87 coder quality auditor jobs found

The Coder I position at 100 Lawrence Memorial Hospital requires expertise in coding, documentation review, and claims filing. The role involves working with medical records to ensure accurate coding following various guidelines and collaborating with healthcare professionals. Qualifications include a High School Diploma, relevant certifications from AHIMA, and a preference for Radiation oncology experience. The role offers remote work options post-training, with excellent benefits and supports for continuing education. #J-18808-Ljbffr

The Medical Coding Auditor is responsible for conducting prospective and retrospective compliance reviews of documentation supporting codes reported by providers or facility coding to ensure accuracy in billing, maximize charge capture, and comply with Federal, State, payer, and institutional requirements. This role involves analyzing medical records, ensuring the accuracy of ICD-10-CM diagnosis coding and CPT/HCPCS coding, and compliance with regulations. The specialist communicates results, makes recommendations, and provides training and education to staff on appropriate documentation, coding, and billing practices. Essential Job Responsibilities Conduct coding and auditing of technical and professional components of services and procedures to ensure accuracy. Perform audits of new physicians on coding and documentation requirements for E/M services and procedures. Track coding issues by provider and present necessary education and training to improve coding. Demonstrate...

Overview At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions. The Outpatient Payment Integrity Coder Auditor is responsible for reviewing outpatient medical claims to ensure coding accuracy, compliance, and appropriate payment in accordance with CMS and payer-specific guidelines. This role supports the development and implementation of payment integrity initiatives by identifying coding and billing inaccuracies, trends, and potential cost savings opportunities across outpatient facility claims. The ideal candidate has advanced knowledge of outpatient coding, APC and EAPG payment methodologies, and clinical documentation requirements, with strong analytical and auditing skills. Salary Range: $100,000 - $102,500 Responsibilities Perform detailed coding audits on outpatient facility claims to validate appropriate CPT/HCPCS, revenue codes, modifiers, and ICD-10 coding...

A healthcare provider is seeking a Clinical Coding Auditor & Trainer to develop training and quality auditing programs. The role primarily offers remote work with some travel to New York expected annually. Candidates should have a valid clinical license and experience in DRG and Medical Record Audits. This full-time position focuses on training, quality assurance, and compliance in a hospital environment. #J-18808-Ljbffr

1 day ago Be among the first 25 applicants This range is provided by TalentPlug LLC. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $55,100.00/yr - $99,000.00/yr Direct message the job poster from TalentPlug LLC The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Position Purpose: Responsible for developing and conducting training and quality auditing programs for the Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care. The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Responsibilities: Conducts auditing of work performed by staff and present...

3 days ago Be among the first 25 applicants About Performant At Performant, we’re focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Our mission is to offer innovative payment accuracy solutions that allow our clients to focus on quality of care and healthier lives for all. Medical Coding Auditor – Inpatient (Remote) Location: Remote. Full‑time. Salary: $70,000 – $85,000 per year. Key Responsibilities Audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD‑10, CPT, and HCPCS codes. Ensure coding practices comply with federal, state, and payer‑specific regulations and guidelines, including HIPAA and CMS standards. Detect discrepancies...

Medical Coder III Join Decypher and make a direct impact on the health and readiness of America's service members, veterans, and their families. Since 2008 Decypher has offered healthcare industry professionals careers where their expertise is valued, and their work makes a meaningful impact. Decypher partners with the Defense Health Agency to deliver professional services, technology, and management solutions. Our mission is to provide and support quality care for our veterans, servicemembers and their families, across the United States. Job Summary: Medical Coder III utilizes advanced expertise in ICD-CM, ICD-PCS, CPT, HCPCS, reimbursement methodologies, and medical coding regulations to accurately support institutional and professional healthcare coding operations. Applies comprehensive knowledge of clinical documentation, healthcare compliance, revenue cycle management, EHR workflows, and coding audit principles to ensure accurate reimbursement, regulatory compliance, and...

Physician Coding Auditor Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare, Medicaid, and third-party payer guidelines to ensure receipt of accurate reimbursement. Physician Coding Auditor is expected to adhere to MedKoder's internal coding/auditing policies and expectations set forth by department management. The Physician Coding Auditor must prioritize daily duties, communicate effectively, and make the decisions necessary to complete all assigned tasks and accomplish their goals. Candidates should have recent auditing and education multi-specialty experience, have been client-facing, have experience presenting or educating in-person or virtually, and ideally have expert-level Epic proficiency. Responsibilities: Perform professional compliance audits of coding and documentation including surgeries,...

