90 coding auditor jobs found

Job Description Job Description Banyan Treatment Centers is seeking a detail-oriented and experienced Billing and Coding Auditor to support the accuracy and compliance of our billing practices across our behavioral health services. This critical role ensures the integrity of our claims processes and supports continuous quality improvement, staff education, and adherence to payer regulations. As a nationally recognized provider of addiction and mental health care accredited by The Joint Commission—with 18 locations, robust Telehealth services, and backed by TPG’s Rise Fund since 2023—our 1,600+ employees are dedicated to delivering compassionate, high‑quality care that transforms lives. Positions Details Location: Flexible |On-site (Pompano Beach, FL), Hybrid or Remote (USA) Reports to: Auditing Manager & Director of RCM Schedule: Full-time Key Responsibilities Conduct regular audits of behavioral health billing and claims for accuracy and...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217* Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical diagnoses and clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements. Trains, instructs and provides technical support...

Physician Coding Auditor The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding. Orlando Health is committed to providing benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. "Orlando Health Is Your Best Place to Work" is not just something we say, it's our promise to you. Orlando Health proudly embraces and honors the individuality of our team members. By sharing different ideas and perspectives and working together as a team, we are better able to relate to, care for...

Physician Coding Auditor The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. Competitive Pay Evening, nights, and weekend shift differentials offered for qualifying positions. All Inclusive Benefits (start day one) Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Job Description Job Description Hybrid-Sunrise, Florida Position Summary: The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through post payment medical records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines and regulatory and contract requirements. Essential Duties and Responsibilities: Performs post payment medical record review audits of claims payments to identify potential fraud, waste, abuse and/or overpayment. Completes and maintains detailed documentation of audits including but not limited to coding guidelines reviewed, medical necessity documentation, decision methodology, and monetary discrepancies identified. Coordinates overpayment recoveries with the Fraud Investigative Unit Manager. Responsible for assisting the Fraud...

Be Part of an Extraordinary Team Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. Build the Possibilities. Make an Extraordinary Impact. Title : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **Virtual: ** _ _ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates...

It's rewarding to be on a team of people that truly believe in making an impact!We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.**Job Summary**The ACO Coding Auditor is responsible for reviewing medical records and identifying, collecting, assessing, monitoring, and documenting claims and encountering information as it pertains to Medicare Risk Adjustment. You implement ongoing quality improvement activities to assure the Medicare Risk score meets all requirements and act as a consulting MRA advisor to the practices you support. You review practices for both CMS and Commercial ACOs for quality compliance.**Essential Duties & Responsibilities*** Performs on-site and remote clinical validation audits and interpretation of medical documentation to capture all Medicare Risk codes in coordination with the physician.* Provides guidance and consultation to practice team members to drive improved MRA coding...

Job Description Job Description Description: Position Summary: Sage Clinical RCM, LLC is seeking an experienced Outpatient Coding Auditor with a strong background in surgical coding . This role is responsible for auditing outpatient surgical encounters to ensure accurate code assignment, compliance with regulatory guidelines, and adherence to payer and client requirements. The ideal candidate has hands-on experience auditing complex outpatient surgical cases and providing clear, constructive feedback to coding staff. Key Responsibilities: Perform audits of outpatient surgical encounters, including operative reports and related documentation Validate accurate assignment of CPT, ICD-10-CM, modifiers, and applicable APCs Ensure compliance with CMS, payer, and official coding guidelines Identify trends, risks, and educational opportunities based on audit findings Provide written audit feedback and coding education to support quality improvement Collaborate with coding...

A leading healthcare system based in souther Florida is now seeking an experienced Remote Medical Coding Auditor to join their award-winning healthcare organization!Regarded as a leading healthcare provider in the vibrant region of South Florida, this renowned hospital system encompasses a network of expansive facilities known for delivering outstanding medical services and excellent patient care.The organization boasts a comprehensive range of healthcare services, including state-of-the-art emergency care, advanced surgical procedures, and specialized medical practices across various fields.Recognized for its commitment to excellence, the network has achieved numerous awards for quality, safety, and patient satisfaction, reflecting its dedication to healthcare innovation and community wellness.The Remote Medical Coding Auditor is responsible for leading the continuous improvement of the inpatient coding staff.Responsibilities include leading complex coding audits, assess coding...

