Coding auditor and educator jobs

Full Time

Riverside University Health System Medical Center Hybrid (Riverside, CA, USA)

Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience in an acute care hospital...

Uo

Health Information Coder 3, Per Diem

University of California San Francisco, CA, USA

Health Information Coder 3, Per Diem HIMS Per Diem 87476BR Job Summary The Health Information Coder III is a senior-level inpatient coder with the knowledge and skill set to utilize the ICD-10-CM and ICD-10-PCS classification systems to code acute academic, teaching inpatient cases. The skill set extends to knowledge and comprehension of code sequences into Diagnoses-Related Groups on acute academic, teaching inpatient cases. Cases are coded to comply with the official guidelines for coding and reporting, practice standards and code of ethics for HIMS coder. Cases are abstracted according to UCSF Health policies and procedures. The focus of coding and abstracting is on a range of all primary hospital services. There is minimal review of coding for quality. DUTIES AND ESSENTIAL JOB FUNCTIONS Retrieve and analyze comprehensive medical records and information systems for appropriate documentation and follow-up as appropriate. Evaluate full episode of care of...

AH

Sr. Certified Coder, Acute Inpatient

Adventist Health Roseville, CA, USA

Job Description Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work. Job Summary: Reviews inpatient records to identify the diagnosis and procedure codes performed during the patients stay are valid and in accordance with coding conventions and guidelines. Records types including inpatient encounter types. Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work. Job Requirements: Education and Work Experience: High School Education/GED or...

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Sr Coder

Common Spirit Health Rancho Cordova, CA, USA

Sr Coder 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 138 hospital-based locations, in addition to its home-based services and virtual care offerings. The posted compensation range of $32.38 - $48.17 /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 Senior Coder, you will act as the lead coder for your designated team. This position will train staff on department policies, procedures,...

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Medical Coder

THE CLINIC INC Los Angeles, CA, USA

Medical Coder Conduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare Risk Adjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding. Essential Duties and Responsibilities: Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records audit HEDIS coding and record collection Report Coding discrepancies patterns identified within the chart review process to the...

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OP Coder Auditor Trainee

Prime Healthcare Ontario, CA, USA

Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation’s leading health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team! Responsibilities The Outpatient Coder Auditor Trainee reviews and analyzes documentation present in the medical record for outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Outpatient Coder Auditor Trainee finalizes the coding and abstracting of the medical record upon ensuring the assignment of...

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Certified Biller Coder Specialist

Bakersfield American Indian Health Project Bakersfield, CA, USA

Hours Per Week: 40 Job Type: Full-time, Non-Exempt Summary/Objectives of Position The Certified Biller & Coder Specialist's responsibility is to ensure the smooth facilitation of communication with funding sources, program partners, and insurance companies. This position will spend most of the time interpreting patient files and using established systems that make it easy for insurers to recognize the type of treatment covered under a patient’s plan. The day-to-day work of the Certified Biller & Coder Specialist includes proper coding of services, procedures, diagnoses, and treatments. Preparing and sending invoices or claims for payment. It is the responsibility of the position to gather documentation to validate the coding choices and argue against any wrongfully denied claims. They analyze all parts of a patient’s visit, including diagnostic tests, consultations, in-office procedures, and prescribed medication. Essential Duties, Functions &...

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Operational Compliance Auditor

Metropolis Corp Los Angeles, CA, USA

Who we are The real world is the next frontier, and at Metropolis, we are creating the artificial intelligence to make it responsive. We are pioneering the Recognition Economy - a future where mundane repetition disappears and being known unlocks access, comfort and belonging everywhere you go. From transforming parking into a seamless drive-in, drive-out experience for millions of Members to expanding our intelligence layer across retail and hospitality, we are building a world that feels instinctive and magical. The future isn't coming; it's here, and we need builders, innovators and problem solvers to help us create it. Who you are Metropolis is seeking an Operational Compliance Auditor to add value and improve our operations by bringing a systematic and disciplined approach to the effectiveness of risk management, control, and governance processes. The ideal candidate possesses thorough knowledge of accounting procedures and sound judgment, as you will review control...

Da

Inpatient Medical Coder - FT - Up to $5,000 Sign on Bonus

Datavant Sacramento, CA, USA

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...

DH

Sr Coder

Dignity Health Rancho Cordova, CA, USA

Job Summary and Responsibilities As a Senior Coder, you will act as the lead coder for your designated team. This position will train staff on department policies, procedures, systems and correct coding requirements. The Sr. Coder additionally will monitor staff workload, audit coders, fill in for out of office coders, and make recommendations to Physician Coding leadership to help improve the efficiency of the team. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time. Train all new coders on department policies, procedures and correct coding principles Provide routine education,training and auditing to their designated coding teams Analyze coder's workload and make recommendations to assigned supervisor to ensure all...

