18 coder quality auditor jobs found

Job Details Compliance Auditor Job Description 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. ESSENTIAL FUNCTIONS: • Performs 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...

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. Essential Functions: Performs 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...

**ABOUT MACHINIFY:**In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify’s AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We’re reshaping healthcare payment through seamless intelligence.**ABOUT THE OPPORTUNITY:**### Hiring Range:$70,000 - $85,000### **Key Responsibilities to include:*** Audit Medical Records: Review and audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD-10, CPT, and HCPCS codes.* Compliance Monitoring: Ensure that coding practices comply with federal, state, and payer-specific regulations and...

UPMC is hiring a full-time Certified Professional Coder to support their Women's Health Departments! This position is a remote position, but will be required to work onsite at an office location during our training period. Candidates must be located within a 60-mile radius of Pittsburgh or willing to relocate to the area. Our Women's Health decentralized coding team provides specialized coding support across multiple subspecialties, ensuring accurate and compliant claim submission for a diverse range of services. The team is experienced in handling complex subspecialty claims and coding scenarios unique to the Women's Health service line, including OB/GYN, Uro-gynecology, and Minimally Invasive Surgeries. With a focus on quality, collaboration, and operational efficiency, the team supports timely charge capture and revenue integrity across multiple practice locations across Western PA. The Certified Professional Coder supports Women's Health services by reviewing and releasing...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Coder Coder Certification Required. The Coder provides coding services and support to assigned Independence Physician Management Markets/Billing Entities, as required, utilizing clinical documentation in multiple electronic health record (EHR) systems. Applies working knowledge of medical terminology, anatomy, CPT-4 and ICD-10 codes and coding skills/ experience to ensure timely and accurate coding of clinical documentation. Meets or exceeds established performance targets (productivity and quality) established by the Coding Manager. Works closely with the Billing Department to ensure accuracy in charge posting to the Practice Management System (PMS). Effectively communicates with providers and market staff to ensure that clinical documentation is completed and signed to avoid coding delays and minimize lag days. Assists in educating providers on clinical documentation requirements to support their coding and ensure all coding (charge) possibilities are being captured. Timely...

Are you an experienced anesthesia medical billing/coding specialist who thrives in a fast-paced surgical environment where accuracy, collaboration, and expertise truly matter? At Intrepidus Surgical Institute, you'll work alongside a dynamic team of anesthesia providers, surgeons, and healthcare professionals supporting high-quality outpatient ophthalmologic and vision surgical procedures. We are seeking a detail-oriented, highly skilled Medical Billing and Coding Specialist who understands the complexities of anesthesia reimbursement and takes pride in driving accurate billing, clean claims, and optimized revenue cycle performance. This is an opportunity to join a collaborative Ambulatory Surgery Center (ASC) environment where your knowledge and contributions directly impact operational success and patient care. Why Join Us? We believe exceptional employees deserve exceptional support. We offer a competitive compensation and benefits package designed to support your...

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...

Responsibilities Remote Opportunity Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. To learn more about IPM visit Physician Services - Independence Physician Management - UHS. POSITION OVERVIEW Coder Certification Required. The Coder provides coding services and support to assigned IPM Markets/Billing Entities, as required, utilizing clinical documentation in multiple electronic health record (EHR) systems. Applies working knowledge...

Quality and Compliance Auditor About Intervala, LLC Intervala is a full-service electronics manufacturing services (EMS) provider, delivering high-quality, complex printed circuit board assemblies, cable and harness assemblies, and electromechanical systems. We partner with customers in diverse industries-including industrial, medical, transportation, and defense-to bring innovative products to life. At Intervala, we combine advanced technology, engineering expertise, and a collaborative culture to ensure reliability, flexibility, and exceptional customer service. Job Summary & Essential Functions Responsible for conducting systematic audits of the Quality Management System (QMS) to ensure compliance with ISO 13485:2016 (Medical Devices) and AS9100D (Aerospace) standards. Supports a high-precision contract manufacturing environment specializing in Printed Circuit Board Assemblies (PCBA), full-box builds, and complex cable and harness assemblies. Primary guardian of...

UPMC Hillman Cancer Center at the Divine Providence Campus in Williamsport is currently hiring a full-time Medical Oncology Coder. This position offers a consistent day shift schedule from 8:00 AM to 4:30 PM, totaling 40 hours per week. This is a great opportunity to join a dedicated oncology team and contribute to accurate, compliant coding that supports high-quality patient care. This position requires candidate to be a Certified Professional Coder (CPC). This is a hybrid position. The initial phase of employment will require on-site work at UPMC Hillman Cancer Center in Williamsport, PA for several months. After this period, mandatory attendance for monthly meetings and other required on-site sessions will continue. Ideally, the candidate will work minimum one day per week in the office at UPMC Hillman Cancer Center, with the remaining time remote. Responsibilities: Query physicians when documentation is inadequate, ambiguous, or unclear to ensure accurate...

