35 coding auditor jobs found

A Fortune 100 healthcare company is seeking an experienced Outpatient Medical Coding Auditor to join their team. This remote position involves managing DME coding disputes and ensuring coding accuracy in compliance with guidelines. The ideal candidate holds a CPC or CCS certification and has at least three years of experience in DME coding audits. The role offers competitive compensation, excellent benefits including health insurance and a 401(k) plan, along with opportunities for career development and performance recognition. Applications are accepted until 03-03-2026. #J-18808-Ljbffr

Become a part of our caring community and help us put health first Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Durable Medical Equipment (DME) auditing and is part of the PPI Coding Disputes Team with Humana. The Disputes Auditor - DME Outpatient Coding on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient DME coding disputes and expertise in...

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...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2675 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 knowledge...

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

A healthcare organization is seeking an Outpatient Medical Coder Auditor to support veterans' coding compliance. The role requires expertise in ICD, CPT, and HCPCS coding systems to perform audits and ensure accurate medical coding. Auditors will work part-time, committing to at least 20 hours weekly. Responsibilities include coding, compliance checks, and assisting facility staff with documentation requirements. This position offers flexibility in scheduling from Monday to Sunday. #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

A leading healthcare data solutions provider seeks an Inpatient Auditing Specialist to conduct coding audits and provide education. This fully remote role requires over 5 years of experience in coding and auditing, with a focus on high DRG accuracy. Competitive pay and comprehensive benefits are offered, allowing individuals to work flexibly from home while contributing to improvements in healthcare data management. #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

Description Sierra7 is looking for a Outpatient Medical Coding Auditor to support the Department of Veterans Affairs. The Auditor will have expertise in International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS). The Medical Coding Auditors will serve as experts of current coding conventions and guidelines related to professional and facility coding and perform audits of encounters to identify areas of non-compliance in coding. This is a Part Time opportunity, and we are looking for auditors who can commit to a minimum of 20 hours per week, scheduled at your discretion from Monday through Sunday weekly. Position Responsibilities: Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure...

Outpatient Medical Coder Auditor (Healthcare) Sierra7 is looking for an Outpatient Medical Coding Auditor to support the Department of Veterans Affairs. The Auditor will have expertise in International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS). The Medical Coding Auditors will serve as experts of current coding conventions and guidelines related to professional and facility coding and perform audits of encounters to identify areas of non‑compliance in coding. This is a Part‑Time opportunity, and we are looking for auditors who can commit to a minimum of 20 hours per week, scheduled at your discretion from Monday through Sunday weekly. Position Responsibilities Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures, and the principles and practices of health services to ensure proper...

A leading healthcare provider in Richmond, VA is seeking a qualified individual for a role that includes performing DRG validation reviews and analyzing medical records. The ideal candidate will have RN or LPN licensure, experience with coding regulations like ICD-10, and strong Microsoft Office skills. This position offers a competitive compensation package, generous paid time off, and opportunities for career development within the organization. #J-18808-Ljbffr

A physician-owned healthcare organization is seeking a Compliance Specialist I to work in Newport News, VA. This full-time role involves auditing medical records to ensure compliance with coding practices and interacting with healthcare providers. Candidates should have knowledge of ICD-10 coding and possess an Associates Degree or equivalent, along with relevant certifications. Excellent customer service and communication skills are essential for this position. Join a diverse and inclusive workforce today! #J-18808-Ljbffr

Description The Medical Coder III 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. Accurately assigns Evaluation and Management (E&M) codes, International Classification of Diseases, Clinical Modification (ICD-CM) diagnoses, ICD-10 Procedure Coding System (ICD-10-PCS), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities derived from medical record documentation (paper or electronic) for the professional and institutional (facility) components of inpatient facility discharges (stays); inpatient...

About the Role Loyal Source is looking for a Hybrid Inpatient Coder for employment opportunities at the Naval Medical Center in Portsmouth, Virginia. 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...

Medical Coder Job Duties: Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. 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. Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines. Follows coding conventions. Serves as coding consultant to care providers. Identifies discrepancies, potential quality of care, and billing issues. Researches, analyzes, recommends, and facilitates plan of action...

Job Description Job Description Medical Biller Job Summary Performs billing of clinical services rendered. General Accountabilities Determines appropriate charges based on services provided. Reviews patient accounts to ensure accuracy and completeness of claims billing for maximum reimbursement. Reviews explanations of benefits from third-party payers to determine if payment was made correctly and if denials can be re-billed. Analyzes and maintains reports to ensure timely submission of claims. Identifies problem accounts requiring further work. Provides information to insurance carriers or patients regarding patient accounts. Assists patients with billing problems. Notifies supervisor of ongoing problems. Resolves or clarifies codes or diagnoses with conflicting, missing, or unclear information by consulting with doctors, and the Practice Manager. Audits appeals of denied claims. Maintains files on all documentation, such as charge slips, Explanations of...

