29 coding auditor jobs found

Welbehealth Pace Program WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits and...

Job Description Job Description Inpatient Medical Coding Auditor/Trainer- Lead (ON-SITE) Walter Reed National Military Medical Center ABOUT US: Laredo Technical Services, Inc. provides staffing services to federal Government agencies all over the world.   LTSi connects the right opportunities to the right people.  With our experience in placing our Team Members throughout the United States and overseas, we excel at providing experienced, professional personnel for a wide range of Professional and Office Administration as well as Medical Services. Our goal is to provide the highest quality professionals in the industry. LTSi’s culture delivers a strong work ethic while going above and beyond with a sense of urgency.  We are an employee-driven company.  We strive for excellence every day, which is what sets us apart from all the other government contractors. As a Certified Service-Disabled Veteran Owned Small Business (SDVOSB) Minority Business...

A leading health insurance company is seeking a Medical Coding Auditor who will review medical claims against records, ensuring proper coding and compliance. This role offers 100% remote work and requires extensive knowledge of outpatient coding and relevant certifications. Candidates should have at least three years of post-certification experience, strong analytical and organizational skills, and proficiency in Microsoft Office. A competitive salary range of $59,300 – $80,900 is offered, along with comprehensive benefits including health insurance and a 401(k) plan. #J-18808-Ljbffr

Become a part of our caring community and help us put health first 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...

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g., ICD‑10‑CM, CPT, HCPCS). The role requires interpretation and independent determination of the appropriate courses of action, contributing to overall cost reduction by increasing the accuracy of provider contract payments in our payer systems and ensuring correct claims payment for appropriate CPT/HCPCS code assignments. The Auditor analyzes, enters and manipulates database data, responds to or clarifies internal requests for medical information, understands departmental, segment and organizational strategy and operating objectives, and follows established guidelines and procedures while making decisions in ambiguous situations. Where you come in The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g.,...

A leading health solutions company in Maryland seeks a Certified Professional Coder (CPC) to review medical claims ensuring coding compliance. The role necessitates strong coding knowledge and the ability to identify errors and fraud. Required qualifications include AAPC certification and at least 3 years of coding or auditing experience. Benefits include comprehensive medical plans, a 401(k), and flexible work schedules. Commitment to diversity is emphasized, and applications close on 01/15/2026. #J-18808-Ljbffr

Summary Who We Are: LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to "improve the health of people in the communities we serve." Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care. The Health Information Management Department supports the mission and goals of Sinai Hospital, Northwest Hospital, Carroll Hospital, Levindale and Grace Medical Center by providing appropriate and timely access to health information for continuity of patient care and other authorized requests. REMOTE WORK OPPORTUNITY Acceptable remote locations: District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia, Reviews medical records for coding accuracy (I10 and CPT) and DRG (CMS or APR) assignment. Develops and provides a structured reporting and education process for HIM...

Job Description I. General 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. II. Principal Responsibilities and Tasks The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified. 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. Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and...

Summary Who We Are: LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to "improve the health of people in the communities we serve." Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care. This position is located on the campus of Carroll Hospital in Westminster, MD. Consideration will be given for a potential hybrid work model after 6 months of successful employment. About the Role: Supports the LifeBridge Health Institutional Compliance. The auditor works under the under general direction of the Director of Institutional Compliance to perform institutional (e.g., hospital, post-acute care (DME, Home Health, etc.) compliance related audit activities to ensure compliance with federal health care program requirements and federal and state laws and regulations. Responsible...

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company...

Coding Specialist Under general supervision, collects data by abstracting, assessing and analyzing demographic and clinical information to accurately assign the appropriate ICD-10-CM codes and CPT codes. Education Associates Degree preferred. Experience At least 3 years of CPT and ICD-10-CM coding experience with certification. 3 years of radiology/interventional radiology coding and charging experience preferred. Knowledge of specialty coding including wound care. Other combinations of formal education, training and experience may be considered. Skills Knowledge of medical terminology and anatomy and physiology Knowledge in all aspects of Radiology and Interventional Radiology and wound care coding Knowledge of coding guidelines as set forth by Official Coding Guidelines, Coding Clinic. Ability to keep current with recent trends within the industry Skill in using computers and software applications Ability to interpret medical terminology in order to code records...

Lead Coding Specialist Adventist HealthCare seeks to hire an experienced Lead Coding Specialist for our Medical Coding Department who will embrace our mission to extend God's care through the ministry of physical, mental, and spiritual healing. As a Lead Coding Specialist, you will: Conduct reviews to validate I-10-CM diagnosis codes and PCS procedure codes for inpatient bill hold related to PSI, PPC & other reimbursement conventions to be resolved prior to final coded data. Manages daily DNFB and DNFC reports and work queues for un-coded or outstanding records. Under the direction of the coding manager, the coding specialist lead should be proficient in communicating with the coding team. Oversees coding corrections, abstracts elements for HSCRC submissions, and ensures coding compliance with coding standards. Liaison between coding and other departments, managing coding-related tasks and denials. Provides mentoring support to coders on coding questions/reviews and...

Job Description Job Description Description: At HeiTech Services, our employees are our biggest assets. HeiTech Services is dedicated to attracting highly skilled and motivated professionals. We value our employees. We offer our employees challenging opportunities that facilitate professional growth and development while also providing the support you need to succeed. We are committed to your success because we understand that our employees are the driving force behind HeiTech Services’ continued growth. Our mission is to help the Federal Government keep Americans safe. * Non-patient care role. This position is responsible for reviewing, prioritizing, and analyzing adverse medical events related to medical devices that are submitted on MedWatch reporting forms via hard copy or electronically to our customer, the Food and Drug Administration (FDA). Additionally, this position is responsible for processing and coding a variety of reports from device...