General Summary Collects, reviews, retrieves and codes Evaluation & Management services, Pathology, and minor procedures based on documentation in the medical record and reports for quality assessment, audit, and billing purposes. Duties and Responsibilities Essential Functions: Performs chart audits, reviewing for accuracy and compliance. Reviews operative reports and other documentation and assigns appropriate diagnosis (ICD-10) and procedure codes (CPT) for final billing. Researches and processes invoice corrections. Reviews and analyzes coding/billing procedures. Presents training and feedback concerning medical coding, compliance, and reimbursement to physicians/providers. Coordinates and implements reimbursement improvement activities with staff and providers. Adheres to WellSpan Coding Compliance Guidelines. Common Expectations: Maintains job specific standards and expectations relative to productivity...

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. 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 fully remote with a flexible schedule, allowing...

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients. Job Summary Our client is seeking an Inpatient Coder responsible for reviewing and analyzing inpatient medical records from admission through discharge. The primary goal of this role is to ensure completeness and accuracy in assigning appropriate ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and DRGs, while maintaining compliance with federal regulations and payer guidelines. Key Responsibilities Review and analyze inpatient medical records for completeness and accuracy. Assign appropriate ICD-10-CM diagnosis and ICD-10-PCS procedure codes. Identify and sequence principal and secondary diagnoses. Ensure accurate assignment of DRGs for reimbursement. Evaluate documentation for severity of illness and risk of mortality. Query physicians for clarification of incomplete or conflicting documentation. Collaborate with...

Description Full-time - This is not a remote position. Evaluates medical records, provides clinical abstracts and assigns appropriate clinical diagnosis and procedure codes for both inpatient and outpatient services in accordance with nationally recognized coding guidelines. Meets quality standards of having 95% of principal diagnoses and procedures correctly coded. Serves as a liaison between clinicians and the coding staff. Collaborates with all members of the revenue cycle to ensure data quality and optimum reimbursement allowable under the federal and state payment systems. Supervises the coding department in relation to the following: distribution of work assignments, dissemination of current coding guidelines and modern technology information, and provides relevant coding education to the coders, clinicians, and revenue cycle staff. Minimum Requirements Knowledge and understanding of ICD10 and CPT coding principles as recommended by the American Health...

Responsibilities Remote Opportunity Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. To learn more about IPM visit Physician Services - Independence Physician Management - UHS. POSITION OVERVIEW Coder Certification Required . The Coder provides coding services and support to assigned IPM Markets/Billing Entities, as required, utilizing clinical documentation in multiple electronic health record (EHR) systems. Applies...

Overview Full-time - This is not a remote position. Evaluates medical records, provides clinical abstracts and assigns appropriate clinical diagnosis and procedure codes for both inpatient and outpatient services in accordance with nationally recognized coding guidelines. Meets quality standards of having 95% of principal diagnoses and procedures correctly coded. Serves as a liaison between clinicians and the coding staff. Collaborates with all members of the revenue cycle to ensure data quality and optimum reimbursement allowable under the federal and state payment systems. Supervises the coding department in relation to the following: distribution of work assignments, dissemination of current coding guidelines and modern technology information, and provides relevant coding education to the coders, clinicians, and revenue cycle staff. Responsibilities Evaluates medical records, provides clinical abstracts and assigns appropriate clinical diagnosis and procedure codes for both...

Job Details Description Review medical records and clinical documentation to assign accurate and complete diagnosis and procedure codes. Apply knowledge of coding systems (ICD-10-CM, ICD-10-PCS, CPT, HCPCS) and coding guidelines (AHA Coding Clinic, CPT Assistant, etc.) to ensure proper code selection. Abstract and enter coded data into electronic health record (EHR) and hospital information systems for billing and reporting purposes. Ensure compliance with federal, state, and payer‑specific coding regulations and hospital policies. Work closely with providers and clinical documentation improvement (CDI) teams to clarify ambiguities or incomplete documentation. Maintain productivity and coding accuracy benchmarks as defined by the department. Support audits and quality reviews by coding leadership or external bodies. Assist with mentoring or training junior coding staff as needed. Stay updated on coding changes, regulatory updates, and continuing education requirements....