TS

Health and Information Management - PB / ProFee Coder

TALENT Software Services Sacramento, CA, USA

Overview Coding Educator (Temp-to-Hire, 13 Weeks) – Location: Within *** Footprint (Hybrid – Mostly Remote with Local Travel). Type: Contingent / Temp-to-Hire. is seeking experienced Professional Fee (Pro Fee)–focused Coding Educators to support large-scale chart review, coding accuracy validation, physician education, and documentation improvement initiatives. These roles are high-visibility and require strong communication and presentation skills to engage directly with clinicians and support Sutter's revenue cycle, audit, and education functions. Candidates must live within the *** geographic footprint and be available for occasional on-site work and local travel. Positions are structured as 13-week temp-to-hire with conversion opportunities. Key Responsibilities Coding Education & Training: Deliver physician and coder education for assigned groups, with emphasis on Pro Fee (ASC, surgery, outpatient) environments. Facilitate individual and group training sessions; must...

AF

Medical Biller/ Collector

All For Health,Health For All INC Glendale, CA, USA

Job Description Job Description All for Health, Health for All, Inc. (AFH) is a nonprofit Federally Qualified Health Center (FQHC) and a certified Patient-Centered Medical Home. For over 40 years, we have provided high-quality, accessible healthcare services to medically underserved and diverse populations across Los Angeles County, Orange County, and the state of Nevada. Our integrated, team-based model includes general family practice, pediatrics, behavioral health, mental health services, and adult day health care. In the past year alone, we served over 30,000 patients across more than 90,000 visits at a dozen clinic locations. AFH is currently seeking dedicated and compassionate individuals to join our mission-driven team. We are hiring Full-Time medical biller/collector. SUMMARY An individual must be able to perform each essential duty satisfactorily which includes billing, posting payments, answering patient questions and concerns by phone or personally in fast-paced,...

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Medical Coder

To Help Everyone Health & Wellness Centers Los Angeles, CA, USA

Job Description Job Description South Los Angeles based FQHC looking for onsite Certified HCC coder . *This is not a remote position Conduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare Risk Adjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding. Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records audit HEDIS coding and record collection...

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Revenue Tax Auditor Supervisor

Louisiana Los Angeles, CA, USA

Overview At the Louisiana Department of Revenue, we are dedicated to fairly and efficiently administering the state’s tax laws to ensure compliance while providing exceptional customer service. We are committed to fostering public trust, enhancing economic growth, and maximizing revenue collection to support essential services that benefit all citizens of Louisiana. We’re looking for a Revenue Tax Auditor Supervisor to join our Field Audit Income Tax Division to supervise and coordinate tax audits for various tax types! Experience requirements: Seven years of experience in tax accounting or tax auditing; OR six years of full-time experience in any field plus twenty-four semester hours in accounting plus four years of experience in tax accounting or tax auditing; OR a bachelor’s degree with twenty-four semester hours in accounting plus four years of experience in tax accounting or tax auditing; OR a bachelor’s degree in accounting, finance, business administration,...

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HEALTH CODER - HCC & RISK ADJUSTMENT

North East Medical Services Burlingame, CA, USA

Health Coder - Hcc & Risk Adjustment Salary Range $42.79 - $48.75 Hourly Overview The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance. Essential Job Functions HCC Coding and Risk Adjustment (RA) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines. Ensure all coding adheres to CMS and ICD-10...

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Health Information Coder 3, Per Diem

University of California Emeryville, CA, USA

Health Information Coder 3, Per Diem The Health Information Coder III is a senior-level inpatient coder with the knowledge and skill set to utilize the ICD-10-CM and ICD-10-PCS classification systems to code acute academic, teaching inpatient cases. The skill set extends to knowledge and comprehension of code sequences into Diagnoses-Related Groups on acute academic, teaching inpatient cases. Cases are coded to comply with the official guidelines for coding and reporting, practice standards and code of ethics for HIMS coder. Cases are abstracted according to UCSF Health policies and procedures. The focus of coding and abstracting is on a range of all primary hospital services. There is minimal review of coding for quality. DUTIES AND ESSENTIAL JOB FUNCTIONS Retrieve and analyze comprehensive medical records and information systems for appropriate documentation and follow-up as appropriate. Evaluate full episode of care of clinical data for inpatient cases and assign...

NE

HEALTH CODER - HCC & RISK ADJUSTMENT

North East Medical Services Burlingame, CA, USA

The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance. ESSENTIAL JOB FUNCTIONS: HCC Coding and Risk Adjustment (RA) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines. Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance. Conduct...

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Medical Biller II (Bilingual Spanish or Vietnamese Required)

Families Together of Orange County Tustin, CA, USA

Job Title: Medical Biller II Salary: $25hr-$28hr DOE Location: Tustin, CA Openings: 1 Position Purpose: The Medical Billing Specialist II supports the revenue cycle team by independently performing a broad range of billing functions with moderate complexity. This role is responsible for accurate insurance verification, charge entry, claim submission, payment posting, and resolution of routine denials to ensure compliance with payer requirements and timely reimbursement. Core Duties and responsibilities, include but are not limited to: Insurance & Eligibility Verification Verify complex insurance coverage (Medi-Cal, Medicare, Managed Care, Commercial, PPO/HMO). Research and resolve discrepancies in patient coverage or eligibility. Document eligibility outcomes in the EHR/PM system. Charge Entry & Coding Support Perform charge entry and apply CPT, ICD-10, and HCPCS codes. Review encounter forms for accuracy; flag missing or incorrect...

