24 coder quality auditor jobs found

***To be considered for the role, you must permanently reside in one of the following states: Alabama, Arkansas, Florida, Georgia, Kentucky, Kansas, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, South Carolina, Tennessee, Texas, Virginia, or West Virginia*** The Senior Compliance Auditor reviews complex audits, performs quality assurance reviews, acts as a peer mentor, and assists management with onboarding process of new auditors. The Senior Compliance Auditor supports the audit supervisor with the development and maintenance of the quarterly audit work plan and audit workflow processes. The Senior Compliance Auditor recommends changes to improve business operations by using professional judgement and knowledge of best practices. This position contributes to special projects, as applicable. The Senior Compliance Auditor performs documentation/chart audits on inpatient and outpatient records, and to provide analysis of the records (provider and facility)...

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 39 US states. What We Do We support the mission critical needs of federal agencies 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 Medical Coding Auditor to join our healthcare consulting practice. The...

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...

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...

Newport News, Virginia FOR APPLICATION REVIEW - PROVIDE YOUR CREDENTIAL OR AHIMA ID NUMBER ON YOUR APPLICATION OR RESUME This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA. Overview Responsible for maintaining coded data quality through ongoing quality review and assessment of outpatient or inpatient records. Performs audits on accuracy of APC or MSDRGs as well as on quality of medical record documentation needed for accurate coding. Works with DRG and CPT denials from commercial payers and writes appeal letters as indicated. What you will do Ensures coding compliance. Applies all coding guidelines and principles as defined in the Coding Clinic and leading authorities. Complies with standardized coding standards, conventions and regulations, corporate compliance standards and reimbursement policies. Identifies training needs and provides education to team members. May teach...

Inpatient Coder (Remote) Full-time Work From Home Must have CCS, RHIA, or RHIT certification Job Summary As a Coding Integrity Specialist III WORK FROM HOME, you will review and evaluate hospital inpatient medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM and ICD-10-PCS codes. A CIS III performs coding and/or code/DRG validation across multiple entities by applying all appropriate coding guidelines and criteria for code selections. Job Qualifications Assign, sequence, validate, and/or edit codes/DRGs and abstracted data (e.g., physician, discharge disposition, query tracking) for inpatient records for multiple facilities using ICD-10-CM and ICD-10-PCS Maintain or exceed established accuracy standards Maintain or exceed established productivity standards Utilize the complete patient medical record documentation in code/DRG assignment, validation, and/or editing of codes/DRGs Undergraduate (Associate's or Bachelor's)...

Company Overview TestPros is a successful and growing business, established in 1988 to provide Information Technology (IT) technical support services to a wide range of Commercial and U.S. Federal, State, and Local Government customers. Our capabilities include Program Management, Program Oversight, Process Audit, Intelligence Analysis, Cyber Security, NIST SP 800-171 / CMMC Assessment and Compliance, Computer Forensics, Software Assurance, Software Testing, Test Automation, Section 508 and WCAG Accessibility Assessment, Localization Testing, Independent Verification and Validation (IV&V), Quality Assurance (QA), Compliance, and Research and Development (R&D) services.TestPros is an Equal Opportunity Employer. TestPros delivers innovative independent IT assessment solutions to critical challenges facing the nation and the world. We support the U.S. Federal Government and Commercial clients within the continental USA.TestPros is dedicated to making lives better, safer and...

Who You Are You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You’re excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change. Your Role As a Lead CDI Coder you are responsible for partnering with physician offices within our established partnerships to assist in translating healthcare documentation into standardized codes, ensuring accurate coding and billing of patient encounters, as supported by the medical record. You serve as a subject matter expert in Coding and Documentation. Role...

Coding Specialist Newport News, Virginia This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA. Overview Responsible for maintaining coded data quality through ongoing quality review and assessment of outpatient or inpatient records. Performs audits on accuracy of APC or MSDRGs as well as on quality of medical record documentation needed for accurate coding. Works with DRG and CPT denials from commercial payers and writes appeal letters as indicated. What you will do Ensures coding compliance. Applies all coding guidelines and principles as defined in the Coding Clinic and leading authorities. Complies with standardized coding standards, conventions and regulations, corporate compliance standards and reimbursement policies. Identifies training needs and provides education to team members. May teach or coordinate coding huddles. Coaches and mentors staff. Performs focused reviews and quality...

