for professional and technical charges Compliance & Quality • Ensure coding compliance with Medicare policies, LCD requirements, and payer-specific guidelines • Stay current with changes to CPT, ICD-10, and HCPCS codes, particularly those affecting radiation oncology • Review coding edits and resolve discrepancies in a timely manner • Maintain...

Job Description Job Description Benefits: 401(k) matching Competitive salary Dental insurance Health insurance Paid time off About Us We are a fast-growing, innovative medical billing company committed to transforming the healthcare revenue cycle through technology, transparency, and top-tier customer service. Our team is passionate about simplifying the complexities of medical billing so healthcare providers can focus on what matters mostpatient care. We're seeking a highly motivated and experienced Charge Posting (Coder) Supervisor to join our leadership team and help us continue delivering exceptional results to our clients across the country. Job Overview As the Medical Coder Supervisor, you will lead group of certified coders to accurately review and approval encounters using industry coding guidelines, optimize workflow efficiency, and oversee a high-performing medical coding team. You'll be responsible for the training, on-going development, quality...