23 coder quality auditor jobs found

Medical Coding Auditor Become a part of our caring community and help us put health first. 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...

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g., ICD‑10‑CM, CPT, HCPCS). The role requires interpretation and independent determination of the appropriate courses of action, contributing to overall cost reduction by increasing the accuracy of provider contract payments in our payer systems and ensuring correct claims payment for appropriate CPT/HCPCS code assignments. The Auditor analyzes, enters and manipulates database data, responds to or clarifies internal requests for medical information, understands departmental, segment and organizational strategy and operating objectives, and follows established guidelines and procedures while making decisions in ambiguous situations. Where you come in The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g.,...

Job DescriptionJob DescriptionAbout Company:Since 1984, Professional Performance Development Group (PPDG) has been proudly Serving Heroes by connecting exceptional healthcare professionals with rewarding opportunities across military, federal, and commercial healthcare facilities. Guided by our core principles of excellence, integrity, and collaboration, we are dedicated to delivering high-quality staffing solutions that strengthen the delivery of patient care nationwide. Rooted in a culture of Linked Prosperity, PPDG values the success of our clients, employees, and partners alike--offering competitive compensation, comprehensive benefits, professional growth, and a cooperative workplace built on trust, respect, and service. As a proud Department of Defense Partner Employer and participant in the Military Spouse Employment Partnership (MSEP), PPDG remains committed to supporting our Nation's Finest through meaningful careers that make a lasting impact.Medical Coder - APVLocation:...

At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact-whether we're supporting data-driven decisions, modernizing systems or safeguarding critical programs. We are seeking an experienced and detail-oriented Senior Medical Coder to support our Medicare Part C Risk Adjustment Data Validation (RADV) initiatives. The ideal candidate will have strong experience in ICD-9-CM/ICD-10-CM coding across various care settings, including inpatient, outpatient, and physician office encounters. The candidate will perform diagnosis coding, support intake reviews, conduct appeal responses, and contribute to quality assurance efforts....

Overview Description At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact—whether we’re supporting data-driven decisions, modernizing systems or safeguarding critical programs. We are seeking an experienced and detail-oriented Senior Medical Coder to support our Medicare Part C Risk Adjustment Data Validation (RADV) initiatives. The ideal candidate will have strong experience in ICD-9-CM/ICD-10-CM coding across various care settings, including inpatient, outpatient, and physician office encounters. The candidate will perform diagnosis coding, support intake reviews, conduct appeal responses, and contribute to quality...

Overview At HeiTech Services, our employees are our biggest assets. HeiTech Services is dedicated to attracting highly skilled and motivated professionals. We value our employees. We offer our employees challenging opportunities that facilitate professional growth and development while also providing the support you need to succeed. We are committed to your success because we understand that our employees are the driving force behind HeiTech Services’ continued growth. Our mission is to help the Federal Government keep Americans safe. Position Description This position is responsible for reviewing, prioritizing, and analyzing adverse medical events related to medical devices that are submitted on MedWatch reporting forms via hard copy or electronically to our customer, the Food and Drug Administration (FDA). Additionally, this position is responsible for processing and coding a variety of reports from device manufacturers (MFR), importers, user facilities, health care...

Job Description Job Description Description: At HeiTech Services, our employees are our biggest assets. HeiTech Services is dedicated to attracting highly skilled and motivated professionals. We value our employees. We offer our employees challenging opportunities that facilitate professional growth and development while also providing the support you need to succeed. We are committed to your success because we understand that our employees are the driving force behind HeiTech Services’ continued growth. Our mission is to help the Federal Government keep Americans safe. * Non-patient care role. This position is responsible for reviewing, prioritizing, and analyzing adverse medical events related to medical devices that are submitted on MedWatch reporting forms via hard copy or electronically to our customer, the Food and Drug Administration (FDA). Additionally, this position is responsible for processing and coding a variety of reports from device...

# Coder-Outpatient $24.41/hr - $37.84/hr Tidal Health Corporate Physician Coding Full Time M-F occasional weekends/nights 8a-430p Responsibilities The Outpatient Coder for Physician Coding accurately abstracts pertinent information from the patient record to apply the appropriate diagnostic and procedural codes to individual professional fee encounters for data submission/analysis and claims processing. This position adheres to the Official ICD-10 Coding Guidelines and the American Academy of Professional Coders (AAPC) Code of Ethics and maintains established productivity and quality standards. The Outpatient Coder will demonstrate continual learning by attending coding webinars and audit review sessions. Position Requirements High school diploma or GED equivalent required. Completion of medical terminology course and/or anatomy and physiology preferred. Required License and/or Certification CCA or CCS through the American Health Information Management Association or CPC-A...

