47 coding auditor jobs found

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. 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 increasing the accuracy...

Position Summary The RCS Medical Coding Auditor is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback. The ideal candidate brings strong hands-on experience with professional fee coding , deep knowledge of E/M, surgical, and modifier use , and the ability to translate audit findings into actionable insights. Key Responsibilities Perform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedback Validate ICD-10-CM, CPT®, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelines Conduct medical chart audits of professional services across multiple specialties...

Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry-standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana's internal standards. The Medical Coding Auditor Evaluation & Management will report to the Manager, Medical Coding. WORK STYLE: Remote/Work at home WORK HOURS: Associates will work on EST, regardless of where the associate resides. All associates must start between 6AM-9AM EST, Monday - Friday as a dedicated schedule. Work...

Become a part of our caring community 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 increasing the accuracy of...

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...

A leading health insurance company is seeking an Inpatient Medical Coding Auditor to work remotely. This role involves reviewing inpatient hospital claims and ensuring accurate coding and reimbursement. Candidates should hold an RHIA, RHIT, or CCS certification with substantial experience in coding audits. Strong attention to detail, excellent communication skills, and the ability to manage multiple priorities are essential. The job offers competitive compensation and various benefits to support overall well-being. #J-18808-Ljbffr

Veradigm is seeking an RCS Medical Coding Auditor in Raleigh, NC, to audit professional medical coding. This role requires strong experience with ProFee coding and deep knowledge of relevant guidelines. Ideal candidates will demonstrate excellent communication and analytical skills. Responsibilities include conducting audits, providing education, and ensuring compliance. The position offers a salary range of $57,728-$80,243 and a comprehensive benefits package. #J-18808-Ljbffr

Position SummaryThe RCS Medical Coding Auditor is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback.The ideal candidate brings strong hands-on experience with professional fee coding , deep knowledge of E/M, surgical, and modifier use , and the ability to translate audit findings into actionable insights.Key ResponsibilitiesPerform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedbackValidate ICD‑10‑CM, CPT, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelinesConduct medical chart audits of professional services across multiple specialtiesIdentify coding discrepancies,...

RCS Medical Coding Auditor page is loaded## RCS Medical Coding Auditorremote type: Hybridlocations: Raleigh, NCtime type: Full timeposted on: Posted 7 Days Agojob requisition id: JR10360**Position Summary**The **RCS Medical Coding Auditor** is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback.The ideal candidate brings strong hands-on experience with **professional fee coding**, deep knowledge of **E/M, surgical, and modifier use**, and the ability to translate audit findings into actionable insights.**Key Responsibilities*** Perform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedback* Validate ICD‐10‐CM, CPT(R), HCPCS, and modifier assignment against clinical...

A healthcare solutions company is seeking a skilled RCS Medical Coding Auditor to perform audits on professional fee medical coding. The ideal candidate should possess a CPC certification and 2+ years of ProFee auditing experience, with a strong focus on accuracy and compliance. Responsibilities include conducting daily quality assurance, validating coding against documentation, and providing training to improve coding practices. This position supports hybrid work and includes a competitive salary range of $57,728 to $80,243. #J-18808-Ljbffr

Internal Auditor The Internal Auditor is responsible for conducting regular medical record and coding compliance reviews to ensure that organizational strategies, practices and internal controls are in place and in compliance with all legal and industry regulations. Regularly reviews appropriate federal and state regulations, industry standard policies and procedures, i.e., CMS, AHIMA, AMA, etc., to ensure compliance. Conducts internal audits, following established protocols, furnishing detailed reports and periodic updates of audit findings, presenting any irregularities or exceptions, as well as pertinent recommendations for improvement, to the Provider, Auditing Supervisor, executive management, the Compliance Committee, Physician Board and others as appropriate. Provides feedback and instruction to the Provider regarding documentation improvements, to include EHR best practices. Essential Duties/Responsibilities: Serve as a compliance resource for all coding regulations...

A healthcare data solutions provider is seeking an Inpatient Auditing Specialist who will perform audits on medical records and ensure compliance with DRGs. This fully remote role requires 3+ years of coding and auditing experience and offers a flexible schedule. Responsibilities include conducting audits, providing education, and maintaining communication with healthcare staff concerning clinical issues. Competitive salary and generous benefits are included in the role's compensation package. #J-18808-Ljbffr

BlueCross BlueShield of South Carolina is looking for a qualified candidate for a remote position performing validation reviews of medical records and coordinating rate adjustments. The ideal applicant will have at least 3 years of medical record management experience and hold relevant certifications. Benefits include subsidized health plans, a 401(k) plan, and paid time off, fostering a diverse and inclusive workplace for all employees. #J-18808-Ljbffr

Overview BlueCross BlueShield of South Carolina is a leading national insurance company that has served the South Carolina community for more than seventy years. We are the largest insurance company in South Carolina, a leading administrator of government contracts, and operate one of the most sophisticated data processing centers in the Southeast. With a diverse family of subsidiary companies we deliver outstanding service to our customers and build on diverse business strengths. Position Purpose Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (serious, preventable medical errors) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Location This is a remote position, Monday -...