Job Title Help Basic Functions Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection. Reviews assigned codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS). Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or evaluation and management (E/M) code to ensure ethical, accurate, and complete coding. Applies guidelines specific to certain diagnoses, procedures, and other criteria used to classify patients under the Veterans Equitable Resource Allocation (VERA) program that...

Base pay range $30.00/hr - $37.00/hr Job Title: Remote Inpatient Medical Coder & Inpatient Team Lead Location: 100% Remote (Must reside in the Central Time Zone ) Schedule: Monday – Friday | 8:00 AM – 4:30 PM CT Employment Type: Full-Time Federal Contract Duration: Long-term Role Overview We are seeking experienced Inpatient Medical Coders and a high-performing Inpatient Team Lead for a high-volume facility within the VA healthcare system. These are fully remote positions requiring a high level of investigative accuracy and a deep understanding of complex inpatient documentation. Note: Previous experience within the VA, a University Medical Center, or a Teaching Hospital is mandatory. Core Responsibilities Medical Coding: Review complex inpatient medical records to assign accurate ICD-10-CM, ICD-10-PCS, and DRGs. Data Validation: Perform 100% data validation of assigned encounters to ensure diagnostic integrity. Provider...

Senior Social Compliance Auditor (CSCA Certified) Full-time Compensation: USD 90,000 - USD 115,000 - yearly SGS is the world’s leading inspection, verification, testing and certification company. SGS is recognized as the global benchmark for quality and integrity. With more than 96,000 employees, SGS operates a network of over 2,600 offices and laboratories around the world. As the Senior Social Compliance Auditor (CSCA) , you will perform third‑party audits per SGS Certification procedures and the requirements for standards. The Senior Social Compliance Auditor is responsible to make relevant decisions concerning the audit process and to inform SGS as required to resolve issues outside the audit process. The Senior Social Compliance Auditor is responsible to collect and analyze sufficient information to provide a recommendation for certification. They have the authority for the control and performance of auditing activities including planning and the control of other...

CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix’s autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. Overview Reporting to the Manager, Medical Coding & Audit, as a Medical Coder II or III, this role will be a key member of the team responsible for ensuring that CodaMetrix meets—and exceeds—our customers’ coding quality expectations. The Medical Coder II or III will be responsible for leveraging their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency...

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...

Newport News, VirginiaFOR APPLICATION REVIEW - PROVIDE YOUR AAPC CERTIFICATION NUMBER ON YOUR APPLICATION OR RESUMEThis position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA.Hours: Labor Pool (as needed)OverviewEnsures high quality documentation that is thorough, accurate and complete to ensure correct reimbursement capture. Assigns diagnostic and procedure codes to simple record types up to highly complex record types. Contributes to the proper management of health information through consistent and accurate code assignment processes adhering to all regulatory coding principles, rules and regulations.What you will doOrganizes and prioritizes assigned work to ensure that work is completed within the assigned time frame. Reviews charts and entire medical records, assigning ICD and CPT code combinations to each data element. Audits for documentation opportunities and queries clinical staff to fill in any gaps...

Company Overview Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities Acentra Health is looking for a Medical Coder-Inpatient to join our growing team. Job Summary: The Medical Coder is responsible for reviewing inpatient medical record documentation to ensure the accuracy, completeness, and...

Under the direction of the Health Information Management Director, the Outpatient Coder I accurately determines ICD-10-CM diagnosis, ICD-10-CM, CPT and HCPCS procedure codes for all outpatient medical records, which may include Emergency Department (ED), outpatient laboratory, diagnostic imaging, minor outpatient procedures, infusion and injections, outpatient labor and delivery, recurring accounts and observation stays. POSITION RESPONSIBILITIES Abstract pertinent information from patient records within various outpatient types and assign appropriate ICD-10-CM, ICD-10 PCS, and HCPCS codes, creating ambulatory payment classifications (APC). Monitor and manage the discharged not final billed (DNFB) accounts within assigned patient types daily to meet financial goals and expectations. Meet coding productivity standards and accuracy rates as determined by company policy. Query clinical staff to achieve accuracy in coding. Educate, train and communicate with medical staff...

