61 coding auditor jobs found

Elevance Health is seeking a DRG Coding Auditor – MS-DRG and APR-DRG to audit inpatient records, review coding accuracy, and support recoveries across lines of business. The role supports a virtual, hybrid work model with in-person training sessions and occasional onsite requirements. Experience with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG is essential, with RHIA/RHIT/CCS/CIC/CCDS certifications preferred. Opportunities span multiple U.S. #J-18808-Ljbffr

Location: Norfolk, Virginia, United States Salary: $92,880 - $160,218 Company: Elevance Health Posted: 2026-08-19 DRG Coding Auditor – MS-DRG and APR-DRG Virtual: This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Responsibilities Audits inpatient medical records and generates high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Performs clinical reviews...

Sentara Health Plans in Norfolk, VA, is seeking a Compliance Coding Auditor to perform internal coding audits, physician education, and AR query management. The role requires expertise in CCI, NCD, and HCC guidelines, and mastery of MPFS impact on RVU for NPP services. Remote work is favored for VA/NC candidates. Ideal candidates have CPC/CCS certification and 4+ years of multi-specialty coding experience, including acute care outpatient coding and professional fee coding. #J-18808-Ljbffr

Location: Norfolk, Virginia, United StatesSalary: $92,880 - $160,218Company: ElevancehealthPosted: 2026-09-07Location: Norfolk, Virginia, United StatesSalary: $92,880 - $160,218Company: ElevancehealthPosted: 2026-09-04Location: Norfolk, Virginia, United StatesSalary: $92,880 - $160,218Company: ElevancehealthPosted: 2026-08-31Location: Norfolk, Virginia, United StatesSalary: $92,880 - $160,218Company: Elevance HealthPosted: 2026-08-19DRG Coding Auditor - MS-DRG and APR-DRGVirtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development . Alternate locations may be considered if candidates reside within a commuting distance from an officePlease note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance...

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...

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...

## Compliance Coding AuditorApplyremote type: Remotelocations: Norfolk, VAtime type: Full timeposted on: Posted Yesterdayjob requisition id: JR-104491**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, including the impact on Relative Value Unit...

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, 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 managed...

Commence is seeking a part-time Coding Specialist to support clinical documentation reviews and coding audits. The role involves remote and office work with healthcare data, ensuring accuracy and compliance while communicating findings clearly to hospitals and clients. Ideal candidates have 2+ years in outpatient coding/audit roles, familiarity with ICD-10-CM/PCS, CPT/HCPCS, and DRG/APRDRG, and a Bachelor’s degree with relevant licensure or credentials such as RHIA/RHIT/CCS. #J-18808-Ljbffr

Medical Auditor (Billing & Coding)At OrthoVirginia, you're part of a team dedicated to delivering expert orthopedic and therapy care across the state. As Virginia's largest provider of musculoskeletal care, we offer full-time and part-time opportunities in a collaborative, team-oriented environment.With more than 159 physicians in over 35 locations—including Lynchburg, Northern Virginia, Richmond, Southwest Virginia, and Hampton Roads—OrthoVirginia is a leader in orthopedic surgery, non-surgical care, and physical, hand, and occupational therapy. Our nationally recognized specialists treat a full range of musculoskeletal injuries and conditions, helping patients of all ages move, heal, and thrive.Join us and become part of a trusted network committed to excellence in orthopedic care.Responsible for conducting coding and documentation audits for assigned providers and consulting and educating providers on documentation requirements and other compliance issues related to...

Medical Auditor (Billing & Coding) At OrthoVirginia, you're part of a team dedicated to delivering expert orthopedic and therapy care across the state. As Virginia's largest provider of musculoskeletal care, we offer full-time and part-time opportunities in a collaborative, team-oriented environment. With more than 159 physicians in over 35 locations—including Lynchburg, Northern Virginia, Richmond, Southwest Virginia, and Hampton Roads—OrthoVirginia is a leader in orthopedic surgery, non-surgical care, and physical, hand, and occupational therapy. Our nationally recognized specialists treat a full range of musculoskeletal injuries and conditions, helping patients of all ages move, heal, and thrive. Join us and become part of a trusted network committed to excellence in orthopedic care. Responsible for conducting coding and documentation audits for assigned providers and consulting and educating providers on documentation requirements and other compliance issues related...

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

The Enterprise Compliance Auditor/Educator will assist with the implementation and facilitation of ongoing compliance auditing, monitoring, and educations associated with all provider services across WVUHS and its affiliates. The duties of this position will help ensure that all healthcare provider (MD/DO, APP, and other non-physician practitioners) organizations remains in compliance with all federal healthcare program rules, regulations, administrative requirements and guidance. MINIMUM QUALIFICATIONS EDUCATION, CERTIFICATION, EXPERIENCE, AND/OR LICENSURE: High School Diploma or Equivalent AND Seven (7) Years of experience in multi-specialty coding, E&M coding, procedural/surgical coding OR ; Associate’s Degree AND Five (5) years experience in multi-specialty coding, E&M coding, procedural/surgical coding. Current certification in one of the following: Certified Professional Coder (CPC)through the American Academy of Professional Coders (AAPC) Registered Health...

