154 coding auditor jobs found

Position Description The Documentation and Coding Auditor supports the billing compliance program by helping prevent, detect, and respond to billing, coding, reimbursement, and documentation risks. This role conducts proactive monitoring, auditing, education and risk assessment activities while also responding to identified concerns, audit findings, regulatory changes, and reported compliance issues. Major/Essential Functions Plan and perform proactive compliance activities, including risk-based audits, pre-bill or concurrent reviews, data monitoring, targeted education, policy or template reviews, and department consultations. Identify and address billing compliance risks before issues escalates by using audit trends, payer updates, denial patterns, regulatory changes, stakeholder feedback, and risk assessment results. Partner with departments before new services, workflows, locations, provider groups, or documentation tools are implemented to assess and reduce billing,...

Documentation & Coding Auditor 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. Travel Required: Up to 25% Pay Basis: Hourly Location: Amarillo Shift: Day 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...

The Texas Tech University Health Sciences Center is seeking a Documentation & Coding Auditor to conduct medical billing coding and documentation quality audits. In this role, you will provide essential feedback to coding specialists and work collaboratively within the team. This position requires strong problem-solving skills and an active professional coding certification. An ideal candidate will have at least five years of experience in medical billing coding and reimbursement, along with knowledge in CPT, ICD-CM, and related coding systems. You will also be responsible for participating in compliance symposiums and conducting annual risk assessments. #J-18808-Ljbffr

HCC Coding Auditor Senior - Health Plan NetworkUS:TX:Irving | Revenue Cycle Audit | Full TimeHCC Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is an onsite position with a remote option.Responsibilities:Perform Medical Record reviews and audits based on organizational priorities. These can include both prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing. Review and audits may lead to the addition, deletion,...

HCC Coding Auditor - Health Plan NetworkUS:TX:Irving | Medical Coding | Full TimeThe HCC Coding Auditor will perform code audits and abstractions using the Official Coding Guidelines for ICD-10-CM and AHA Coding Clinic Guidance, following all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor will be involved with quality assurance auditing and risk adjustment code abstraction for the following programs: Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is a hybrid role.Responsibilities:Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.Performs Medical Record reviews and audits based on organizational priorities. These can include prospective and concurrent Clinical Documentation Improvement (CDI) workflows and retrospective auditing. Review and audits may lead to the addition,...

CHRISTUS Health is seeking a Senior HCC Coding Auditor to perform audits, abstractions, and quality reviews aligned with ICD-10-CM and CMS HCC guidelines. This onsite role offers a remote option within a hybrid structure, supporting Commercial and Medicare Advantage risk adjustment programs. The ideal candidate will have 3+ years of hospital coding/audit experience, AHIMA or AAPC certification, and strong communication skills to educate providers on documentation and coding best practices. #J-18808-Ljbffr

Hendrick Health in Abilene, Texas is seeking a Coding Auditor. The role involves conducting coding compliance audits for inpatient and outpatient encounters and validating coding assignments following established guidelines. Candidates should have an Associate's degree in a relevant field and five years of coding experience. The position requires a strong attention to detail, proficiency in MS Office, and excellent interpersonal skills. A coding certification is preferred. This is an opportunity to work in a supportive environment with a focus on accuracy and productivity. #J-18808-Ljbffr

Risk Adjustment Coding Auditor Role type: Risk Adjustment Coding Auditor Quantity of resources: 2 Duration: 6 months This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's. Required Skillset MS Suite CPC certified CRC certified 5+ years of risk adjustment experience #J-18808-Ljbffr

Baylor Scott & White Health in Dallas is seeking a Coding Auditor I to perform coding quality audits, advise coders, and ensure accurate ICD‑10, HCPCS, and CPT coding. This role emphasizes collaboration with Clinical Documentation Specialists to improve documentation quality and compliance. The position requires 5 years of coding experience with at least 1 year as an auditor and certification in RHIA/RHIT/CCS/CCS‑P/CPC/COC/CIC/CIRCC. On-site role with comprehensive benefits plan. #J-18808-Ljbffr

Job Overview Role type: Risk Adjustment Coding Auditor. Quantity of resources: 2. Duration: 6 months. JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's. Required Skills MS Suite CPC certified CRC certified 5+ years of risk adjustment experience Equal Opportunity Statement We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. #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. 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 an 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...

