112 coding auditor jobs found

Job Summary (Par time-Potential for Fulltime) The Certified ER Medical Coding Auditor is responsible for auditing emergency department medical records to ensure accurate coding, compliance, and optimal reimbursement. This role also includes training and mentoring offshore coding teams to maintain high-quality standards and consistency across operations.  Key Responsibilities Audit ER charts for accurate assignment of  ICD-10-CM, CPT, and HCPCS codes Validate  E/M level selection  for emergency department visits Ensure compliance with payer guidelines and regulatory standards (CMS, HIPAA) Identify  under coding, over coding, and documentation deficiencies  Prepare detailed audit reports with corrective recommendations Provide education and feedback to coders and providers Train and mentor offshore coding teams  on ER coding guidelines and audit findings Conduct regular  quality review sessions and calibration meetings  with offshore staff Develop and update...

Are you ready to make a real difference in people's lives? Join the Harris Center for Mental Health and IDD as a Medical Coding Auditor . Under the direction of the Compliance Manager, the Medical Coding Auditor conducts medical record audits to ensure that documentation meets required standards and regulations. Maintains up-to-date information on all the standards set by JCAHO, Medicare, Medicaid, and other entities relating to medical records. Reviews medical records for coding accuracy and completeness. Prepares audit reports that highlight deficiencies and suggest solutions. Your Role in Action Analyzes medical records and identifies documentation deficiencies. Reviews and verifies documentation supports diagnoses, procedures and treatment results. Identifies diagnostic and procedural information. Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes. Ensures compliance...

Job Description Insight Global is seeking a Medical Coding Auditor for a large healthcare client in Houston, TX. This role is responsible for performing second-level reviews of surgical cases submitted by coders through a designated work queue, with a primary focus on validating the accuracy of surgical procedure codes. The auditor will review cases across multiple surgical specialties, including cardiology and urology, on a daily basis, pulling claims by individual coder to conduct detailed audits. The position requires strong surgical coding experience to determine coding accuracy and compliance, audit coder performance, and ensure quality standards are met. When coders fall below a 95% accuracy threshold, the auditor will provide targeted education, including setting up training sessions and developing PowerPoint presentations to educate coders on new or updated codes. Additionally, this role is responsible for staying current on coding changes related to surgical procedures...

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...

A leading healthcare staffing company is seeking a Medical Coding Auditor in Houston, TX. This role involves reviewing surgical cases to verify the accuracy of coding and providing educational support to coders. Ideal candidates will have 2-5+ years of cardiology coding experience, be CPC or CCS certified, and possess a strong background in various surgical specialties. The position promotes a diverse and inclusive environment where all candidates are considered regardless of their background. #J-18808-Ljbffr

A healthcare organization located in Dallas is seeking a Certified ER Medical Coding Auditor to oversee the auditing of emergency department records. The role focuses on ensuring precise coding and compliance while also training offshore coding teams. Candidates should have 3–5 years of ER coding experience, ideally with auditing experience and relevant certifications. Strong knowledge of coding guidelines and EHR systems is essential. This position offers the potential for full-time employment. #J-18808-Ljbffr

A national healthcare provider is seeking a Medical Coding Auditor/Educator to evaluate and present audit results and educate staff. The ideal candidate will possess certifications in coding and have 3-5 years of relevant experience in hospital administration or multi-specialty practices. Responsibilities include ensuring compliance with coding standards and providing educational resources to physicians and coders. This role may require travel of 25% to 50% monthly, with all expenses reimbursed by the company. #J-18808-Ljbffr

Overview Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care. We have a rich history at Tenet. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many...

Job Description Job Description Hi, we're Oscar. We're hiring a Senior Specialist, Coding Auditor to join our Payment Integrity. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: You will support issue resolution in the Oscar claim environment. You will be responsible for the end-to-end claims repayment quality, process improvement and supporting root cause analysis . You will report into the VP, Payment Integrity. Work Location: This is a remote position, open to candidates who reside in: Tempe, Arizona; Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; New York City, New York; Philadelphia, Pennsylvania; Salt Lake City, Utah. While your daily work will be completed from your...

