43 coding auditor jobs found

Professional Coding Auditor/Education Specialist Job Location: SGMC Patient Financial Services Department: Revenue Cycle Medical Group Schedule: Full Time, 8 HR Day Shift, 8-5 on site Position Summary This position requires on-site presence at SGMC Health Main Campus. Remote work is not available for this role. The ideal candidate for the Professional Coding Auditor/Education Specialist role will be a Certified Professional Coder (CPC), with preference given to those holding a Certified Professional Medical Auditor (CPMA) or Certified Documentation Expert Outpatient (CDEO) certifications, although relevant experience may substitute for these credentials. The candidate must have a strong foundation in medical coding, including extensive knowledge of ICD-10, HCPCS, and CPT, along with expertise in multispecialty and complex coding, and experience in abstracting E/M and CPT codes. Proficiency in anatomy and physiology, medical terminology, and regulatory compliance related to...

Description WHAT IT'S LIKE AT SGMC HEALTH Purpose . No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place. Excellence . We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service. Team Spirit. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. Award Winning Performance. We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides. WHY YOU WILL LOVE SGMC HEALTH SGMC has great benefit options, depending on the role that you are going into- including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities...

Become a part of our caring community The 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 Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

Inpatient Drg Coding Auditor Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs...and more! Job Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. Reviews...

Become a part of our caring community The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate DRG and ICD-10-CM/ PCS coding assignments for accuracy within the coding disputes team from a variety of medical records. The Disputes Auditor - MSDRG Inpatient Coding on the Disputes Team consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality. Will be an experienced medical coding auditor with in-depth experience in inpatient coding audits (MSDRG/APDRG) Ensures overall accuracy and compliance of coding disputes reviews by adhering to all appropriate coding guidelines and communicates disputes outcomes to providers in a professional and concise manner. Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices Manages multiple...

Professional Coding Auditor & Educator The Professional Coding Auditor & Educator works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Responsibilities: Responsible for reviewing and analyzing all aspects of the department clinical documentation and care to ensure timely, accurate, and compliant charge capture and submission Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges Collaborates with Coding Supervisor to ensure clinical documentation in high-risk areas is consistent and complete Identifies...

This is a remote based position. Applicants can be located nationwide Back 1d Outpatient Coding Auditor #2814 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced...

Coding Auditor - Professional Coder Auditor-Professionals are responsible for auditing of coding assignment with providers and coders, training of coding professional staff, pro-fee based coding includes the assignment of Assigns ICD-CM, CPT, HCPCS codes, E&M assignment, modifiers, and charge posting. Interacts with medical staff, nursing, ancillary departments, provider offices, and outside organizations. Department: Physician coding Hours: Full-Time, 40 hours a week required Required: High School Diploma, CPC, CEMA within 6 months of hire, CPMA within 1 year of hire Pay: Based on experience, starting at $23.87/hour Location: Remote or onsite: At this time, you must reside in one of the following locations: Alabama, Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, New Mexico, Ohio, Oklahoma, South Carolina, Tennessee, Texas Responsibilities Assists coders with coding questions.,...

A healthcare institution in Valdosta, GA is seeking a Professional Coding Auditor/Education Specialist. The ideal candidate will be a Certified Professional Coder (CPC) with expertise in medical coding including ICD-10, HCPCS, and CPT. Strong analytical skills and proficiency in Microsoft Office are essential for this full-time on-site role. Responsibilities include conducting audits, educating healthcare providers, and developing training materials to improve coding compliance and efficiency. Competitive benefits include 401(k), healthcare options, and tuition reimbursement. #J-18808-Ljbffr

South Georgia Medical Center seeks a Professional Coding Auditor/Education Specialist to conduct audits, educate healthcare providers, and manage coding compliance. Ideal candidates should hold a Certified Professional Coder (CPC) certification, with a strong foundation in medical coding, including knowledge of ICD-10, HCPCS, and CPT. The position is full-time, requiring on-site presence in Valdosta, Georgia, and offers benefits such as healthcare insurance, 401(k) with match, and tuition reimbursement. #J-18808-Ljbffr

Emory Healthcare is seeking an experienced Inpatient DRG Coding Auditor in Atlanta, Georgia. The role involves reviewing inpatient medical records for coding accuracy and completeness, conducting audits, and coordinating with clinical staff to improve documentation. Candidates should have a Certified Coding Specialist (CCS) certification and a minimum of five years of experience in ICD-10 coding within an acute care setting. The position offers comprehensive health benefits and additional support programs to ensure your professional growth. #J-18808-Ljbffr

Signature Performance is seeking an Outpatient Coding Auditor, located remotely within the continental United States, to conduct quality reviews and audits of coding practices. This full-time position emphasizes standards compliance and offers opportunities for educating staff on coding accuracy. Minimum requirements include a formal coding credential and over 5 years of medical coding experience. Benefits include health insurance, paid time off, and tuition assistance. #J-18808-Ljbffr

