34 coding and cdi jobs found

Job Description Job Description Senior Medical Coder – Urology/Nephrology Location Irving, TX | Onsite Compensation & Schedule • $35.75/hour – Non-Urology Certified Coder | $42.00/hour – Certified Urology Coder (CUC) • Full Time |8:00 AM - 5:00 PM • Temp to Perm (W2) • Start Date: March 16, 2026 Role Impact: The Senior Medical Coder ensures accurate, compliant coding for high-dollar and specialty professional fee accounts within Urology and Nephrology. This role directly supports clean claims, optimized reimbursement, and reduced denials by maintaining a minimum 95% coding accuracy rate. Success is defined by precision in ICD-10-CM, ICD-10-PCS, and CPT code assignment, strong collaboration with HIM (Health Information Management) and CDI (Clinical Documentation Improvement) teams, and consistent productivity performance. Key Responsibilities • Assign diagnosis and procedure codes in accordance with ICD-10-CM/PCS Official Guidelines and AMA CPT guidelines...

Job Description Job Description Specialty Senior Medical Coder – General Surgery Location: Irving, TX COMPENSATION & SCHEDULE • $35.75/hr (Non-CGSC Certified) | $42.00/hr (CGSC Certified – General Surgery) • Monday–Friday | 8:00 AM–5:00 PM • W2 | Temp to Perm • Start Date: 03/16/2026 ROLE IMPACT: The Specialty Coder Senior – General Surgery ensures accurate, compliant coding for high-dollar inpatient and outpatient professional services. This role drives revenue integrity by reducing denials, supporting clean claims, and maintaining a minimum 95% coding accuracy rate. Success is defined by precise code assignment, strong documentation review, and consistent productivity in a remote environment. Key Responsibilities • Assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes in accordance with Official Coding Guidelines and AMA CPT standards • Code inpatient and outpatient Evaluation & Management (E/M) and surgical/operative procedures, generating accurate...

Job Title Responsibilities: Performs the functions of all services of IP coding. Responsible and accountable for coding and DRG accuracy, timeliness of coding, and utilization of systems used to perform coding functions. Maintains relationship with Coding Manager/Supervisor, CDI team, Business Office and Case Management staff. Performs primary function of coding inpatient records, to include DRG assignment and validation. Maintains knowledge of outpatient coding and other areas to assist as needed. Utilizes the 3M Encoder to code and classify accurately all medical records according to ICD-10-CM/PCS. Responsible and accountable for maintaining performance skills. Qualifications 1. Three to Five years coding experience required (Inpatient preferred) 2. Advanced training in medical coding (ICD10-CM/PCS, CPT and APC). 3. Medical terminology, anatomy and physiology required. 4. Computer skills. 5. Ability to read medical reports, interpret lab values pertinent to coding...

Where compassion meets innovation and technology and our employees are family. Thank you for your interest in joining our team! Please review the job information below. General Purpose of Job: Ensures that coding compliance initiatives are met with all record types. Reviews and analyzes medical records and abstracted data submitted by the coding staff to determine the accuracy of code assignment and adequacy of clinical documentation according to regulatory requirements. Performs frequent internal reviews and education maintenance long‑term to ensure accuracy in the ever‑changing environment of coding, documentation, quality initiatives, and impact to reimbursement. Can code, train, and educate on all types of outpatient medical records to provide timely coverage in all coding areas helping to ensure accuracy, stability, and efficiency in our revenue cycle. Code several different specialties, help train new coders, review records for provider audits, assist with new physician...

Description JOB SUMMARY: Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems. JOB RESPONSIBILITIES: • KEY RESPONSIBILITY 1: 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. o Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and observation visits for the purpose of reimbursement, research and compliance with federal and state regulations. o Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate...

Inpatient Coder Our client is seeking experienced Inpatient Coders to support high-volume, complex hospital systems. This role is responsible for accurate ICD?10?CM and ICD?10?PCS coding of inpatient encounters in accordance with official coding guidelines, regulatory requirements, and client-specific workflows. Coders must consistently meet both productivity and quality standards in large hospital environments. Key responsibilities include: Assign accurate ICD?10?CM and ICD?10?PCS codes for inpatient records following official coding guidelines, UHDDS guidelines, and CMS directives Abstract and enter coded data into client electronic medical record systems Assign Present on Admission (POA) indicators in accordance with AHA guidelines Query providers to clarify conflicting, incomplete, or ambiguous clinical documentation when appropriate Collaborate with Clinical Documentation Integrity (CDI) and Revenue Cycle teams to resolve documentation and coding issues Identify and...