Coding Specialist Under general supervision, collects data by abstracting, assessing and analyzing demographic and clinical information to accurately assign the appropriate ICD-10-CM codes and CPT codes. Education Associates Degree preferred. Experience At least 3 years of CPT and ICD-10-CM coding experience with certification. 3 years of radiology/interventional radiology coding and charging experience preferred. Knowledge of specialty coding including wound care. Other combinations of formal education, training and experience may be considered. Skills Knowledge of medical terminology and anatomy and physiology Knowledge in all aspects of Radiology and Interventional Radiology and wound care coding Knowledge of coding guidelines as set forth by Official Coding Guidelines, Coding Clinic. Ability to keep current with recent trends within the industry Skill in using computers and software applications Ability to interpret medical terminology in order to code records...

Lead Coding Specialist Adventist HealthCare seeks to hire an experienced Lead Coding Specialist for our Medical Coding Department who will embrace our mission to extend God's care through the ministry of physical, mental, and spiritual healing. As a Lead Coding Specialist, you will: Conduct reviews to validate I-10-CM diagnosis codes and PCS procedure codes for inpatient bill hold related to PSI, PPC & other reimbursement conventions to be resolved prior to final coded data. Manages daily DNFB and DNFC reports and work queues for un-coded or outstanding records. Under the direction of the coding manager, the coding specialist lead should be proficient in communicating with the coding team. Oversees coding corrections, abstracts elements for HSCRC submissions, and ensures coding compliance with coding standards. Liaison between coding and other departments, managing coding-related tasks and denials. Provides mentoring support to coders on coding questions/reviews and...

Overview This position is contingent upon the successful award of the associated contract. Employment is not guaranteed until the contract is awarded, and the position is officially activated. Job responsibilities and requirements are subject to change. Medical Reviewer, Certified Coder About J29 At J29, we believe in empowering our employees to do great things for the benefit of others. Our culture is built on purpose, service, and impact — not just for our clients, but for our communities. We are a mission-driven, people-first organization that believes strong culture, thoughtful leadership, and meaningful philanthropy are inseparable from business success. Key Responsibilities RVC Reviewers perform both automated and complex reviews of Medicare Fee-for-Service (FFS) claims—including Part A/B, DMEPOS, and Home Health/Hospice—to assess overpayments, underpayments, and proper payments as determined by Recovery Audit Contractors (RACs). They apply Medicare policies and...

Job Description Job Description Inpatient Medical Coding Auditor/Trainer- Lead (ON-SITE) Walter Reed National Military Medical Center ABOUT US: Laredo Technical Services, Inc. provides staffing services to federal Government agencies all over the world.   LTSi connects the right opportunities to the right people.  With our experience in placing our Team Members throughout the United States and overseas, we excel at providing experienced, professional personnel for a wide range of Professional and Office Administration as well as Medical Services. Our goal is to provide the highest quality professionals in the industry. LTSi’s culture delivers a strong work ethic while going above and beyond with a sense of urgency.  We are an employee-driven company.  We strive for excellence every day, which is what sets us apart from all the other government contractors. As a Certified Service-Disabled Veteran Owned Small Business (SDVOSB) Minority Business...

About Integrated Management Strategies (IMS) LLC We are a women-owned small business and management consulting firm that provides an array of business and technical services. IMS is headquartered in the Washington, D.C. metropolitan area, with employees across 24 US states. What We Do We support the mission critical needs of federal agencies and commercial businesses by leveraging our experience, talent and can-do attitude, and solve their strategic and operational challenges. How We Do It We earn our clients' trust through our personalized approach and attention to detail, allowing us to collaborate and solve even the most complex problems. About the role Are you ready for your next career adventure?! Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting. We are seeking an experienced Outpatient Medical Coder...

Datavant is a leading data platform company revolutionizing health data exchange. Our mission is to ensure that every healthcare decision is made with the right data, delivered timely and in the appropriate format. Powered by the most extensive health data network in the U.S., our platform guarantees secure, accessible, and usable data to enhance health decisions. We are proud to be trusted by the foremost life sciences organizations, government bodies, and healthcare providers. By joining our team, you will be part of a high-performing and values-driven culture. Together, we are addressing some of healthcare's most challenging issues with innovative technology solutions. We embrace a diverse array of professional and personal experiences among our team members as we pursue our ambitious goals for healthcare. What We're Seeking We are on the lookout for seasoned and certified inpatient coders to join our team. The perfect candidate will have exceptional attention to...

