45 coding auditor jobs found

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. 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...

Coding Auditor Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings. The posted compensation range of $30.49 - $46.03/hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law. Job Summary and Responsibilities As a Coding Auditor, you will be a central figure ensuring accurate and timely reimbursement by proactively resolving medical coding claim...

Become a part of our caring community The 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 Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

This is a remote based position. Applicants can be located nationwide Back 1d 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...

Become a part of our caring community The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate DRG and ICD-10-CM/ PCS coding assignments for accuracy within the coding disputes team from a variety of medical records. The Disputes Auditor - MSDRG Inpatient Coding on the Disputes Team consults and collaborates with coding professionals within and across departments 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 inpatient coding audits (MSDRG/APDRG) Ensures overall accuracy and compliance of coding disputes reviews by adhering to all appropriate coding guidelines and communicates disputes outcomes to providers in a professional and concise manner. Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices Manages multiple...

City/State: Tarrytown, New York Grant Funded: No Department: REV - Revenue Integrity Engagement Team Work Shift: Day Work Days: MON-FRI Scheduled Hours: 8:30 AM-5 PM Scheduled Daily Hours: 7.5 HOURS Pay Range: $76,632.04-$95,790.05 Job Summary The Senior Coding Auditor performs detailed audits of medical cases to ensure accuracy of assigned codes, charges, availability of documented medical records, medical accounts and compares the cases with the itemized bill and overall procedures. The Senior Coding Auditor reviews and audits current and retro accounts, and reports audit outcomes regarding charge errors, percentage of savings or losses for the facility, data processing errors, the performance of the hospital charging system as well as documentation and justification within the medical record and itemized bill. Works cooperatively with the Associate Directors/Director in the identification of process improvement initiatives related to the coding and charging of hospital services....

A leading health insurance provider based in Olympia, WA, is seeking an Inpatient Medical Coding Auditor. The role involves reviewing inpatient hospital claims for proper reimbursement and requires strong qualifications, including RHIA, RHIT, or CCS certification with MS-DRG experience. This remote position allows for flexible work hours and contributes significantly to cost reduction and accuracy in provider payments. Join a company committed to the well-being of its clients and team members. #J-18808-Ljbffr

Job Summary and Responsibilities As a Coding Auditor, you will be a central figure ensuring accurate and timely reimbursement by proactively resolving medical coding claim defects before billing. You will play a vital role in optimizing our revenue cycle and maintaining financial integrity. Every day, you will meticulously research and review coding-related claim denials, providing expert guidance on corrections to prevent future issues and recover lost revenue. You will also proactively address pre-billing resolution of coding defects, safeguarding against reimbursement impacts. To be successful in this role, you will combine a robust understanding of medical coding and reimbursement methodologies, exceptional analytical skills, and meticulous attention to detail. You will demonstrate a proactive problem-solving approach, driven by a commitment to maximizing financial accuracy and efficiency. As a remote employee, we will provide you with the equipment needed to work from home,...

Montefiore Medical Center is seeking a Senior Coding Auditor located in Tarrytown, New York. This role involves detailed audits of medical cases to ensure coding accuracy, and collaboration with management for process improvement initiatives. The ideal candidate will have a degree in Nursing or a related field and experience in health information systems. With rigorous guidance required for quality assurance and support to the Coding Auditors, strong analytical and communication skills are essential. This position offers a comprehensive insight into hospital billing practices and regulatory compliance. #J-18808-Ljbffr

Virginia Mason Franciscan Health is seeking a remote Coding Auditor to ensure accurate reimbursement by resolving coding claim defects proactively. You will research claim denials and provide expert guidance to prevent future issues. The ideal candidate has a high school diploma or equivalent, at least one year of coding experience, and a relevant certification. This role requires critical thinking, attention to detail, and the ability to work under pressure. #J-18808-Ljbffr

Signature Performance is seeking an Outpatient Coding Auditor for a remote position based in the United States. The ideal candidate will have a passion for performing quality reviews and audits, ensuring standards are met in accordance with policy. The successful candidate will demonstrate skills in organization, professionalism, and coaching while handling multiple projects efficiently. Strong coding knowledge and relevant experience of over 5 years are essential for this role. #J-18808-Ljbffr