We are seeking a detail-oriented and experienced Coder Auditor to join our dynamic team. The ideal candidate will be responsible for ensuring the accuracy and completeness of clinical data used to support risk adjustment coding for our Medicare plan. You will work closely with healthcare providers and clinical teams to identify and mitigate documentation gaps, ultimately supporting our mission to provide exceptional care to our members. Responsibilities: Audit and QC the coding teams output for accuracy and compliance with HCC/ICD-10-CM guidelinesReview disposition decisionsSpeak directly with providers writing and following up on provider queries for insufficient or ambiguous documentationEducate providers on documentation practices that support accurate risk adjustment codingServe as the escalation point for complex charts and coding questions from the coding teamTrack error patterns and trends in coding quality and report on themBe able to work independently as a senior-level...

Location Miramar, Florida Overview 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 and...

Managing multiple projects remotely, the full-time Medical Auditor Project Lead will oversee client needs, perform production work, maintain audit standards, and provide feedback to auditors while ensuring high-quality deliverables. Key responsibilities Oversee project management and client expectations to ensure timely and quality deliverables Audit medical records and validate clinical documentation to meet quality standards Prepare audit findings and provide recommendations based on detailed analysis Required qualifications CPC certification required; CPMATM or RHIT preferred Extensive experience in coding, billing, auditing, and compliance within the healthcare industry Proficient knowledge of AMA, OIG, CMS, and national coding guidelines Experience in developing training materials and delivering presentations Demonstrated ability to manage multiple projects simultaneously

Providing expert analysis and education, the full-time remote Certified Coding Auditor and Educator will conduct comprehensive audits, deliver targeted training, and ensure compliance with coding standards in professional services. Key responsibilities Conduct comprehensive audits of coding and documentation for accuracy and compliance with regulatory guidelines Provide actionable feedback to improve documentation quality and coding accuracy for providers and coders Develop and deliver education and training programs based on audit findings and regulatory updates Required qualifications Associate degree in Health Information Management or a related field, or equivalent education and experience Comprehensive knowledge of ICD-10, HCPCS, CPT, and HCC guidelines, as well as medical terminology and regulatory guidelines Three to five years of professional coding or auditing experience Certification as a Registered Health Information Technician (RHIT), Registered Health Information...

Working remotely from anywhere in the U.S., the full-time Outpatient Coding Compliance Auditor will perform audits of outpatient facility coding to ensure compliance with ICD-10-CM diagnoses, CPT/HCPCS codes, and billing standards while effectively communicating findings to stakeholders. Key responsibilities: Perform coding compliance and quality audits in support of the Compliance Program and client expectations Independently analyze clinical documentation from medical records and validate coding accuracy for outpatient facilities Identify audit findings and calculate billing error rates, providing follow-up validation for corrective action plans Required qualifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Outpatient Coder (COC) 5+ years of Outpatient Facility coding experience, including knowledge of NCCI/OCE billing edits 5+ years of Outpatient Facility audit experience, including familiarity with Medicare regulations and OPPS...

To ensure compliance with coding guidelines, the remote California Licensed Coding Auditor will perform quality reviews and audits, coordinate with department leadership, and contribute to process improvements in a full-time capacity. Key responsibilities Conduct regular quality reviews and audits for hospital inpatient and outpatient coding, facilitating the coder audit appeal process Prepare detailed audit reports that outline findings, recommendations, and necessary corrective actions Maintain up-to-date knowledge of coding guidelines and regulations, identifying educational opportunities for staff Required qualifications High School Education/GED required; Associate's/Technical Degree preferred Five years of acute care inpatient and/or outpatient coding experience required Three years of coding auditing/monitoring experience preferred Certified Coding Specialist credential through AHIMA required Certified Coding Specialist (CCS) certification required

Position Title: Inpatient Coding Auditor Department: HIM Coders Job Description: Ask your recruiter about our competitive wages and total rewards package! Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment. This position may be filled as levels I, II, or III, depending on individual experience, education, certification(s), and business need. ****Ideal candidate will have experience in complex inpatient coding at an academic medical center.**** General Description Ensures accurate, quality, and compliant Inpatient facility coding through prebill and retrospective audits of coder work and providing targeted education to improve consistency and documentation quality. Essential Job Duties Responsibilities listed in this section are core to the position. Inability to perform these responsibilities, with or without an accommodation, may result in disqualification from the position. · Performs all functions of coding...