The Professional Coding Auditor & Educator works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Responsibilities: Responsible for reviewing and analyzing all aspects of the department clinical documentation and care to ensure timely, accurate, and compliant charge capture and submission Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges Collaborates with Coding Supervisor to ensure clinical documentation in high-risk areas is consistent and complete Identifies inconsistencies in medical reports and works...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

DEPARTMENT: Physician Practice Management FACILITY: Medical Office Building WORK TYPE: Full Time SHIFT: Daytime SUMMARY: Assess the educational needs of coding specialists and providers regarding coding and documentation and direct development of effective regularly scheduled educational programs that meet the needs of the health system. Serve as the primary resource to physicians for documentation and coding issues. Conduct ongoing coding and billing training programs for billing and coding specialists and providers. Creates presentations, develops learning material, handbook, and other training materials. Conducts coding and data quality reviews and prepares complex reports as required. Ensures all education activities comply with clinical billing standards and government regulation with concentration on hospital inpatient procedures, ambulatory, and specialty physician services. RESPONSIBILITIES: * Keeps abreast of pertinent federal, and state regulations...

Datavant is seeking an Inpatient Auditing Specialist to join their team in Atlanta, Georgia. This remote position focuses on coding quality and compliance within a collaborative environment. Key responsibilities include performing coding audits and providing coder education. The ideal candidate will have 5+ years of experience in inpatient coding, maintain a high DRG accuracy rate, and possess familiarity with tools like Epic and Cerner. Competitive benefits and a sign-on bonus are offered. #J-18808-Ljbffr

A leading health data platform company in Atlanta is seeking an Inpatient Auditing Specialist to conduct coding audits and provide educational support. This fully remote role requires 3-5 years of auditing experience, particularly in Trauma Level 1 facilities. Candidates should possess strong organizational and communication skills as they collaborate with healthcare professionals to enhance coding quality and compliance. Competitive pay ranges from $35 to $45 per hour, along with comprehensive benefits. #J-18808-Ljbffr

A leading healthcare provider is seeking a Specialty Coder II to work remotely, requiring residency in Florida, Georgia, North Carolina, or South Carolina. This role involves assigning diagnosis and procedural codes, auditing documentation, and mentoring other coders. Candidates should have a Certified Professional Coder certification and at least two years of coding experience. BayCare offers competitive benefits including medical, dental, and education assistance. #J-18808-Ljbffr

A consulting firm based in Hinesville, GA, seeks a Lead Medical Coder and Auditor to support U.S. Armed Forces health facilities. The successful candidate will ensure accurate coding of medical records and perform quality checks to comply with federal regulations. This full-time position demands a minimum of 2 years of coding experience and relevant certifications. The role offers competitive compensation, comprehensive benefits, and opportunities for professional development. #J-18808-Ljbffr

Compliance Audit And Analysis Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more Description Reporting to the Manager, Compliance Audit and Analysis, develops and executes audit, monitoring, and education for inpatient hospital billing, coding and documentation programs that ensure compliance with regulatory standards. Continuously evaluates inpatient hospital/clinical billing compliance activities to assess compliance with the Compliance Audit and Analysis...

Lead Medical Coder and Auditor ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. ProSidian Seeks a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on athe medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land dominance, across the full range of military...

Lead Medical Coder and Auditor [PR0001D] Full‑time ProSidian is looking for “Great People Who Lead” at all levels in the organization. Are you a talented professional ready to deliver real value to clients in a fast‑paced, challenging environment? ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. Linking strategy to execution, ProSidian assists client leaders in maximizing company return on investment capital through design and execution of operations core to delivering value to customers. Visit www.ProSidian.com or follow the company on Twitter at www.twitter.com/prosidian for more information. ProSidian Seeks a Lead...

Description Certified Medical Coder/Biller Location Richmond Hill, GA | Hybrid Remote Employment Type Full-time Reports to Billing Manager Department Revenue Cycle Management Job Summary The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key Responsibilities Claims Processing: Prepare and submit accurate and timely insurance claims for services rendered. Verify patient insurance coverage and ensure correct billing to the appropriate payer. Review and process Explanation...

The Supervisor, Claims Audit – A&H Core Team, is responsible for leading a team of claims auditors focused on reviewing and rendering decisions on liability for claims made under Medical Stop Loss policies issued to Skyward non‑captive insurance clients. This role oversees the claims audit process for accident and health captive programs, ensuring claims are handled accurately, efficiently, and in accordance with company standards and client expectations. The manager will guide and support staff, ensure compliance with audit protocols, and partner with stakeholders to drive quality results and client satisfaction. This position will work a hybrid schedule in our Kennesaw, GA office. Essential Duties And Responsibilities Supervise, train, and mentor the Claims Audit team, ensuring adherence to claims audit standards and achievement of performance goals Oversee audits of medical claims across Skyward insurance programs (monitoring over/under payments, duplicate payments,...