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Certified Coder

Red Oaks Medical Group, Inc. Red Bluff, CA, USA

Description Are you Compassionate, Collaborative, Respectful and strive for Excellence? If so, you share our CORE Values and we invite you to join our team as a Business Office Representative. Certified Coder Reports to: Business Office Manager Organizational Peers: Business Office Personnel Direct Reports: N/A Position Details: Non Exempt, Full Time, M-F, 40 hours a week Pay Range : $25.75-33.99/hour Job Summary: Responsible for precise and accurate translation of patient medical records into CPT, ICD-10-CM, and HCPCS codes within an office environment as well as conducting provider audits. Essential Job Responsibilities: New Clinician Audits Clinician audits for correct coding and optimal reimbursement (Random Audits) Provider education to clinicians with coding/documentation Reports quarterly on Bell Curves Possesses expertise in ICD-10, CPT, and HCPCS codes, as well as HIPAA regulations and LCD/NCCI edits....

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Lead Coder

Desert Regional Medical Center Palm Springs, CA, USA

Overview Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Desert Regional Medical Center hospital, were seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success. At Desert Regional Medical Center, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include: Medical, dental, vision, and life insurance 401(k) retirement savings plan with employer match Generous paid time off Career development and continuing education opportunities Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits...

2C

Certified Medical Coder / Certified Professional Coder (CPC)

22nd Century Technologies Orange, CA, USA

Job Title: Certified Medical Coder / Certified Professional Coder (CPC) Duration: 3 months Location: Orange, CA 92868 Shift: Monday through Friday, 8:00 a.m. - 5:00 p.m. Mode: Onsite Pay Rate: $27.98-$43.37/hr Role & Responsibilities: Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department. Supports the manager in ensuring current coding methodology and modifier rules are applied to appropriate reimbursement and ensures the organization is following Medicare and Medi-Cal protocol for payment of claims. Maintains and monitors code listing updates for International Classification of Diseases (ICD)-10-Clinical Modification (CM)/Procedure Coding System (PCS), Current Procedural Terminology (CPT) and...

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Him Coder III

Cottage Health Goleta, CA, USA

Job Description Codes and abstracts inpatient and outpatient conditions, diseases, reason for encounters, social determinants of health and PCS/CPT procedures to report accurate administrative and clinical data, utilizing approved coding guidelines as set forth in Official Coding Guidelines, ICD Book, Coding Clinic for ICD-CM/PCS, AHA Coding Clinic for HCPCS and CPT Book. Assigns appropriate DRG/APC prospective payment systems and classifications, to reflect the appropriate severity and illness for inpatient and specialty cardiac, neurology, and vascular outpatient encounters. Collaborates closely with clinicians and CDI staff, not excluding inpatient rehab coordinators to obtain appropriate documentation, as needed. Assists with internal coding audit and training activities Responsibilities This is not an exhaustive statement of duties, responsibilities, or requirements. Employees will be required to perform any job, with related instruction given by their supervisor,...

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Coding Auditor

Trinity Health Modesto, CA, USA

Details Client Name WelbeHealth - Modesto Job Type Local Offering Non-Clinical Profession Professional Specialty IT Job ID 13826730 Job Title Coding Auditor Weekly Pay $1040.0 Shift Details Shift Days 5x8 Scheduled Hours 40 Job Order Details Start Date 11/27/2023 End Date 02/26/2024 Duration 13 Week(s) Job Description Duties and Responsibilities: -Assist with retrospective and concurrent coding for PACE (Programs of All-Inclusive Care for the Elderly) Dual participants. -Conducts pre-visit chart preparations and post visit chart reviews. -Conducts audits and participates in provider education programs to ensure compliance with CMS risk adjustment diagnosis coding guideline. -Works closely with direct manager in identifying opportunities for HCC coding education. -Complete all required documentation in a timely and accurate manner. -Protect privacy and maintain confidentiality of all company procedures and...

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Medical Biller I

Community Health Centers of the Central Coast Santa Maria, CA, USA

Job Title: Medical Biller I Department: Patient Accounting Reports To: Business Office Manager FLSA Status: Non-Exempt Wage Range that the Company Expects to Pay: Medical Biller I: $25.00 - $27.56 per hour SUMMARY Under the direct supervision of the Director of Business Office, the Medical Biller is responsible for utilizing both practice management systems; Athena and NextGen. The employee is responsible for preparing and posting fee tickets for various sites and programs. The Medical Biller will post and balance payments received, handle all incoming billing calls, and work aging for various programs and payers. The employee will send patient statements, run month end reports, and submit third party claims electronically and/or manually. The employee will ensure that all providers and facilities are paneled with the various insurances and state programs. The Medical Biller will maintain current knowledge of CPT, HCPC and ICD10 coding practices. The...

64 coding auditor and educator jobs found