Responsibilities Position Summary Performs the functions of all services of IP coding. Responsible and accountable for coding and DRG accuracy, timeliness of coding, and utilization of systems used to perform coding functions. Maintains relationship with Coding Manager / Supervisor, CDI team, Business Office and Case Management staff. Performs primary function of coding inpatient records, to include DRG assignment and validation. Maintains knowledge of outpatient coding and other areas to assist as needed. Utilizes the 3M Encoder to code and classify accurately all medical records according to ICD-10-CM/PCS. Responsible and accountable for maintaining performance skills. Qualifications Three to Five years coding experience required (Inpatient preferred) Advanced training in medical coding (ICD10-CM/PCS, CPT and APC) Medical terminology, anatomy and physiology required Computer skills Ability to read medical reports, interpret lab values pertinent to coding diagnoses, abstract...

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...

Responsibilities POSITION SUMMARY: Performs the functions of all services of IP coding. Responsible and accountable for coding and DRG accuracy, timeliness of coding, and utilization of systems used to perform coding functions. Maintains relationship with Coding Manager/Supervisor, CDI team, Business Office and Case Management staff. Performs primary function of coding inpatient records, to include DRG assignment and validation. Maintains knowledge of outpatient coding and other areas to assist as needed. Utilizes the 3M Encoder to code and classify accurately all medical records according to ICD-10-CM/PCS. Responsible and accountable for maintaining performance skills. Qualifications QUALIFICATIONS: 1. Three to Five years coding experience required (Inpatient preferred) 2. Advanced training in medical coding (ICD10-CM/PCS, CPT and APC). 3. Medical terminology, anatomy and physiology required. 4. Computer skills. 5. Ability to read medical reports,...

Where compassion meets innovation and technology and our employees are family. Thank you for your interest in joining our team! Please review the job information below. General Purpose of Job: Ensures that coding compliance initiatives are met with all record types. Reviews and analyzes medical records and abstracted data submitted by the coding staff to determine the accuracy of code assignment and adequacy of clinical documentation according to regulatory requirements. Performs frequent internal reviews and education maintenance long-term to ensure accuracy in the ever-changing environment of coding, documentation, quality initiatives, and impact to reimbursement. Can code, train, and educate on all types of outpatient medical records to provide timely coverage in all coding areas helping to ensure accuracy, stability, and efficiency in our revenue cycle. Code several different specialties, help train new coders, review records for provider audits, assist with...

Job Description Our client is seeking experienced Inpatient Coders to support high-volume, complex hospital systems. This role is responsible for accurate ICD‑10‑CM and ICD‑10‑PCS coding of inpatient encounters in accordance with official coding guidelines, regulatory requirements, and client-specific workflows. Coders must consistently meet both productivity and quality standards in large hospital environments. Key Responsibilities Assign accurate ICD‑10‑CM and ICD‑10‑PCS codes for inpatient records following official coding guidelines, UHDDS guidelines, and CMS directives Abstract and enter coded data into client electronic medical record systems Assign Present on Admission (POA) indicators in accordance with AHA guidelines Query providers to clarify conflicting, incomplete, or ambiguous clinical documentation when appropriate Collaborate with Clinical Documentation Integrity (CDI) and Revenue Cycle teams to resolve documentation and coding...

Job Description Our client is seeking experienced Inpatient Coders to support high-volume, complex hospital systems. This role is responsible for accurate ICD‑10‑CM and ICD‑10‑PCS coding of inpatient encounters in accordance with official coding guidelines, regulatory requirements, and client‑specific workflows. Coders must consistently meet both productivity and quality standards in large hospital environments. Key Responsibilities Assign accurate ICD‑10‑CM and ICD‑10‑PCS codes for inpatient records following official coding guidelines, UHDDS guidelines, and CMS directives Abstract and enter coded data into client electronic medical record systems Assign Present on Admission (POA) indicators in accordance with AHA guidelines Query providers to clarify conflicting, incomplete, or ambiguous clinical documentation when appropriate Collaborate with Clinical Documentation Integrity (CDI) and Revenue Cycle teams to resolve documentation and coding issues Identify and communicate...