Introduction Grade: 20 Location of Position: 100 South Charles Street, Baltimore, Maryland 21201 Main Purpose of Job The main purpose of this position is to supervise a staff of UI Contributions Tax Auditors assigned to ensure fair and equal administration of Unemployment Insurance law to all Maryland employers. This position educates Maryland employers, accountants, and attorneys about the Maryland Unemployment Insurance program and state and federal unemployment insurance laws. The Auditor VI position supervises the assigned team of Auditors IV to Auditors I with the audit staff. This position ensures efficient resource management and quality customer service within the Field Investigation and Audit Unit. Position Duties Position duties include but are not limited to the following: Supervise and assist in the training of UI Contributions Tax Auditors, and perform audits, disputed claims, claimant questionnaires, delinquency collection, and special investigation assignments...

Description Performs functions such as reviewing documentation and selecting the appropriate procedure and / or diagnosis code to be entered in billing documents. Insures that teaching physician requirements are met and are clearly reflected in the documentation; and other duties as assigned. ESSENTIAL FUNCTIONS Selects the appropriate procedural and diagnostic code based on provider documentation, utilizing HIPAA Standardized Code Set and applying CMS/payor guidelines. Ensures that teaching physician documentation and billing requirements are met and are clearly reflected. Review provider coding and provide training and feedback on coding questions and issues. Assists billing and collections staff with denials and charge correction requests as needed. Continually refreshes and applies knowledge of government regulations as they relate to coding and billing. Performs internal pre-pay audits based on compliance guidelines when required. Communicates with physicians about...

Overview This position is contingent upon the successful award of the associated contract. Employment is not guaranteed until the contract is awarded, and the position is officially activated. Job responsibilities and requirements are subject to change. Medical Reviewer, Certified Coder About J29 At J29, we believe in empowering our employees to do great things for the benefit of others. Our culture is built on purpose, service, and impact — not just for our clients, but for our communities. We are a mission-driven, people-first organization that believes strong culture, thoughtful leadership, and meaningful philanthropy are inseparable from business success. Key Responsibilities RVC Reviewers perform both automated and complex reviews of Medicare Fee-for-Service (FFS) claims—including Part A/B, DMEPOS, and Home Health/Hospice—to assess overpayments, underpayments, and proper payments as determined by Recovery Audit Contractors (RACs). They apply Medicare policies and...

Candidate should ideally be located in Baltimore, MD Monro’s family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach.  Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company’s regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color.  Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto service in the industry.  Do you have what it takes to shape a...

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 24 US states. What We Do We support the mission critical needs of federal agencies and commercial businesses 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 Outpatient Medical Coder...

Datavant is a leading data platform company revolutionizing health data exchange. Our mission is to ensure that every healthcare decision is made with the right data, delivered timely and in the appropriate format. Powered by the most extensive health data network in the U.S., our platform guarantees secure, accessible, and usable data to enhance health decisions. We are proud to be trusted by the foremost life sciences organizations, government bodies, and healthcare providers. By joining our team, you will be part of a high-performing and values-driven culture. Together, we are addressing some of healthcare's most challenging issues with innovative technology solutions. We embrace a diverse array of professional and personal experiences among our team members as we pursue our ambitious goals for healthcare. What We're Seeking We are on the lookout for seasoned and certified inpatient coders to join our team. The perfect candidate will have exceptional attention to...

Job Title: Inpatient Coder Shift time: can vary but needs to be day time hours Time zone: MUST Reside on CST/EST Equipment: Facility will NOT provide equipment. Contractors must have their own equipment for contract duration Conversion: The role is a temp to perm opportunity (cannot hire from Alaska, California, or Hawaii) JOB SUMMARY: General Summary: Under direct supervision, accurately codes hospital inpatient accounts for the purpose of appropriate reimbursement, research, statistics and compliance to federal and state regulations in accordance with established ICD-10-CM/PCS coding classification systems. Responsibilities and Tasks: *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. *Analyzes, codes and abstracts complex inpatient cases such as trauma, rehab, neurology, critical...

About Integrated Management Strategies (IMS) LLC We area women-owned small business and management consulting firm that provides an array of business and technical services. IMS is headquartered inthe Washington, D.C. metropolitan area, with employees across 24 US states. What We Do We support the mission critical needs of federal agencies and commercial businesses 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 Outpatient Medical Coder to join our healthcare...

Description At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact-whether we're supporting data-driven decisions, modernizing systems or safeguarding critical programs. We are seeking a detail-oriented and experienced Medical Coder to support Risk Adjustment and Medicare Part C audits by accurately coding inpatient, outpatient, and physician office medical records. The ideal candidate has a strong understanding of ICD-9-CM/ICD-10-CM coding guidelines and consistently demonstrates high accuracy and productivity. Responsibilities: Perform diagnosis coding of inpatient, outpatient, and physician office medical records...

Description At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact-whether we're supporting data-driven decisions, modernizing systems or safeguarding critical programs. We are seeking an experienced and detail-oriented Senior Medical Coder to support our Medicare Part C Risk Adjustment Data Validation (RADV) initiatives. The ideal candidate will have strong experience in ICD-9-CM/ICD-10-CM coding across various care settings, including inpatient, outpatient, and physician office encounters. The candidate will perform diagnosis coding, support intake reviews, conduct appeal responses, and contribute to quality assurance...