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...

Description General Definition of Work The Richmond Behavioral Health Authority has a full-time position available for a Medical & Electronic Records Program Supervisor in our Quality & Standards Division. The successful candidate will perform difficult skilled administrative support and technical work supervising Health Information Coordinators, maintain the privacy and confidentiality of individual's information in a hybrid paper and electronic health record system, ensure that all laws and regulatory procedures related to releasing client information are followed, respond to all subpoenas for client medical records, coordinate duties and activities for Health Information Coordinators and related work as needed or assigned. Work is performed under the limited supervision of the Director of Compliance. Essential Functions Oversees the daily operations of the medical records department to include scheduled coverage. Supervises staff; assigns, directs, and...

Starts out onsite, then transitions to REMOTE 4 days/week. Job Summary: Required Services provide single path medical coding services and related medical records functions. Single path coding combines facility coding and professional coding and allows one coder to code facility and professional codes for the same patient utilizing a single coding platform. perform technically complex professional services coding for medical conditions and assign the correct International Classification of Diseases, ICD-10-CM, Procedure Coding System (PCS) Current Procedural Terminology (CPT), Health Care Financing Administration Common Procedure Coding System (HCPCS), and Evaluation and Management (E&M) codes for diagnosis, acuity of care and procedures for a wide range of medical specialties to include coding of complicated cases identified as difficult to classify such as treatment of burn injuries, combat related injuries, orthopedic surgery, cardiothoracic surgery, interventional...

Coder RMG (Labor Pool) page is loaded## Coder RMG (Labor Pool)remote type: Remotelocations: Newport Square Professional Center - Newport News, Virginiatime type: Part timeposted on: Posted Todayjob requisition id: 2026-034308Newport News, Virginia**FOR APPLICATION REVIEW - PROVIDE YOUR AAPC CERTIFICATION NUMBER ON YOUR APPLICATION OR RESUME*****This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA.*****Hours:** Labor Pool (as needed)**Overview** Ensures high quality documentation that is thorough, accurate and complete to ensure correct reimbursement capture. Assigns diagnostic and procedure codes to simple record types up to highly complex record types. Contributes to the proper management of health information through consistent and accurate code assignment processes adhering to all regulatory coding principles, rules and regulations. **What you will do*** Organizes and prioritizes...

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...

Job Description - Coder II (7454-1498) Wythe County Community Hospital POSITION SUMMARY Under the direction of the Health Information Management Director, the coder II accurately determines ICD-10-CM diagnosis, and ICD-10-CM, CPT and HCPCS procedure codes for all patient types to include inpatient, observation, surgical day care, Emergency Department (ED) outpatient and recurring patients. POSITION RESPONSIBILITIES Abstract pertinent information from patient records within various inpatient and outpatient types. Assign International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) / International Classification of Diseases, Tenth Revision, Clinical Modification Procedural Coding System (ICD-10 PCS) codes or Healthcare Current Procedural Coding System (HCPCS) codes, creating ambulatory payment classification (APC) or diagnosis related group (DRG). Monitor and manage the discharged not final billed (DNFB) accounts within assigned patient types daily...

City / State Norfolk, VA Work Shift First (Days) Overview :Sentara Health Plan is currently hiring an Associate Fraud and Abuse Investigator / Certified Professional Coder (CPC) Remote! Status :Full-time, permanent position (40 hours) Work hours :8am to 5pm EST, M-F Location :This position is remote for candidates that live in the following states :VA, NC, AL, DE, FL, GA, ID, IN, KS, LA, ME, MD, MN, NE, NV, NH, ND, OH, OK, PA, SC, SD, TN, TX, UT, WA, WV, WI, WY! With travel to Virginia Beach 1x a year.Job Responsibilities :Responsible for contributing to in-depth investigations for suspected fraud or abuse with respect to provider, pharmacy, employer, member, and broker interactions involving the full range of products.Responsible for contributing to the review of the quality of pharmacy, physician, ancillary and hospital based coding in routine desk audits as well as occasional on-site audits.Contribute to the review of reimbursement systems relating to health insurance claims...