36 coding auditor and educator jobs found

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Overview Summary: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments. For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding. Submits daily productivity report to HIM manager by defined deadline. Meets and...

Job Description Job Description Description: Position Summary Sage Clinical RCM, LLC is seeking an experienced Outpatient Coding Auditor with a strong background in surgical coding . This role is responsible for auditing outpatient surgical encounters to ensure accurate code assignment, compliance with regulatory guidelines, and adherence to payer and client requirements. The ideal candidate has hands-on experience auditing complex outpatient surgical cases and providing clear, constructive feedback to coding staff. Key Responsibilities Perform audits of outpatient surgical encounters, including operative reports and related documentation Validate accurate assignment of CPT, ICD-10-CM, modifiers, and applicable APCs Ensure compliance with CMS, payer, and official coding guidelines Identify trends, risks, and educational opportunities based on audit findings Provide written audit feedback and coding education to support quality improvement Collaborate with coding...

Medical Oncology Coding Specialist Apply the appropriate diagnostic and procedural code to patient health records for purposes of document retrieval, analysis and claim processing. Abstract pertinent information from patient records. Assign the International Classification of Diseases, Clinical Modification (ICD), Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes, creating Ambulatory Patient Classification (APC) or Diagnosis-Related Group (DRG) assignments. Perform complex coding. Obtain acceptable productivity/quality rates as defined per coding policy. Query physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Maintain knowledge of, complies with and keep abreast of coding guidelines and reimbursement reporting requirements. Conduct chart audits for physician documentation requirements & internal coding; provide...

A leading health care organization in Pensacola is seeking a Compliance Auditor to audit outpatient services claims. This entry-level role requires a Bachelor's Degree in Health Information Management and 5 years of healthcare experience. You will analyze records for compliance and educate staff on coding practices. The ideal candidate has excellent communication skills and a strong attention to detail. This position offers the opportunity to significantly impact healthcare compliance and reimbursement. #J-18808-Ljbffr

Job Description Job Description Benefits: 401(k) matching Bonus based on performance Company parties Dental insurance Employee discounts Health insurance Opportunity for advancement Paid time off Parental leave Training & development Vision insurance The Medical Billing Specialist is responsible for the billing and collection of office visits, procedures, nurse procedures, and all other billing events as a result of practice activities. Additional responsibilities include keeping up to date with coding and billing regulations as well as maintaining an understanding and compliance with all Skin Wellness Physicians policies and procedures. Essential Duties and Responsibilities As assigned, but not limited to the following: Develops and implements, with the Practice Administrator, procedures for all aspects of the billing process including charge entry, day end balancing, claims submission and edit, insurance follow up, patient balance follow up, denials,...

Onsite Position - Not Remote The Villages Health is a patient-centered primary care driven, multi-specialty medical group with over 800 team members. Our unique care model gives us both the time and resources to truly care for our patients, along with a company culture that supports a healthy work-life balance for our team members. Our purpose, mission and vision is to empower Villagers and the surrounding communities to live out their dreams by keeping them healthy and healing them quickly. Together, we are changing the way healthcare is delivered and are making a positive difference in the lives of our patients and the communities we serve. In doing so, The Villages Health is creating America's Healthiest Hometown. Our full-time benefits include medical, dental & vision insurance, matching HSA & 401k, PTO & paid holidays, The Villages Charter School eligibility, and much more! Hiring Event: Please bring your resume and join us: Friday, December 19th, 2025 from...

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 accuracy...

Responsible for providing coding quality auditing services and evaluating clinical documentation for all providers within the USFTGP organization. Establishes and provides timely communication of identified quality issues concerning documentation and coding with a target minimum of a 95% accuracy/passing rate. More specifically this team member will: Audit retro and concurrent medical provider clinical documentation while adhering to Medicare guideline • Review documentation to assign/audit correct diagnosis codes Identify areas for documentation improvement and effectively communicates with providers and staff. Perform in a professional manner, exercising good judgment and ethical standards. Interacts effectively and builds respectful working relationships across the organization. • Demonstrate integrity by adhering to high standards of personal and professional conduct. Comply with the Standards of Ethical Coding as set forth by the American Health Information...

divh2Coding Specialist/h2pResponsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment./ppstrongMinimum Qualifications:/strong/pp1. Graduate of Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience./pp2. Certification in one of the following: RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), COC (Certified Outpatient Coder), CCS...

Coding Specialist At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up. Seeks clarification from providers...

Memorial Healthcare System Coding Specialist At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Location: Miramar, Florida Summary: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. For physician billing, collaborates with billing department to ensure all bills are satisfied. For...

