42 coding auditor jobs found

The Certified Professional Medical Auditor is responsible for performing comprehensive audits of medical records, coding, and billing to ensure accuracy, compliance with federal and state regulations, and alignment with payer policies. This role helps protect the organization from financial risk, supports accurate reimbursement, and promotes high standards of documentation and clinical integrity. Key Responsibilities Perform prospective and retrospective audits of medical records, coding, and billing across assigned service lines (e.g., outpatient, inpatient, behavioral health, SUD/MH, lab). Verify that documentation supports ICD‑10‑CM, CPT, and HCPCS coding; identify under‑coding, over‑coding, unbundling, and other compliance risks. Review claims for adherence to Medicare/Medicaid, commercial payer, and regulatory guidelines; ensure compliance with NCCI edits and payer‑specific policies. Prepare clear, detailed audit reports summarizing findings,...

Phoenix Behavioral Healthcare, LLC is seeking a highly skilled Executive   Director of Revenue Cycle Management (RCM) to oversee and optimize the full revenue cycle across multiple behavioral health facilities, clinics, laboratories, and E&M service lines. This onsite leadership role manages all aspects of RCM operations—including intake, UR/UM alignment, coding, billing, claims submission, collections, clinical documentation improvement, denial management, appeals, and compliance oversight. Key Responsibilities: Lead, manage, and optimize end-to-end revenue cycle operations for all Phoenix facilities Oversee billing and coding for inpatient, outpatient, lab, and professional services (UB-04 & CMS-1500) Direct UR/UM workflow integration to improve documentation quality and turnaround times Manage and mentor a full RCM support team (billers, coders, auditors, documentation trainers, compliance) Develop standardized...

Whether you are looking to expand your current knowledge or looking to share your extensive skills with us, this could be the start of something amazing. We are a small, close knit team that works together to accomplish tasks daily. Qualifications: Knowledge in Surgery Billing and Coding Coding Certification- CASCC or COC preferred Experience with Microsoft 365 products Minimum 3 years experience in surgical billing Knowledge in all aspects of RCM Insurance credentialling- preferred Job Requirements: Coding and Charge Capture Insurance Claims Billing Resolution of rejections Coding reviews of denials Appeal assistance Coding reviews of documentation in question by the coding team Management of payor chart audits Insurance overpayment reviews Issuance of disputes as needed Ability to assist in aging follow on unpaid claims Address physician documentation matters Month end closing Utilization of reports Knowledge of and adherence to...

A Certified Inpatient and Outpatient Professional Documentation Expert is responsible for ensuring the accuracy, completeness, and compliance of clinical documentation across both inpatient and outpatient settings. They collaborate with physicians, nurses, and other providers to clarify diagnoses, procedures, and treatment plans so that the medical record supports the patient’s severity of illness, risk of mortality, medical necessity, and appropriate reimbursement. Key duties include concurrent and retrospective chart review, generating and tracking provider queries, applying official coding and documentation guidelines, educating clinical staff on best practices, and monitoring documentation quality metrics to support regulatory, audit, and revenue cycle integrity.

Position:   Experienced OT/PT/SLP   Medical Biller (Remote W2 employee) Location:   Florida, Maryland, Virginia, or Idaho residents only Start Date:   January 12, 2026 Classification:   Non-Exempt, Hourly Hours:   Up to 40 hours per week Important Details You Must Review Carefully Before Applying: This is a fully remote position but showing as hybrid to attract people in the Florida region You must reside in one of the following states to be considered: Florida, Maryland, Virginia, Idaho You must be aware that the compensation is hourly between $18-$26 per hour. If you are seeking highest compensation - please don't apply. The role does not include traditional benefits. No paid time off, no retirement plan, no traditional benefits. We do offer health benefits via an HRA for full-time employees with up to $400 per month contribution. You must have extensive medical billing experience preferably in Speech Therapy private practice sector. This role...