A healthcare services company in Dallas is looking for a Certified ER Medical Coding Auditor. This role involves auditing emergency department medical records, ensuring accurate coding, and providing training to offshore coding teams. Strong expertise in ER coding and auditing is essential, along with relevant certifications. Candidates should have 3–5 years of ER coding experience and be familiar with EHR/EMR systems. Join us in maintaining high-quality standards in medical coding and compliance. #J-18808-Ljbffr

Position Description Performs medical billing coding and documentation quality audits; provides feedback to coding and reimbursement specialists, coders, and educates them. This job has no supervisory responsibilities. Major/Essential Functions Current and active professional medical billing coding certification required from an accredited organization. Billing and coding experience in a multi-specialty group practice and/or academic practice setting is preferred. Five or more years of health care items/services. Managerial/supervisory and program management implementation experience strongly preferred. Ability to initiate administrative activities as necessary. Excellent oral and written communication skills. Ability to write and present ideas and information in a concise manner. Ability to work collaboratively with all individuals. Professional bearing, sound business judgment and persuasive skills. Strong problem-solving skills, self-starter, ability...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and...

Data Quality Auditor Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). IP, OP Coding: Reviews medical records for the determination of accurate assignment of all documented ICD-10-CM codes for diagnoses and procedures. Abstracts accurate required data elements (facility/client specific elements) including appropriate discharge disposition....

Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: • Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to...

Job Description Job Description Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc.   Job Responsibilities/Duties: · Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or...

Overview This position is responsible for conducting coding audits, communicating results and recommendations to providers, management, and executive administration, and providing training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, CDT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical and/or dental record notes to reported CDT, CPT, HCPCS, and ICD codes with consideration of applicable FQHC and payer/title/grant coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with the Office of the CMO and provider leadership to identify and assist providers with coding. Report findings and recommendations to Compliance Officer or...

OverviewThis position is responsible for conducting coding audits, communicating results and recommendations to providers, management, and executive administration, and providing training and education to providers and ancillary staff.This position will support the implementation of changes to the CPT, CDT, HCPCS and ICD-10 codes on an annual basis.ResponsibilitiesEssential Duties :Conduct prospective and retrospective chart reviews (i.e.baseline, routine periodic, monitoring, and focused) comparing medical and / or dental record notes to reported CDT, CPT, HCPCS, and ICD codes with consideration of applicable FQHC and payer / title / grant coding requirements.Identify coding discrepancies and formulate suggestions for improvement.Communicate audit results / findings to providers and / or ancillary staff and share improvement ideas.Work with the Office of the CMO and provider leadership to identify and assist providers with coding.Report findings and recommendations to Compliance...

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report...

A leading health data platform company is seeking an Inpatient Auditing Specialist to conduct facility coding audits and provide educational support on coding quality. This fully remote role offers a flexible schedule and requires 5+ years of experience in inpatient coding or auditing, preferably with relevant certifications. The ideal candidate will possess strong organizational and teamwork skills and maintain a high accuracy rate in coding operations. #J-18808-Ljbffr

A healthcare organization based in Austin, Texas is seeking a Coding Auditor to conduct coding audits, ensure compliance with medical billing guidelines, and provide training for providers and staff. The ideal candidate should have a minimum of 5 years of healthcare experience and 4 years of coding experience. Relevant certifications are required. This position plays a crucial role in supporting the implementation of coding changes and improving accuracy across the organization. #J-18808-Ljbffr

A healthcare compliance company is seeking a Certified Professional Coder (CPC) to ensure accurate clinical documentation for outpatient behavioral health services. Responsibilities include reviewing medical records, auditing charts for ICD-10 and CPT code assignment, and collaborating with teams for claim submissions. Candidates must hold a CPC certification and have at least 2 years of medical coding experience, demonstrating strong attention to detail and proficiency with EMR systems. This role supports a diverse work environment. #J-18808-Ljbffr

Job Description The Compliance Auditor, Billing and Coding Compliance is responsible for the oversight and management of auditing and monitoring billing and coding compliance activities, assist with internal compliance policies and procedures, completing compliance risk assessments, and developing risk-based educational materials to ensure compliance with federal/state laws and regulations, and UT Health San Antonio policies. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Responsibilities Provide oversight on billing compliance auditing, monitoring, and educational activities within the compliance department. Performs audits of electronic and manual documentation, coding, and billing systems. Conducts close-out meetings with senior management of audited departments. Maintain current knowledge of changes in federal and state coding and billing regulations/guidelines...

We have a Medical Coding Auditor/Educator career opportunity for an experienced professional to join our team at Pediatrix Medical Group. We are a national organization, and one of the nation’s largest providers of prenatal, neonatal and pediatric services. Talented business professionals from diverse backgrounds choose Pediatrix because we are an exciting and innovative company that focuses on a team approach to improve the lives of patients everywhere. We are confident that you'll love being a part of the Pediatrix team. The Medical Coding Auditor/Educator will evaluate, prepare, and present audit results and educational instruction to physicians, coders, and other staff using corporate approved audit and education tools and materials. They will be responsible for accurate and compliant coding and documentation review of pertinent medical records and physician services to identify need for coding education; coding education to physicians, coders, and other staff involved...