DRG Coding Auditor Principal _Virtual: _ _ ​_ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group...

Position Summary Department : Patient Accounting- Physicians Status: Full Time Shift: Remote Location: Orlando, FL Title: Physician Coding Auditor Summary: The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding. Forbes has named Orlando Health as one of America's Best-In-State Employers. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. "Orlando Health Is Your Best Place to Work" is not...

About the job Medical Record Audit / Coding Auditor OUR CLIENT is a contracting and data management services organization dedicated to primary care physicians throughout Florida IN THIS ROLE YOU are responsible to assist in the development, undertaking and maintenance of a long term comprehensive, clinical coding audit program for inpatient and outpatient activity. To develop and Implement policies to support the clinical coding audit function Receive, review and communicate findings on patient billing coding related complaints. Identify training needs through the audit program of work and liaise with the clinical coding training manager and audit manager to provide the necessary training identified Conduct routine, risk based, proactive or reactive compliance reviews of procedural and diagnosis coding/billing and medical record documentation performed by clinical service providers Prepare reports as required relative to these monitoring and review...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

Join Datavant, a leading data platform company revolutionizing health data exchange. Our mission ensures that every healthcare decision is guided by the right data at the right time and in the right format. As the world's foremost health data network, our platform enables secure, accessible, and actionable data, empowering healthcare stakeholders including life sciences firms, government agencies, and care providers. By becoming part of Datavant's high-performing, values-driven team, you'll contribute to innovative technology solutions that address some of healthcare's most challenging issues. Our diverse team brings various professional, educational, and life experiences together to achieve our ambitious goals for the healthcare sector. What You'll Be Doing: Conduct audits of coded medical charts according to the client's guidelines as assigned by the quality supervisor. Navigate multiple client guidelines with ease. Maintain a 95% quality average at the...

divh2Coding Specialist/h2pResponsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment./ppstrongMinimum Qualifications:/strong/pp1. Graduate of Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience./pp2. Certification in one of the following: RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), COC (Certified Outpatient Coder), CCS...

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 25 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2024-2025 & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 45 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 extend beyond...

Job Title Performs quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS-DRG, APR-DRGs, and overall coding accuracy retrospectively and concurrently. Provides continuing education to individual coders and the coding staff concerning changes in the coding and reimbursement system and any weaknesses identified during the coding validation reviews. Reviews, analyzes, and interprets clinical documentation, seeking clarification from the physician when discrepancies exist, and effectively communicates with physicians and allied health personnel. Assists with writing compelling appeals to all DRG denials from outside agencies, referencing Official Coding Guidelines and Coding Clinic advice as appropriate to defend the DRG assignment and protect the organization's reimbursement. Serves as a resource to other departments in the Revenue Cycle to ensure business continuity and optimal revenue cycle management. Qualification Requirements High School Grad or Equiv...

Our promise to you: Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address:...

Our promise to you: Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address:...

Physician Compliance Auditor Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal...

Him Coding/Compliance Auditor 2 Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of medical excellence and community care for more than a century. Throughout its rich and storied history, Jackson Memorial - located in the heart of the City of Miami - has been ground zero for some of the world's greatest medical breakthroughs and important moments in South Florida. We've grown into one of the nation's largest public hospitals, and one of the few that is also a world-class academic medical center with a proud mission and proven success. Jackson Memorial is an accredited, tertiary teaching hospital with 1,500 licensed beds, where nearly every medical specialty is provided by some of the world's most skilled and highly regarded multidisciplinary team of healthcare professionals. The HIM Coding/Compliance Auditor 2 analyzes abstracted, coded data for the purpose of ensuring coding accuracy. Serves as a resource for expert knowledge...

About the Job Position Highlights: Compliance Auditors conduct Compliance Department audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including detection and correction of documentation, coding, and billing errors. The Compliance Auditor evaluates the adequacy and effectiveness of controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to professional or hospital documentation, coding and billing, and federal and state regulations and guidelines. The Compliance Auditor communicates audit results to physicians, physician leadership, senior management, management, and staff and provides physician and coder education. The Compliance Auditor will act as a liaison with assigned faculty members, developing relationships and functioning as a resource to all providers and their staffs and will serve as an...