Summary This position is located in the Health Information Management (HIM) section at the Kansas City VA Medical Center. MRTs (Coder) Auditors are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. These coding practitioners analyze and abstract patients' health records, and assign alpha-numeric codes for each diagnosis and procedure. Learn more about this agency Duties Help Duties consist of significant scope, complexity (difficulty), range of variety, and be performed by the incumbent at least 25% of the time. Auditors must be able to perform all duties of a MRT (Coder). Auditors serve as experts of current coding conventions and guidelines related to professional and facility coding. Auditors perform audits of encounters to identify areas of non-compliance in coding. They facilitate improved overall quality,...

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law. Description Medical Coder and Auditor - Family Care Practice Full-Time Monday - Friday Flexible Schedule $25.00 - $39.00 per hour (depending on experience) Medical Coder and Auditor Benefits: Annual performance review, performance-based merit increase Health, dental and vision benefits available with coverage effective the first of the month following date of hire Full complement of voluntary benefits $1,000 annual employer HSA contribution for employees enrolled in CNYFC high deductible health plan Free office visits with NP or PA employees who are patients of the practice and enrolled in CNYFC high deductible health plan Waiver program for health benefits ($3,000...

Compliance Auditor Under general supervision, using a unique combination of clinical expertise and billing knowledge, the Compliance Auditor monitors and improves the quality of clinical and financial documentation related to the provision of patient services. The Compliance Auditor will compare clinical and financial records to ensure that the documentation provided supports the patient charges listed. The Compliance Auditor will utilize our technology to codify and quantify findings to assist with reporting, monitoring and educating where appropriate. Responsibilities Perform audits of clinical documentation of physician, technical or specialty (e.g., Home Health, Hospice, Inpatient Rehab) billing and payment records and applicable industry standard billing codes by analyzing medical records, coding records and health system bills validating clinical documentation in conjunction with the bill; assessing the level and accuracy of coding, determining that governmental and...

6 days ago Be among the first 25 applicants This range is provided by TalentPlug LLC. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $55,100.00/yr - $99,000.00/yr Direct message the job poster from TalentPlug LLC Job Title Clinical Coding Auditor & Trainer Job Location Remote (Candidates must be residents of New York) Summary The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Position Purpose Responsible for developing and conducting training and quality auditing programs for the Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care. Applicants must be willing to travel to New York twice a year. Responsibilities Conducts auditing of work performed by staff and present findings and recommendation for areas...

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...

Kids for the Future is seeking a Full-Time Facility Outpatient Coding Auditor to work remotely. This role involves abstracting codes from medical records, ensuring compliance with health standards, and performing quality reviews. The ideal candidate will possess relevant coding credentials and have at least five years of experience in coding assignments. The position offers various benefits including health insurance, a 401(k) with company match, and learning opportunities, making it an excellent opportunity for experienced coders. #J-18808-Ljbffr

Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that healthcare is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. About NYC Health + Hospitals MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus Health network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus Health has been committed to building strong relationships with its...

Job TypePart-timeDescriptionRequired :3-5 years of experience in acute care facility (hospital) medical coding auditing or complianceLocation :RemoteJob Summary :The Medical Coding Auditor is responsible for reviewing medical records to ensure accurate coding and compliance with regulatory requirements.This role ensures continuous quality improvement in coding practices while maintaining compliance with healthcare laws and organizational policies.Occasional travel may be required for audits or meetings.Key Responsibilities :Conduct reviews and audits of medical records for coding accuracy (ICD-10-CM, CPT, HCPCS) and documentation compliance.Ensure compliance with federal, state, and payer-specific regulations, including CMS guidelines.Identify and address coding discrepancies and recommend corrective actions.Prepare detailed audit reports with findings and provide feedback on documentation and coding practices.Collaborate with relevant departments to resolve audit findings and...

Medical Biller & Coder 7 (Team D) Remote LATAM role. Compensation listed in USD with local currency equivalent. This particular role is a Peru-based independent contractor engagement. Freedom Health Systems, Inc. is a mission-driven healthcare advisory and management consulting firm that partners with behavioral health and human services organizations to improve access, equity, and operational excellence. We specialize in guiding providers through program development, accreditation, compliance, and clinical best practices. While Freedom Health Systems does not provide direct clinical services, the organization delivers critical operational support through revenue cycle management, prior authorization, medical billing and coding, compliance consulting, and administrative services to outpatient behavioral health providers. Service Title: Medical Biller & Coder 7 (Team D) Alternate Service Titles: Medical Billing Specialist (Contractor), Medical Coding Specialist...