West Virginia University Health System is seeking an Enterprise Compliance Auditor/Educator to support ongoing auditing, monitoring, and education across WVUHS and affiliates. The role ensures provider organizations meet CMS, state, and payer regulations, with emphasis on documentation, coding accuracy, and medical necessity. The incumbent will lead audits, prepare comprehensive reports, and deliver education programs for physicians, APPs, and staff. #J-18808-Ljbffr

The Enterprise Compliance Auditor/Educator will assist with the implementation and facilitation of ongoing compliance auditing, monitoring, and educations associated with all provider services across WVUHS and its affiliates. The duties of this position will help ensure that all healthcare provider (MD/DO, APP, and other non-physician practitioners) organizations remains in compliance with all federal healthcare program rules, regulations, administrative requirements and guidance. MINIMUM QUALIFICATIONS EDUCATION, CERTIFICATION, EXPERIENCE, AND/OR LICENSURE: High School Diploma or Equivalent AND Seven (7) Years of experience in multi-specialty coding, E&M coding, procedural/surgical coding OR ; Associate’s Degree AND Five (5) years experience in multi-specialty coding, E&M coding, procedural/surgical coding. Current certification in one of the following: Certified Professional Coder (CPC)through the American Academy of Professional Coders (AAPC) Registered Health...

West Virginia University Health System is seeking an Enterprise Compliance Auditor/Educator to support ongoing auditing, monitoring, and education across WVUHS and affiliates. The role ensures provider organizations meet CMS, state, and payer regulations, with emphasis on documentation, coding accuracy, and medical necessity. The incumbent will lead audits, prepare comprehensive reports, and deliver education programs for physicians, APPs, and staff. #J-18808-Ljbffr

About the Position The positions fall under the Defense Health Agency (DHA) Atlantic Network at the Naval Medical Center Portsmouth, Patient Administration Department (PAD) providing guidance and functional expertise to improve coding accuracy, and functioning primarily as a medical auditor/trainer. (See duties below). This is a Direct Hire Solicitation. Qualifications Who May Apply: US Citizens. In order to qualify, you must meet the experience requirements described below. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional...

Job Title Essential Duties and Responsibilities These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned. Coordinate, supervise, and respond to third-party patient bill audits. Perform patient-requested audits in a timely manner. Perform random quality audits as schedule permits. Assist Patient Account personnel with patient questions about itemized charges. Maintain reporting systems for audit activities and identify patterns and trends in results. Act as a resource for all hospital departments regarding charging questions and issues. Routinely review inpatient and outpatient records for appropriate coding and charging. Provide educational sessions for revenue-producing departments regarding appropriate charging processes and procedures. Work cooperatively with the Patient Accounting staff and other healthcare professionals in obtaining correct HCPCS codes and modifiers. Assist the Health...

Job Posting About the Position: The positions fall under the Defense Health Agency (DHA) Atlantic Network at the Naval Medical Center Portsmouth, Patient Administration Department (PAD) providing guidance and functional expertise to improve coding accuracy, and functioning primarily as a medical auditor/trainer. (See duties below).

Summary With direction from the Director, the Nurse Auditor/ Senior Revenue Integrity Specialist is responsible for auditing itemized charges versus the patient medical record and other applicable hospital documentation, assigning modifiers to appropriate claims, researching edited claims for medical necessity, and advising the billing staff of appropriate HCPCS codes and modifiers. The Nurse Auditor/ Revenue Integrity Specialist works directly with revenue producing departments regarding lost charges, billing questions, and proper coding and charging. The nurse auditor reviews documentation on all Observation accounts for carve-out observation hours, the charge coding of ED Visits and Injection and Infusion charges. Essential Duties and Responsibilities Coordinate, supervise, and respond to third party patient bill audits. Perform patient requested audits in a timely manner. Perform random quality audits as schedule permits. Work and review a high volume of accounts assigned to...

Essential Duties and Responsibilities These duties and responsibilities represent the general tasks performed on a daily basis; other tasks may be assigned. Coordinate, supervise, and respond to third‑party patient bill audits. Perform patient requested audits in a timely manner. Perform random quality audits as scheduled. Assist Patient Account personnel with patient questions about itemized charges. Maintain a reporting system of audit activities and identify patterns and trends of results. Act as a resource for all hospital departments with charging questions and issues. Routinely review inpatient and outpatient records for appropriate coding and charging. Provide educational sessions for revenue‑producing departments regarding appropriate charging process and procedures. Work cooperatively with the Patient Accounting staff and other health‑care professionals in obtaining correct HCPCS codes and modifiers. Assist the Health Information Department with RAC requests,...

Amazon.com Services LLC in Arlington, VA is seeking a Medical Coder I to support the One Medical Senior Health Revenue Cycle by reviewing coding accuracy for office visits and procedures. You will assign ICD-10-CM, CPT and other codes in a production environment, ensuring compliance with guidelines. The role emphasizes auditing, timely responses to email requests, and collaboration with the Medicare Risk Operations team to drive positive program outcomes. #J-18808-Ljbffr

Overview Join the Indian Health Service and make a meaningful impact in Native communities. In this role, you will support vital healthcare operations that ensure patients receive timely, high-quality care. If you’re looking for a rewarding career where your work directly supports patient services and community well‑being, we encourage you to apply. Real ID Requirement A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021). Responsibilities Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final diagnoses accurately reflect care provided. Reviews provider documentation to ensure appropriate Evaluation and Management (E/M) levels and correct CPT code assignment. Assigns and sequences ICD, CPT, HCPCS, CDT, and DSM codes based on documented...

Supervisor- Emergency Transport-Prince William Medical Center Job Description Job Code: SU2000 Full Time Days/Mid-shifts FLSA Status: Non -Exempt About Us We are welcoming a new era in healthcare where achieving good health is just the beginning. AtUVACommunity Health, we believe in caring for the whole person by getting to know – and making connections with – our patients. By combining the talent andexpertiseof our people, the breadth of capabilities across our system, and our commitment to helping our communities get better and stay healthy, we are improving the patient experience. As aUVACommunity Healthteam member, you will have a voice in patient care decisions, support the most advanced medicaltechnologiesand llena strong senseof satisfaction from making a difference in people’s lives every day. Job Summary The Supervisor, Emergency Transport provides day-to-day operational and clinical oversight of ambulance and patient transport servicesfor assigned site specific...