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

Datavant in Olympia, Washington is seeking an Inpatient Auditing Specialist to join their remote team. In this role, you will conduct audits related to coding quality and compliance, actively addressing customer needs and delivering exceptional service. Ideal candidates will have at least 5 years of experience in inpatient coding or auditing, with a focus on accuracy and regulatory adherence. Datavant offers a supportive and collaborative work environment with a $2,500 sign-on bonus and comprehensive benefits, including medical, dental, vision, and 401(k) matching. #J-18808-Ljbffr

A leading data collaboration company in Olympia, WA, seeks an Inpatient Auditing Specialist. This role focuses on coding quality, compliance assessments, and education in a fully remote setting with a flexible schedule. Candidates should have 3+ years of experience in inpatient coding and auditing, with a preference for CCS certification. Benefits include competitive salary, sign-on bonus, and comprehensive training. #J-18808-Ljbffr

Description As a key member of the Amazon One Medical Revenue Cycle team the Coding Compliance Auditor will be responsible for supporting Amazon One Medical Clinical and Revenue Cycle teams in managing and optimizing compliant healthcare revenue cycle operations. Demonstrating increased autonomy and strategic thinking and problem-solving skills, this role will perform detailed reviews of medical coding practices to ensure accuracy, compliance with regulatory requirements and adherence to organizational policies and procedures. This role reports into the Coding Compliance Auditing Manager, Revenue Cycle. As someone who naturally enjoys finding ways to improve the status quo, you adeptly identify and create processes necessary to get work done. You comfortably interact with your team members as well as other teams and easily tailor your message and communication style to different audiences. You have a high accountability bar and know how to motivate others, consistently...

Inpatient Facility Medical Coder To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional coding...

Providence in Spokane, United States is seeking a Coding Specialist to educate providers on coding standards and conduct chart audits. You will also answer coding questions and review financial records. A national certification is required, along with 2 years of experience in medical billing and coding. Join our team focused on whole-person care, where your contributions are valued. We empower our caregivers to provide the best patient care, especially for vulnerable communities. #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. Core Values 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 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 Summary The...

Baylor Scott & White Health in Olympia, WA is looking for a Physician Compliance Auditor II to oversee compliance audits and ensure documentation meets standards. Responsibilities include conducting chart audits, providing recommendations, and developing educational materials for staff. Candidates should possess a bachelor's degree and have at least 4 years of auditing experience, alongside active coding certification (CPC or CCS-P). This remote position offers a salary range of $26.66 to $40.00 per hour based on experience. #J-18808-Ljbffr

Inpatient Medical Coder Company Overview Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG is bidding on a federal contract for several coding positions. You would be a W-2 employee with HPMG, not a government employee. Summary Responsible for assigning accurate ICD codes for diagnoses and procedures. The Medical Severity - Diagnostic Related Group (MS-DRG) is automatically assigned by the grouper software for inpatient stays. Inpatient coders may also assign accurate ICD diagnoses, CPT and HCPCS codes, modifiers, and quantities from medical record documentation for professional services (rounds or IBWA encounters). They train and educate military staff on coding issues and play a significant role in coding compliance activities. Mandatory Knowledge and Skills Excellent computer and communication skills for provider and staff interactions. Knowledge of anatomy/physiology, disease processes, medical terminology,...

Billing/Certified Coder The Billing/Certified Coder at Aesthetic Surgery Centre, PLLC plays a critical role in ensuring accurate and efficient medical billing and coding processes that directly impact the financial health of the practice. This position involves meticulously reviewing patient records and surgical documentation to assign appropriate medical codes for procedures and diagnoses in compliance with regulatory standards. The role requires collaboration with clinical staff to clarify documentation and resolve coding discrepancies, thereby optimizing reimbursement and minimizing claim denials. The successful candidate will manage billing submissions, follow up on unpaid claims, and maintain up-to-date knowledge of coding guidelines and payer policies. Ultimately, this position supports the center's mission by facilitating smooth revenue cycle operations and contributing to high-quality patient care through precise administrative practices. Minimum Qualifications:...

Description Coding Specialist is a nationally certified professional coder who educates and support Providers, Division Directors/Managers and clinical staff by providing ongoing coding training to ensure adherence to agency regulations. Coders will conduct random chart audits and provide direct feedback to providers. Coders will be responsible for investigating and answering provider coding questions. Coders will review various data/reports and provide additional feedback. Coders will routinely visit Providence Medical Groups (PMG) clinics and attend clinical meetings. Coders will stay current with annual updates to CPT and ICD-10 and HCPCS codes. Providence caregivers are not simply valued – they’re invaluable. Join our team at Physician Management Group in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them....

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...

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...