Company Description *Candidate should ideally be located in Norfolk, VA or Raleigh, NC* Monro’s family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach. Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company’s regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color. Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto service in the industry. Do you...

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 We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

Job Family : Operational Effectiveness Consulting Travel Required : Up to 25% Clearance Required : Ability to Obtain Public Trust What You Will Do: The Revenue Integrity Analyst (Medical Coding) supports accurate documentation, compliant coding, and optimized charge capture within MHS GENESIS, the Military Health System's enterprise EHR. The role ensures correct configuration of revenue cycle workflows and reduces revenue leakage through data analysis, system support, and cross-functional collaboration. Responsibilities of this role are as follows, to include but not limited to: System Configuration & Workflow Validation Validate, test, and troubleshoot MHS GENESIS / Cerner coding workflows, including charge capture pathways, coding forms, charge router logic, and billing system integrations. Ensure accurate mapping and configuration of ICD-10-CM, CPT/HCPCS, modifiers, clinical documentation, and charge codes across departments....

Job Family : Operational Effectiveness Consulting Travel Required : Up to 25% Clearance Required : Ability to Obtain Public Trust What You Will Do: Guidehouse is seeking a Revenue Integrity Analyst (Medical Biller) with strong billing, coding, and revenue cycle expertise to support the modernization of MHS GENESIS, the DoD's enterprise EHR. The role ensures accurate billing, compliant charge capture, and efficient claim resolution by analyzing data, auditing documentation, and collaborating with clinical, coding, IT, and financial teams across the Military Health System. Responsibilities of this role are as follows, to include but not limited to: Revenue Integrity & Charge Capture Optimize and validate MHS GENESIS / Cerner charge capture workflows, CDM logic, billing rules, and revenue cycle configuration. Conduct charge capture validation, reconciliation of clinical activity to billing outputs, and identification of DNFB risks and...

Essential Duties and Responsibilities: - Abstract and code clinical data. - Audit medical records to ensure compliance with the organization's coding procedures and standards. - Accurately enter coded data in a system and validate data entered. - Research correct coding practices, clearly document and share findings with others. - Review denials and recommend billing corrections. - Train staff members on the coding process. Minimum Requirements - High School diploma or equivalent with 0 - 2 years of experience. - Additional clinical licensure may be required based on project. - Must be a Certified Medical Coder, Certified Professional Coder, or a Certified Coding Specialist. - Knowledge of Medical Billing and Coding Systems such as CPT and HCPCS is essential. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday required. Additional Skills and Experience: - Familiarity with retrospective payment reimbursement highly preferred....

City / State Norfolk, VA Work Shift First (Days) Overview :Sentara Health Plan is currently hiring an Associate Fraud and Abuse Investigator / Certified Professional Coder (CPC) Remote! Status :Full-time, permanent position (40 hours) Work hours :8am to 5pm EST, M-F Location :This position is remote for candidates that live in the following states :VA, NC, AL, DE, FL, GA, ID, IN, KS, LA, ME, MD, MN, NE, NV, NH, ND, OH, OK, PA, SC, SD, TN, TX, UT, WA, WV, WI, WY! With travel to Virginia Beach 1x a year.Job Responsibilities :Responsible for contributing to in-depth investigations for suspected fraud or abuse with respect to provider, pharmacy, employer, member, and broker interactions involving the full range of products.Responsible for contributing to the review of the quality of pharmacy, physician, ancillary and hospital based coding in routine desk audits as well as occasional on-site audits.Contribute to the review of reimbursement systems relating to health insurance claims...

Responsibilities ***Our Business Department is currently welcoming a full time Certified Medical Coder Specialist!*** **This position is fully in-person and not remote** Key Responsibilities: Assemble and analyzes all discharged records and maintains an organized system for notification of deficiencies. Responsible for sending reports to referral sources and healthcare providers as identified. Assigns appropriate medical codes to charts to assure accurate billing. Assists with data collection and presentation for facility PI activities. Responsible for release of medical record information from active and discharge files in accordance with all applicable legal, accrediting and regulatory agency requirements. Files all loose reports into discharged records. Maintains "copy" file and outside information file. Maintains permanent file and incomplete chart file. Coordinates the transcription of dictated or written materials for medical record reports. The...