Job Title: Inpatient Coder Shift time: can vary but needs to be day time hours Time zone: MUST Reside on CST/EST Equipment: Facility will NOT provide equipment. Contractors must have their own equipment for contract duration Conversion: The role is a temp to perm opportunity (cannot hire from Alaska, California, or Hawaii) JOB SUMMARY: General Summary: Under direct supervision, accurately codes hospital inpatient accounts for the purpose of appropriate reimbursement, research, statistics and compliance to federal and state regulations in accordance with established ICD-10-CM/PCS coding classification systems. Responsibilities and Tasks: *Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. *Analyzes, codes and abstracts complex inpatient cases such as trauma, rehab, neurology, critical...

About Integrated Management Strategies (IMS) LLC We area women-owned small business and management consulting firm that provides an array of business and technical services. IMS is headquartered inthe Washington, D.C. metropolitan area, with employees across 24 US states. What We Do We support the mission critical needs of federal agencies and commercial businesses by leveraging our experience, talent and can-do attitude, and solve their strategic and operational challenges. How We Do It We earn our clients’ trust through our personalized approach and attention to detail, allowing us to collaborate and solve even the most complex problems. About the role Are you ready for your next career adventure?! Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting. We are seeking an experienced Outpatient Medical Coder to join our healthcare...

Become a part of our caring community and help us put health first 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...

Description At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact-whether we're supporting data-driven decisions, modernizing systems or safeguarding critical programs. We are seeking a detail-oriented and experienced Medical Coder to support Risk Adjustment and Medicare Part C audits by accurately coding inpatient, outpatient, and physician office medical records. The ideal candidate has a strong understanding of ICD-9-CM/ICD-10-CM coding guidelines and consistently demonstrates high accuracy and productivity. Responsibilities: Perform diagnosis coding of inpatient, outpatient, and physician office medical records...

Description At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact-whether we're supporting data-driven decisions, modernizing systems or safeguarding critical programs. We are seeking an experienced and detail-oriented Senior Medical Coder to support our Medicare Part C Risk Adjustment Data Validation (RADV) initiatives. The ideal candidate will have strong experience in ICD-9-CM/ICD-10-CM coding across various care settings, including inpatient, outpatient, and physician office encounters. The candidate will perform diagnosis coding, support intake reviews, conduct appeal responses, and contribute to quality assurance...

Location: Remote City/State: Baltimore, Maryland Position Type: Contract / Travel Department: Health Information Management (HIM) Schedule: Full-time JOB SUMMARY: The Inpatient Coder is responsible for reviewing inpatient medical records and assigning accurate ICD-10-CM and ICD-10-PCS codes in accordance with official coding guidelines, regulatory requirements, and Client policies. This position supports timely and accurate billing, reimbursement, and compliance and is fully remote. ESSENTIAL RESPONSIBILITIES: • Review inpatient medical records to assign appropriate ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes • Ensure coding accuracy and compliance with AHIMA, AHA, CMS, and official coding guidelines • Abstract clinical data accurately into the coding system • Meet established productivity and quality benchmarks • Identify documentation issues and work with CDI or providers as appropriate • Maintain confidentiality and comply with HIPAA regulations •...

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...

Job Description Job Description About Company: Since 1984, Professional Performance Development Group (PPDG) has been proudly Serving Heroes by connecting exceptional healthcare professionals with rewarding opportunities across military, federal, and commercial healthcare facilities. Guided by our core principles of excellence, integrity, and collaboration , we are dedicated to delivering high-quality staffing solutions that strengthen the delivery of patient care nationwide. Rooted in a culture of Linked Prosperity , PPDG values the success of our clients, employees, and partners alike—offering competitive compensation, comprehensive benefits, professional growth, and a cooperative workplace built on trust, respect, and service. As a proud Department of Defense Partner Employer and participant in the Military Spouse Employment Partnership (MSEP) , PPDG remains committed to supporting our Nation’s Finest through meaningful careers that make a lasting impact....

Description Supernus Pharmaceuticals is an award-winning biopharmaceutical company with more than 30 years of experience in developing and commercializing products that treat central nervous system (CNS) diseases. At Supernus, we develop innovative products that help treat neurological and psychiatric conditions. We currently have 9 products in the market that are making a real impact on patient outcomes. Job Summary: This position will work closely with the Medical Director, Postpartum Depression and will have primary responsibility for medical review in both promotional and medical review committees. This role will perform scientific, technical, and quality checks of materials for scientific accuracy, substantiation, quality, and relevant pharmaceutical regulations and codes, and serve a consultive role with cross functional teams in the appropriate development of materials subject to PRC and MRC review. In addition, the Associate Director will have additional...