50 coding auditor jobs found

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...

Medical Coding Auditor Responsible for the creation and maintenance of audit and education programs that will ensure success for all staff and employed providers based on their specific needs and support accurate, compliant coding practices for ECU Health Physicians in accordance with coding guidelines. Conducts internal auditing of medical coding activities using concurrent, prospective and retrospective models as appropriate and/or required. Reviews electronic health information to determine accuracy of coding, billing and documentation, including validation of ICD10CM, CPT, HCPCS and modifier assignment related to medical provider professional Part B services according to regulatory and institutional policy. Reports findings, both written and verbal, to leadership as necessary to include provision of corroborating regulatory or policy guidance. Maintains documentation of all audit activities and communicates the findings with leadership. Utilizes findings to generate topics...

Baylor Scott & White Health is seeking a Coding Auditor I to perform coding quality audits and provide feedback to coders using ICD-10-CM/PCS, HCPCS, CPT and related references to ensure accurate classification and billing. The role collaborates with Clinical Documentation Specialists, abstracts data, and completes production coding when required. A certified coder with 5 years of experience (RHIA/RHIT/CCS/CCS-P/CPC/COC/CIC/CIRCC) is preferred, with at least 1 year as an auditor. #J-18808-Ljbffr

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

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. Our Core Values are: 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:...

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...

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

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...

CaroMont Health in Gastonia, NC seeks a compliance auditor/coder to implement and maintain a system-wide program ensuring accurate coding and documentation in line with federal guidelines. The role leads provider meetings, prepares audit reports, and supports risk assessments and annual planning. Requires a health information management degree or 5–10 years of audit/coding experience, plus CPC/COC/CCS certifications and strong regulatory knowledge. #J-18808-Ljbffr

Job Summary Assists with implementing and maintaining a system-wide effective compliance program through performance of compliance and coding quality audits. Under indirect supervision, assures appropriateness and accurate coding assignments in accordance with federal coding regulations and guidelines. Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to professional and facility fee documentation, coding and billing, including CMS and OIG compliance standards. Leads meetings with providers to review the audit findings and recommend ways to improve when indicated. Prepares written reports of findings. Also responsible for providing assistance with coding inquiries from providers, coders, billing staff, etc. Monitors relevant resources and publications related to high-risk compliance areas. Serves as an audit software system administrator as assigned. Serves...

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

Serco Inc. in the United States seeks qualified Medical Coding Auditing Specialists to support the DHA Medical Coding Program Branch. The role focuses on audits across DHA Markets to ensure ICD-CM, CPT, HCPCS, and DRG compliance while contributing to enterprise risk assessment. Candidates will audit DHA facilities, help develop annual work plans, and assist with government surveillance activities. A HIM/health information management background and professional coding certifications are required. #J-18808-Ljbffr

What We’re Looking For: The Provider Practice Coding Consultant role is an opportunity to make a significant impact in the field of medical coding. You will provide essential consulting services and educational support, guiding healthcare professionals on improved coding practices. Collaborating closely with key stakeholders such as clients and healthcare leaders, you'll meet and exceed customer expectations through identifying and proposing solutions, and being a responsible and reliable teammate. This role offers a unique opportunity to play a pivotal role in elevating coding quality, ensuring compliance, and optimizing service outcomes in both hospitals and alternative care settings. What You Will Do: Review medical records and assign precise codes to ensure accurate coding aligned with client needs (CPT, ICD-10-CM, ICD-10 procedures, ICD-10-CM and ICD-10 PCS, HCPCS). Conduct data quality reviews of records to assess compliance with official coding and documentation...

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,...

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. *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 subordinate employees and assist...

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 site visits to assigned clinics in the Charlotte, NC area. 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...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

UNC Health Care in North Carolina seeks a healthcare coder to capture data from medical records for reimbursement, statistics, research and benchmarking. You will work daily with the CDI Auditors as part of the Clinical Documentation Improvement Team (CDI) and support accurate documentation. Requires RHIT/RHIA or CCS credentials, an associate degree in Health Information Technology or Nursing (LPN/RN), 3 years of healthcare coding experience, and ICD-9/ICD-10 proficiency. #J-18808-Ljbffr

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Join First Choice Community Health Centers Nestled in the heart of North Carolina, Harnett County offers a unique blend of small-town charm and convenient access to big-city amenities. Located less than an hour from both Raleigh and Fayetteville, residents enjoy the tranquility of rural living with the benefit of nearby urban excitement. At First Choice, we're proud to offer employment opportunities in this beautiful area, giving you the chance to work in a close-knit community while staying connected to the vibrant Triangle region. With a perfect balance of peaceful + affordable living and easy access to cultural and career opportunities, Harnett County is an ideal place to call home. Position Summary The Medical Billing Specialist will be responsible for billing and collections for Medicare, Medicaid, Insurance, and Self Pay patients for all Medical and Dental clinics. Responsibilities of individual Billing Specialist will vary depending on assignment of responsibilities...

Revenue Cycle Manager Responsible for billing team leadership, subject matter expertise and performing a variety of regular tasks to ensure timely and comprehensive billing and collections for Medical and Dental services rendered by First Choice Community Health Center (FCCHC) providers. Supervises billing specialists to ensure all tasks are completed timely and accurately. The Revenue Cycle Manager is expected to devote 50% of work time to learn leadership and subject matter expert responsibilities. The Revenue Cycle Manager should proactively seek to further develop billing process competencies; and assist in implementation of process improvements. Team Leadership Supervise and coordinate the workload of the billing staff to ensure all task are completed accurately and in a timely manner. Define and communicate current and new billing tasks and definitions of the billing team. Recommend and report billing issues of concern related to clinic operations. Run, work and...