Certified ER Medical Coding AuditorThe 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 ResponsibilitiesAudit ER charts for accurate assignment of ICD-10-CM, CPT, and HCPCS codesValidate E/M level selection for emergency department visitsEnsure compliance with payer guidelines and regulatory standards (CMS, HIPAA)Identify under coding, over coding, and documentation deficienciesPrepare detailed audit reports with corrective recommendationsProvide education and feedback to coders and providersTrain and mentor offshore coding teams on ER coding guidelines and audit findingsConduct regular quality review sessions and calibration meetings with offshore staffDevelop and update training materials, Review SOPs, and coding...

Certified Medical Coding AuditorIntegrative Emergency Services, LLC ("IES") is seeking a Certified Medical Coding Auditor with emphasis on auditing surgical services. Although a CPMA is preferred, a related certification from AAPC or AHIMA is acceptable. The Coding Auditor is responsible for accurate professional fee coding and documentation review for assigned surgical service lines (URSA/NTCC/TSN). This role evaluates medical records to ensure proper CPT, HCPCS Level II, and ICD-10-CM code assignment in accordance with payer guidelines and regulatory standards. This role supports documentation integrity, identifies coding compliance risks (including undercoding, overcoding, and unbundling), and contributes to clean claim submission and optimal reimbursement through coding analysis, audits, and special projects. Candidates can work in either a hybrid or remote setting. If remote, must reside in a state IES operates in: AZ, CO, TX, OK, IN, MO, AL, SC, FLIES is dedicated to...

Summary: HCC Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is an onsite position with a remote option. Responsibilities: Perform Medical Record reviews and audits based on organizational priorities. These can include both prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk adjustment. Perform code...

Job Description Job Description Role type: Risk Adjustment Coding Auditor Quantity of resources: 2 Duration: 6 months JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's. Required skillset: MS Suite CPC certified CRC certified 5+ years of risk adjustment experience

Position Description Performs 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 This position is based in Lubbock; however, weekly travel to and from Amarillo will be required for training. Plan and perform proactive compliance activities, including risk-based audits, pre-bill or concurrent reviews, data monitoring, targeted education, policy or template reviews, and department consultations. Identify and address billing compliance risks before issues escalate by using audit trends, payer updates, denial patterns, regulatory changes, stakeholder feedback, and risk assessment results. Partner with departments before new services, workflows, locations, provider groups, or documentation tools are implemented to assess and reduce billing, coding, documentation, supervision, and reimbursement risks. Maintain or...

This is a remote based position. Applicants can be located nationwide Back 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...

Vytwo Technologies Inc. seeks a Risk Adjustment Coding Auditor to perform first and second pass auditing for CMS RADV programs. The role supports a small team with two resources over a 6-month duration, ensuring accuracy and compliance in coding and documentation. The candidate should be a certified risk adjustment coder with CPC and CRC credentials and at least five years of risk adjustment experience. #J-18808-Ljbffr

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

Remote Chicago - 550 Van Buren North Carolina Nevada Virginia Texas Florida Maryland Tennessee New York-New York City Wyoming Idaho Massachusetts Michigan-Other West Virginia-Other Nebraska Maine West Virginia-Charleston Washington-Seattle Wisconsin Pennsylvania-Pittsburgh Colorado-Denver California-San Francisco Vermont Delaware-Wilmington Iowa Ohio-Other District of Columbia Georgia Missouri-St. Louis New Hampshire Indiana-Other Mississippi Pennsylvania-Philadelphia Minnesota Arkansas Utah Missouri-Kansas City Kentucky-Other Michigan-Detroit New Jersey Montana California-Los Angeles Alabama-Other New Mexico North Dakota South Carolina Rhode Island Full time JR-0015943 Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives,...

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...

Coding Compliance Auditor Conducts coding compliance audits of inpatient and outpatient encounters to validate code assignment. Follows the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. Job Requirements Minimum Education Associates degree in relevant field preferred or combination of equivalent of education and experience Minimum Work Experience Five (5) years coding experience including; but not limited to; hospital inpatient and outpatient encounters Required Licenses/Certifications AHIMA and/or AAPC Coding Credential; CCS preferred Required Skills; Knowledge; and Abilities Ability to consistently and accurately audit coding of inpatient and outpatient encounters Ability to create clear and concise audit reports and maintain productivity standards Must successfully pass pre-hire coding assessment Knowledge of medical terminology;...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We’re Looking For: As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical...

Datavant is seeking a meticulous HCC Auditor to translate clinical documentation into precise ICD-10 codes for risk adjustment and reimbursement. You will audit charts, adapt to multiple client guidelines, and uphold high quality in a remote, fast-paced environment. Required are 2 years of HCC coding and auditing experience, ICD-10 expertise, and AHIMA/AAPC credentials. Strong communication and organizational skills enable success across projects and teams. #J-18808-Ljbffr