Job Description:Employment type:Contract (initial 3 months; likely extension) Schedule:Full-time, Monday“Friday (flexible daytime hours) Location:Remote (U.S. only) About the Role We're hiring an experiencedInpatient Medical Coderto support acute-care facility coding for a Level I Trauma Hospital. The ideal candidate is AHIMA-credentialed, highly accurate with ICD-10-CM/PCS and MS-DRG/APR-DRG assignment. Key Responsibilities Review inpatient medical records and assign ICD-10-CM/PCS codes with appropriate DRG assignment (MS-DRG/APR-DRG as applicable). Ensure compliance with AHIMA , AHA Coding Clinic , CMS , and facility guidelines. Query providers per policy to clarify documentation and support compliant code/DRG selection. Meet or exceed productivity and 95“98%quality standards. Collaborate with HIM/CDI teams to resolve discrepancies and optimize documentation integrity. Maintain HIPAA compliance and safeguard PHI in a remote work...

Job Title :Gastroenterology ProFee Coder (E / M & Surgical) Company Description Vee Healthtek, Inc.delivers cutting-edge solutions that transform healthcare organizations.We offer a comprehensive suite of services that leverage our industry expertise to provide the best value to our clients.Through close collaboration and a deep understanding of market trends, we create customized strategies that deliver tangible outcomes.Our technology-driven services empower organizations to thrive in the evolving healthcare landscape, resulting in improved workflows, increased cost efficiency, and streamlined business processes.Learn more at www.veehealthtek.com.Job Summary The Gastroenterology ProFee Coder is responsible for accurate assignment of diagnosis, procedure, and Evaluation & Management (E / M) codes for physician professional services within a gastroenterology practice or health system.This role focuses exclusively on professional fee coding , ensuring compliance with CPT,...

JOB SUMMARYSupport and provide coding and compliance training to clinical personnel, billing, and / or other client staff.Establish effective communication with clinical staff, and / or hospital staff to address documentation, coding, and reimbursement issues.Use knowledge of coding and compliance guidelines to identify potential billing / reimbursement issues.Participate in special audits and system administration as necessary.ESSENTIAL DUTIES AND RESPONSIBILITIESInclude the following.Others may be assigned.Performs diagnosis data submissions to Client, Vendors and internal StakeholdersDevelop monthly productivity and revenue projectionsResponsible for chart assignment oversight and monitoring accounts on holdPrepares data collection reports for leadershipMonitors diagnosis submission progress; Audit diagnosis submission files to ensure accuracyReviews, analyzes and oversight of prebill / post bill reviews and pending accountsWorks to resolve workflow, systems and complex matters...

Medical AI Auditor We are building the future of clinical documentation, and we need your expert eye to keep it accurate, safe, and reliable. AI-generated medical notes are transforming healthcare by giving providers their time back, but AI needs human expertise to stay grounded. As a Medical AI Auditor, you won't be handling traditional billing and coding compliance. Instead, you will act as the ultimate clinical guardrailreviewing AI-generated behavioral health records to detect "hallucinations" (clinically inaccurate or unsupported content that looks plausible but is factually incorrect). If you are a detail-obsessed medical coder or clinical documentation specialist who loves the intersection of healthcare and technology, this is your sandbox. What You'll Do Detect & Correct: Audit AI-generated behavioral health notes against source session data, catching subtle clinical inaccuracies, unsupported inferences, or errors in medical terminology. Evaluate Note Structure:...

OverviewThis position is responsible for conducting coding audits, communicating results and recommendations to providers, management, and executive administration, and providing training and education to providers and ancillary staff.This position will support the implementation of changes to the CPT, CDT, HCPCS and ICD-10 codes on an annual basis.ResponsibilitiesEssential Duties :Conduct prospective and retrospective chart reviews (i.e.baseline, routine periodic, monitoring, and focused) comparing medical and / or dental record notes to reported CDT, CPT, HCPCS, and ICD codes with consideration of applicable FQHC and payer / title / grant coding requirements.Identify coding discrepancies and formulate suggestions for improvement.Communicate audit results / findings to providers and / or ancillary staff and share improvement ideas.Work with the Office of the CMO and provider leadership to identify and assist providers with coding.Report findings and recommendations to Compliance...