About the Job Position Highlights: Compliance Auditors conduct Compliance Department audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including detection and correction of documentation, coding, and billing errors. The Compliance Auditor evaluates the adequacy and effectiveness of controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to professional or hospital documentation, coding and billing, and federal and state regulations and guidelines. The Compliance Auditor communicates audit results to physicians, physician leadership, senior management, management, and staff and provides physician and coder education. The Compliance Auditor will act as a liaison with assigned faculty members, developing relationships and functioning as a resource to all providers and their staffs and will serve as an...

Job Description Job Description General Responsibilities: Reporting to the Director of Revenue Cycle, the Medical Coder translates clinical documentation into standardized codes for billing, reporting, and quality initiatives. This role supports coding audits, revenue cycle workflows, and regulatory compliance. Key responsibilities include verifying clinical information with medical staff, resolving documentation gaps, and collaborating with billing staff to ensure accurate claims submission. The medical coder ensures appropriate codes are assigned to all procedures and diagnoses. Essential Functions: Assigns and sequences of ICD-10-CM, CPT & HCPCS codes accurately in compliance with government and insurance regulations. Ensures codes reflect patient diagnoses and procedures as documented by clinicians, meeting payer, OSHA, and HIPAA requirements. Reviews and abstracts clinical documentation from outpatient encounters to assign accurate ICD-10-CM, CPT/HCPCS codes,...

divh2Coding Specialist/h2pResponsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment./ppstrongMinimum Qualifications:/strong/pp1. Graduate of Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience./pp2. Certification in one of the following: RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), COC (Certified Outpatient Coder), CCS...

Ambulatory Surgery Center (ASC) Cardiology Coder MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and above all excellent customer service. MedHQ, LLC, is a 2022 Becker's Top 150 Places to Work in Healthcare company. We believe our quality of service begins with our quality of team member. We offer exceptional benefits and working environments to exceptional employees. Position Summary The Ambulatory Surgery Center (ASC) Cardiology Coder is responsible for accurately reviewing,...

Physician Compliance Auditor Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal...

Physician Coding Auditor The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. Competitive Pay Evening, nights, and weekend shift differentials offered for qualifying positions. All Inclusive Benefits (start day one) Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility...

Him Coding/Compliance Auditor 2 Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of medical excellence and community care for more than a century. Throughout its rich and storied history, Jackson Memorial - located in the heart of the City of Miami - has been ground zero for some of the world's greatest medical breakthroughs and important moments in South Florida. We've grown into one of the nation's largest public hospitals, and one of the few that is also a world-class academic medical center with a proud mission and proven success. Jackson Memorial is an accredited, tertiary teaching hospital with 1,500 licensed beds, where nearly every medical specialty is provided by some of the world's most skilled and highly regarded multidisciplinary team of healthcare professionals. The HIM Coding/Compliance Auditor 2 analyzes abstracted, coded data for the purpose of ensuring coding accuracy. Serves as a resource for expert knowledge...

Job Description Job Description ONSITE POSITION - Not Remote About The Villages Health The Villages Health is a patient-centered primary care driven, multi-specialty medical group with over 800 team members. Our unique care model gives us both the time and resources to truly care for our patients, along with a company culture that supports a healthy work-life balance for our team members. Our purpose, mission and vision is to empower Villagers and the surrounding communities to live out their dreams by keeping them healthy and healing them quickly. Together, we are changing the way healthcare is delivered and are making a positive difference in the lives of our patients and the communities we serve. In doing so, The Villages Health is creating America’s Healthiest Hometown. Our Full-time Benefits Medical, Dental & Vision Insurance | Matching HSA & 401k | PTO & Paid Holidays | The Villages Charter School Eligibility | & much more! Hiring Event Please...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

Job Description Job Description Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas....

Job Description Job Description JOB TITLE: Coding Compliance Auditor REPORTS TO: Director of Billing and Credentialing FLSA STATUS: Non-Exempt JOB SUMMARY The Coding Compliance Auditor is responsible for conducting ongoing audits of provider documentation, coding accuracy, and revenue integrity to ensure compliance with federal and state regulations, payer guidelines, and internal policies. This role evaluates clinical documentation and coding practices to reduce risk, improve reimbursement accuracy, and support continuous compliance and quality improvement initiatives across the organization. QUALIFICATIONS / EDUCATION Associate or Bachelor’s degree in Health Information Management, Healthcare Administration, Nursing, or related field preferred. Minimum 2–3 years of experience in medical coding, auditing, or revenue cycle compliance required. Strong knowledge of CPT, ICD-10-CM, HCPCS, and modifier usage. Knowledge of Medicare, Medicaid, and commercial payer...