About The Role The Hybrid Inpatient Coder position plays a critical role in ensuring accurate medical coding and documentation. This involves handling complex case scenarios, applying a combination of facility coding and professional coding, and aligning with industry standards like ICD-10-CM, CPT, and HCPCS codes. The coders will code inpatient facility and inpatient professional rounds and facilitate proper documentation and communication with medical staff to enhance compliance and coding accuracy. Key Responsibilities Accurately assign various medical codes and modifiers for inpatient discharges and surgical procedures. Review and resolve inconsistencies in medical documentation. Educate and provide feedback to providers regarding documentation support. Collaborate with medical coding auditors and provide coding guidance to staff. Utilize Military Health System (MHS) to access and code patient records supporting other facilities. Maintain Defense Health Agency (DHA) coding...

Baylor Scott & White Health is seeking a Physician Compliance Auditor II located in Raleigh, North Carolina. The role involves auditing compliance activities, providing recommendations, and ensuring documentation meets standards across multiple specialties. Candidates should have four years of experience, active coding certification, and a Bachelor's degree. The position is remote and offers a pay range of $26.66 to $40.00 based on experience. Join a diverse workforce dedicated to improving health outcomes. #J-18808-Ljbffr

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 The...

A regional financial institution is seeking a Document Review Specialist to ensure compliance with loan documentation in the real estate process. You will review executed closing packages for accuracy in alignment with federal regulations and internal policies. The ideal candidate has 2-5 years of real estate lending experience and familiarity with regulatory guidelines like TILA and RESPA. Offering a hybrid work model, this role requires attention to detail and excellent communication skills. #J-18808-Ljbffr

Clinical Coding Specialist III Thoroughly reviews patient medical records as required to specifically and accurately code diagnoses and procedures treated or otherwise impacting the patient care. Effectively verifies the electronic medical record contains supporting documentation to justify diagnostic and procedural code assignments and follows up accordingly if questionable. Assists with auditing medical records for quality of coding and to ensure appropriate reimbursement, and reports findings to the Coding Program Manager. Also serves as backup for coding, billing, abstracting, and/or auditing of Outpatient and ED records. The Clinical Coding Specialist III is responsible for remaining current on all ICD and CPT coding changes as well as payer specific requirements and regulations. Responsibilities Coding of complex inpatient records. Successful demonstration of proficiency and compliance with regulatory requirements Identification of principal diagnosis and appropriate...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. Remote Work Location This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Virginia, South Carolina, Tennessee, Florida, and Texas. Occ Summary The Medical Coder Specialist will have frequent and daily interactions with internal and external clients, including but not limited to physician and...

Medical Records Coder II At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Virginia, South Carolina, Tennessee, Florida, and Texas. *Now offering a $10,000 sign-on bonus that will pay out in 4 equal installments over 24 months - 6-month increments. Occ Summary The Medical Records Coder II is a certified coder. Coordinate/review the work of...

Certified Professional Coder II The Certified Professional Coder II is part of a dynamic team of PEDIATRIC Coders supporting patient care by driving accuracy and adherence to coding guidelines, governmental and private Third-Party rules, and regulations. Demonstrating Novant Health's commitment to deliver the most remarkable patient experience, in every dimension, every time. What You Will Do: Schedule: Monday Friday, daytime hours Perform monthly on-site visits to assigned clinics in the Charlotte area. Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and compliance with CMS, NCQA, third party payers and other regulatory agencies. Review and code work queues assigned by applying coding principles for correct coding including sequencing. Query providers for clarification of incomplete or ambiguous documentation as appropriate and monitor for timely responses. Provide education...

Certified Professional Coder III As a Certified Professional Coder III, you will be part of a dynamic team of Cardiovascular Coders supporting patient care by driving accuracy and adherence to coding guidelines, governmental and private Third-Party rules, and regulations. Helping Novant Health deliver the most remarkable patient experience, in every dimension, every time. What You Will Do: Schedule: Monday Friday, daytime hours. Perform monthly visits to assigned clinics in the Charlotte region. Review surgical operative reports and abstract clinical diagnoses, procedure codes, and other pertinent information to bill appropriately for services. Perform coding of cardiovascular events (surgeries, procedures, office visits). Ensure all technical aspects of the assignment of diagnostic and procedure coding are carried out in accordance with established standards and in compliance with CMS, NCQA, third party payers and other regulatory agencies. Ensure physicians are...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington....