45 coding auditor jobs found

Compliance Coding Auditor Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year. All queries arising from the audit process are...

Inpatient Medical Coding Auditor – PPI Coding Disputes Reports to the manager and reviews DRG, ICD-10-CM, and PCS coding assignments for accuracy within the coding disputes team. The auditor consults and collaborates with coding professionals across departments to ensure timely, compliant, and high-quality coding dispute outcomes. Responsibilities Review DRG and ICD-10-CM/PCS coding assignments for accuracy. Ensure overall accuracy and compliance of coding dispute reviews by adhering to coding guidelines. Communicate dispute outcomes to providers in a professional and concise manner. Leverage auditing expertise to make coding decisions based on industry guidelines and best practices. Manage multiple priorities and collaborate with peers to ensure timely completion of inpatient coding disputes. Qualifications RHIA, RHIT or CCS certification held for at least four years. Minimum of three years performing inpatient coding reviews or audits in health insurance and/or...

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 39 US states. What We Do We support the mission critical needs of federal agencies 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 Medical Coding Auditor to join our healthcare consulting practice. The...

Join Our Award-Winning Team and Work with the Best! We are thrilled to share that UASI has been recognized as a Top Workplace by the Cincinnati Enquirer in 2022, 2023, and 2024. With over 40 years of experience and enduring partnerships with our valued clients, we are proud of the stability we’ve built and the long‑term success of our dedicated team. We are currently seeking an experienced facility inpatient Coding Auditor to join our team on a full‑time basis. The Coding Auditor will perform inpatient coding audits and review services to client sites remotely from a home office. Additional responsibilities include: Work with clients performing coding audit and/or review services on a variety of Inpatient facility record types Identify trends based on coding audit and review findings and formulate recommendations for corrective action plans Perform necessary research to support findings (e.g., online searches, pulling CMS transmittals, program memorandums) Provide...

Trend Health Partners is looking for an Outpatient Coding Auditor to ensure accurate coding compliant with CMS guidelines. The position offers a salary range of $65,000 to $85,000 and includes a competitive benefits package. Responsibilities include reviewing medical documentation, ensuring coding accuracy for outpatient claims, and assisting in new concept development. Candidates must have a coding certification and proficient knowledge in ICD-10, CPT, and HCPCs coding. A collaborative work environment is fostered with continual development opportunities. J-18808-Ljbffr

3 days ago Be among the first 25 applicants About Performant At Performant, we’re focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Our mission is to offer innovative payment accuracy solutions that allow our clients to focus on quality of care and healthier lives for all. Medical Coding Auditor – Inpatient (Remote) Location: Remote. Full‑time. Salary: $70,000 – $85,000 per year. Key Responsibilities Audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD‑10, CPT, and HCPCS codes. Ensure coding practices comply with federal, state, and payer‑specific regulations and guidelines, including HIPAA and CMS standards. Detect...

A healthcare services provider is seeking an Inpatient Medical Coding Auditor to work remotely. This role involves extracting clinical information from medical records and ensuring proper reimbursement for inpatient hospital claims. Ideal candidates will have at least four years of experience with RHIA, RHIT, or CCS certifications. Benefits include competitive medical, dental, and vision packages along with a 401(k) plan. This position is vital for maintaining accuracy in provider contract payments and improving overall healthcare efficiency. #J-18808-Ljbffr

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...

Compliance Coding Auditor page is loaded## Compliance Coding Auditorremote type: Remotelocations: Norfolk, VAtime type: Full timeposted on: Posted 2 Days Agojob requisition id: JR-99531**City/State**Norfolk, VA**Work Shift**First (Days)**Overview:**# Compliance Coding AuditorPerforms a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines.Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology,...

At TREND Health Partners, a tech-enabled payment integrity company, our mission is to facilitate collaboration between payers and providers for mutual benefit and waste reduction, ultimately improving access to healthcare. We achieve this by aligning the common goals of payers and providers and fostering collaboration through a shared technology platform and seamless workflows. Joining TREND Health Partners means becoming a part of a dynamic growing organization that promotes a collaborative and innovative work environment. Our comprehensive compensation package includes competitive salaries, highly valued health insurance, a 401(k) plan with employer match, paid parental leave, and more. The Outpatient Coding Auditor’s responsibility is to review medical records, clinical documentation, and claims to ensure accurate ICD-10, CPT, and HCPCs coding and compliance with CMS and coding guidelines. The role will be to apply coding principles based on industry standards and...

divh2Clinical Nurse Auditor Payment Integrity/h2pWe are seeking an experienced Clinical Nurse Auditor to join our Payment Integrity team. In this role, you will leverage your clinical expertise, medical coding proficiency, and auditing skills to identify, monitor, and analyze unusual utilization patterns and potential fraud by healthcare providers. You will conduct prepayment claims reviews, post-payment audits, and comprehensive provider record reviews to ensure accurate billing, compliance with payer regulations, and integrity in reimbursement practices. This position requires a Registered Nurse (RN) with coding certifications such as CPC (Certified Professional Coder), CIC (Certified Inpatient Coder), CDI (Clinical Documentation Improvement), or a similar credential, through AAPC or AHIMA. Knowledge of commercial insurance plans, Medicare, and Medicaid programs is essential./ppHow You Will Make an Impact/pulliInvestigations and Audits: Conduct in-depth medical reviews through...

United Cerebral Palsy of Georgia is seeking an Auditor/Educator for Inpatient Coding in Lynchburg, VA. This role involves performing internal coding audits and coordinating coder education within the Health Information Management department. The ideal candidate should have a minimum of 5 years of hospital Inpatient coding experience, an associate degree in health information management, and proficiency with ICD-10 coding systems. #J-18808-Ljbffr

A healthcare organization in Lynchburg, Virginia, is seeking an experienced Auditor/Educator for Inpatient Coding. This role involves conducting internal coding audits, coordinating staff education, and ensuring compliance with coding guidelines. The ideal candidate will have at least five years of inpatient coding experience and strong knowledge of ICD-10 coding. Responsibilities include monitoring coder progress and developing training programs, while also being a resource for the coding staff. Competitive benefits are offered. #J-18808-Ljbffr

Newport News, Virginia FOR APPLICATION REVIEW - PROVIDE YOUR CREDENTIAL OR AHIMA ID NUMBER ON YOUR APPLICATION OR RESUME This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA. Overview Responsible for maintaining coded data quality through ongoing quality review and assessment of outpatient or inpatient records. Performs audits on accuracy of APC or MSDRGs as well as on quality of medical record documentation needed for accurate coding. Works with DRG and CPT denials from commercial payers and writes appeal letters as indicated. What you will do Ensures coding compliance. Applies all coding guidelines and principles as defined in the Coding Clinic and leading authorities. Complies with standardized coding standards, conventions and regulations, corporate compliance standards and reimbursement policies. Identifies training needs and provides education to team members. May teach...

Coding Specialist Newport News, Virginia This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA. Overview Responsible for maintaining coded data quality through ongoing quality review and assessment of outpatient or inpatient records. Performs audits on accuracy of APC or MSDRGs as well as on quality of medical record documentation needed for accurate coding. Works with DRG and CPT denials from commercial payers and writes appeal letters as indicated. What you will do Ensures coding compliance. Applies all coding guidelines and principles as defined in the Coding Clinic and leading authorities. Complies with standardized coding standards, conventions and regulations, corporate compliance standards and reimbursement policies. Identifies training needs and provides education to team members. May teach or coordinate coding huddles. Coaches and mentors staff. Performs focused reviews and quality...

Datavant is seeking a Profee Auditing Specialist to conduct coding audits and ensure compliance within the healthcare sector. This fully remote position requires 5+ years of experience in Professional Fee coding, with a strong emphasis on customer service and leadership skills. The ideal candidate will have a CPC certification and experience with software such as Epic and Cerner, contributing to healthcare data solutions that improve health outcomes. #J-18808-Ljbffr

A leading healthcare data platform company is seeking an Inpatient Auditing Specialist. This remote role requires 5+ years of inpatient coding experience and offers flexible scheduling. Responsibilities include performing coding audits, providing education, and maintaining a 95% DRG accuracy rate. Competitive pay is estimated between $35 - $45 hourly, alongside benefits. Ideal candidates will have CCS or similar certifications. #J-18808-Ljbffr

1 day ago Be among the first 25 applicants This range is provided by TalentPlug LLC. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $55,100.00/yr - $99,000.00/yr Direct message the job poster from TalentPlug LLC The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Position Purpose: Responsible for developing and conducting training and quality auditing programs for the Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care. The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Responsibilities: Conducts auditing of work performed by staff...