Coder II Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings. As a Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Every day you will accurately translate patients' medical records into standardized codes for diagnoses and treatments. Using your expertise and training, you will ensure compliance with legal, regulatory, and organizational standards. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards...

Job Summary The Coder 2 is skilled in three or more types of outpatient, profee, or low‑acuity inpatient coding. The Coder 2 may code low‑acuity inpatients, one‑time ancillary/series, emergency department, observation, day surgery, and/or professional fee, including evaluation and management (E/M) coding or profee surgery. For professional fee coding, team members in this job code are proficient for inpatient and outpatient, for multi‑specialties. The Coder 2 uses the International Classification of Disease (ICD‑10‑CM, ICD‑10‑PCS), Healthcare Common Procedure Coding System (HCPCS), including Current Procedural Terminology (CPT), and other coding references. These references ensure accurate coding and grouping of classification assignments (e.g., MS‑DRG, APR‑DRG, APC, etc.). The Coder 2 will abstract and enter required data. Essential Functions Of The Role Examines and interprets documentation from medical records and completes accurate coding of diagnosis, procedures and...

Overview JOB SUMMARY The primary purpose of the SPEC, PHYS SVC CODING II is to code physician charges by assigning ICD-10, CPT, HCPCS codes and modifiers from medical record documentation. Must have the ability to utilize multiple resources to support code assignment. Must possess knowledge on how to resolve coding denials and pre-bill coding edits. Productivity and accuracy are measured via internal audits and must be maintained. Level II roles include but are not limited to evaluation and management coding, radiology, and emergency department coding. Responsibilities Assign ICD-10, CPT, HCPCS and modifiers codes from documentation Review and appropriately resolve pre-bill edits Review and appropriately resolve coding denials Meet or exceed productivity standards Meet or exceed accuracy rate of 95.5% in monthly internal audits Effectively present coding issues to internal team members, internal clients, or external clients Deliver information in a one-on-one or small group...

Key Responsibilities Conduct detailed audits of patient medical records to ensure clinical documentation supports quality care, medical necessity, and accurate billing practices. Identify documentation, coding, billing, and compliance discrepancies and develop corrective action recommendations. Prepare comprehensive audit reports and communicate findings to leadership and operational teams. Monitor compliance risks related to Medicare, Medicaid, and other federal healthcare programs. Provide consultative guidance regarding healthcare compliance regulations and best practices. Assist with responses to government audits, investigations, and regulatory inquiries. Review potential refund and repayment obligations related to federal healthcare programs. Support policy and procedure development based on regulatory updates and audit findings. Monitor changes in healthcare laws, regulations, and compliance requirements. Collaborate with clinical, revenue cycle,...

Description Providence is calling for Compliance Auditor - Remote The Revenue Cycle Compliance Hospital Auditor conducts audits to evaluate compliance with a wide variety of Federal and State laws, regulatory rules & regulations, PSJH policies and procedures. Areas of audit focus for this position may involve clinical and non-clinical services, including but not limited to revenue cycle: Rev Cycle departments, Rev Cycle Billing Offices, External Vendor; HIM Coding, Revenue Integrity RI, Chargemaster CDM, EPIC, and Clinical Documentation CDT. This position works collaboratively with Case Management, Utilization Review, Revenue Integrity, our PB Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs and Finance under the supervision of the Rev Cycle Compliance Senior Manager. The Revenue Cycle Compliance Hospital auditor navigates and analyzes data across both the Clinical EMR and Epic Billing systems. This includes reviewing...

About Us Here at Baylor Scott & White Health we promote the well‑being of all individuals, families, and communities. Baylor Scott and White is the largest not‑for‑profit healthcare system in Texas that empowers you to live well. Core Values We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar‑for‑dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level. Job Summary This...

Job Summary and Responsibilities The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk‑adjusting conditions and supporting provider documentation improvement. Comprehensive Record Review & HCC Expertise: Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC documentation and coding. Advanced...