35 coding auditor jobs found

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...

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...

At Children's Wisconsin, we believe kids deserve the best. Children's Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country. We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today. Please follow this link for a closer look at what it's like to work at Children's Wisconsin: https://www.instagram.com/lifeatcw/ The Coding Auditor and Educator should be proficient in coding and...

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world. At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you're interested in joining a health care system that is changing the face of care and well-being in our community, we...

6AM City, LLC seeks a Medical Coding Auditor to ensure compliance with official coding guidelines and conduct thorough data audits. You will review medical records, validate coding assignments, and communicate findings effectively through various means. The ideal candidate has a strong understanding of ICD-9-CM and CPT-4 coding, excellent attention to detail, and is able to work independently. The role may include both virtual work and some physical demands. #J-18808-Ljbffr

Gainwell Technologies is seeking a Senior Associate for the Outpatient Coding Auditor position, responsible for conducting coding reviews of medical records to ensure compliance with guidelines. The ideal candidate will have at least 2 years of experience in coding or auditing, as well as the necessary professional credentials. This position offers a remote work environment with benefits starting on the first day. The pay range is between $70,000 to $80,000 annually, with multiple additional perks including flexible vacation, a 401(k) match, and various development opportunities. #J-18808-Ljbffr

6AM City, LLC seeks a Medical Coding Auditor to ensure compliance with official coding guidelines and conduct thorough data audits. You will review medical records, validate coding assignments, and communicate findings effectively through various means. The ideal candidate has a strong understanding of ICD-9-CM and CPT-4 coding, excellent attention to detail, and is able to work independently. The role may include both virtual work and some physical demands. #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....

Gainwell Technologies is seeking a Senior Associate for the Outpatient Coding Auditor position, responsible for conducting coding reviews of medical records to ensure compliance with guidelines. The ideal candidate will have at least 2 years of experience in coding or auditing, as well as the necessary professional credentials. This position offers a remote work environment with benefits starting on the first day. The pay range is between $70,000 to $80,000 annually, with multiple additional perks including flexible vacation, a 401(k) match, and various development opportunities. #J-18808-Ljbffr

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings and recommendations...

A leading medical coding firm is seeking an experienced CPC certified medical coder in Texas to conduct coding audits and provide litigation support. Candidates should have a minimum of 5 years of coding experience, with at least 3 years in Texas. The role includes performing audits, conducting reviews for medical necessity, and preparing documentation. The firm offers a comprehensive benefits package, including medical, dental, vision coverage and a 401k plan with company match. #J-18808-Ljbffr

Datavant is looking for an Inpatient Auditing Specialist to join their remote team. The successful candidate will conduct coding audits, provide education, and maintain high standards of accuracy while working flexibly from home. The role requires at least 5 years of experience in facility inpatient coding and knowledge of EMRs like Epic and Cerner. Benefits include a competitive salary, medical coverage, and training from professionals. #J-18808-Ljbffr

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings and...

A healthcare organization in Wisconsin is seeking a coding auditor to conduct billing and coding audits, provide training, and ensure compliance with regulations. The ideal candidate has extensive experience in procedural and diagnostic coding, with relevant certifications. Strong attention to detail and communication skills are essential. This position offers a chance to work within a collaborative environment focused on compliance and accurate reporting. #J-18808-Ljbffr

A healthcare organization in Wisconsin is seeking a coding auditor to conduct billing and coding audits, provide training, and ensure compliance with regulations. The ideal candidate has extensive experience in procedural and diagnostic coding, with relevant certifications. Strong attention to detail and communication skills are essential. This position offers a chance to work within a collaborative environment focused on compliance and accurate reporting. #J-18808-Ljbffr

A leading medical institution in Wauwatosa seeks a Coding Specialist to serve as an expert in multi-specialty documentation, coding, and billing. This role involves auditing coding practices, educating clinicians and coding staff, and maintaining compliance with regulations. Candidates should have a Bachelor's degree, 6 years of experience in medical coding, and relevant certification. The salary range is between $74,500 and $94,900 annually, with excellent benefits included. #J-18808-Ljbffr

CorroHealth Inc in Wisconsin is looking for a qualified Coding Auditor to perform complex analyses of medical records to identify errors and ensure compliance. The position requires a recognized coding credential and at least two years of related experience. The Coding Auditor will collaborate with coders, providing technical support and monitoring quality. Strong communication and analytical skills, coupled with attention to detail, are essential for success. The role offers a supportive work environment with opportunities for professional development. #J-18808-Ljbffr

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data integrity and validation of the coded information for external and internal affairs. This position typically reports to the Coding Compliance Manager. Minimum Qualifications Education: High school diploma or GED, required....

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data integrity and validation of the coded information for external and internal affairs. This position typically reports to the Coding Compliance Manager. Minimum Qualifications Education: High school diploma or GED, required....

Baylor Scott & White Health is looking for a Physician Compliance Auditor II to conduct audits and evaluate compliance, ensuring documentation accuracy for various services. The role requires strong knowledge in CPT, ICD-10, and HCPCS coding, with a preference for candidates with coding certification. This position is 100% remote and offers a pay range of $26.66 to $40.00 based on experience. The ideal applicant should have extensive auditing experience and be able to educate staff on compliance matters. #J-18808-Ljbffr

Outpatient Coder Team Lead – Remote page is loaded## Outpatient Coder Team Lead – Remotelocations: West Allis, WItime type: Full timeposted on: Posted Todayjob requisition id: R13818*At Children’s Wisconsin, we believe kids deserve the best.**Children’s Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country.**We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today.****Please follow...

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...

JOB SUMMARY: The primary purpose of the position is to review both procedural and diagnostic (ICD-10) coding to ensure appropriate billing and insurance regulations are met. This position will be staffed during clinic hours and is largely remote. Occasionally in-person meetings with providers will be required. Must live within reasonable traveling distance from Hudson, WI.CORE DUTIES AND RESPONSIBILITIES:Have in-depth understanding of coding and compliance rules and regulations.Responsible for reviewing provider documentation, coding and posting charges for healthcare services; including Primary Care, Lab/Pathology, Podiatry and more.Provide coding education and engage with assigned providers.Research and communicate governmental and payer-specific rules and regulations to ensure coding compliance.Identify and communicate best practices based on provider documentation, insurance payer medical policies and CMS guidelines.Review, code and post charges for hospital outpatient and...

ThedaCare Coder (Clinic - III) The Coder (Clinic - III) performs coding review for surgical specialties for ThedaCare Physician Services to accurately reflect services rendered. Reviews and processes charges using industry standard methodologies (CPT, ICD-10-CM, HCPCS), abides by Standards of Ethical Coding (AAPC/AHIMA), and complies with official coding guidelines and other regulatory requirements. Audits medical record documentation and educates providers on documentation improvement opportunities and risks. Educates and trains new team members to department standards. Mentors and observes team members in department responsibilities. Upholds and demonstrates department expectations and accuracy in regards to coding responsibilities including payer denials and claim edits. Job Description: Schedule: Full time, benefit eligible 40 hrs/week Business hours (i.e 8:00am-5:00pm) Remote Position Preferred skill set and experience strong in surgical coding; Urology...