Starts out onsite, then transitions to REMOTE 4 days/week. Job Summary: Required Services provide single path medical coding services and related medical records functions. Single path coding combines facility coding and professional coding and allows one coder to code facility and professional codes for the same patient utilizing a single coding platform. perform technically complex professional services coding for medical conditions and assign the correct International Classification of Diseases, ICD-10-CM, Procedure Coding System (PCS) Current Procedural Terminology (CPT), Health Care Financing Administration Common Procedure Coding System (HCPCS), and Evaluation and Management (E&M) codes for diagnosis, acuity of care and procedures for a wide range of medical specialties to include coding of complicated cases identified as difficult to classify such as treatment of burn injuries, combat related injuries, orthopedic surgery, cardiothoracic surgery, interventional...

***To be considered for the role, you must permanently reside in one of the following states: Alabama, Arkansas, Florida, Georgia, Kentucky, Kansas, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, South Carolina, Tennessee, Texas, Virginia, or West Virginia*** The Senior Compliance Auditor reviews complex audits, performs quality assurance reviews, acts as a peer mentor, and assists management with onboarding process of new auditors. The Senior Compliance Auditor supports the audit supervisor with the development and maintenance of the quarterly audit work plan and audit workflow processes. The Senior Compliance Auditor recommends changes to improve business operations by using professional judgement and knowledge of best practices. This position contributes to special projects, as applicable. The Senior Compliance Auditor performs documentation/chart audits on inpatient and outpatient records, and to provide analysis of the records (provider and facility)...

Careers With Purpose Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Job Summary Responsible for conducting internal audits and monitors to ensure that the organization’s processes and operations are in compliance with laws, corporate guidelines, best practices, and contractual agreements. Knowledgeable of general audit concepts and techniques, including the type of audits, the approaches and processes, and the subsequent activities as they relate to internal audits. Demonstrates the ability to interpret Federal rules and regulations. Demonstrates the ability to research regulation from various data sources. Demonstrates an advanced knowledge and skill in analyzing patient records to identify non-conformances in Current...

Posting Details Posting Summary Working Title Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Role Title Role Code FLSA Exempt Pay Band UG Position Number 295A0003 Agency Tidewater Community College Division Tidewater Community College (Div) Work Location Suffolk - 800 Hiring Range Commensurate with qualifications and experience. Emergency/Essential Personnel No EEO Category I-Faculty Full Time or Part Time Part Time Does this position have telework options? -Telework options are subject to change based on business needs- No Does this position have a bilingual or multilingual skill requirement or preference? Work Schedule Varies Sensitive Position No Job Description Tidewater Community College has served South Hampton Roads - both students and employers - for 50 years. It has grown from 1 campus into a regional educational and economic force. TCC is...

Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Tidewater Community College's Workforce Solutions Department seeks an experienced Medical Coder/Auditor to lead a hands-on Certified Professional Medical Auditor (CPMA) exam–preparation course. This position is an adjunct instructor position in the college's non-credit program under Workforce Solutions. This program includes both continuing education for professional development and industry recognized credential attainment, which may be offered Asynchronously, at TCC campuses and other convenient locations throughout the community. The CPMA instructor will prepare students to audit medical records and ensure coding accuracy and compliance. Emphasis is placed on healthcare regulations, documentation review, and revenue integrity. The candidate will deliver engaging CPMA-focused instruction using real-world coding scenarios, chart reviews, and denial analysis. The instructor must be...

Title: Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Agency: Tidewater Community College Location: Suffolk - 800 FLSA: Exempt Hiring Range: Commensurate with qualifications and experience. Full Time or Part Time: Part Time Additional Detail Job Description: Tidewater Community College has served South Hampton Roads - both students and employers - for 50 years. It has grown from 1 campus into a regional educational and economic force. TCC is the largest provider of higher education and workforce services in Hampton Roads, enrolling nearly 25,000 students in 2024-25. Founded in 1968 as a part of the Virginia Community College System, Tidewater Community College (TCC) services South Hampton Roads with 4 campuses in Chesapeake, Norfolk, Portsmouth, and Virginia Beach, 7 regional centers and 2 important cultural institutions. The college had 3,399 graduates in 2024-2025, 40 percent of whom pursued degrees...