45 coding auditor and educator jobs found

Revenue Integrity Analyst (Medical Biller) Guidehouse is seeking a Revenue Integrity Analyst (Medical Biller) with strong billing, coding, and revenue cycle expertise to support the modernization of MHS GENESIS, the DoD's enterprise EHR. The role ensures accurate billing, compliant charge capture, and efficient claim resolution by analyzing data, auditing documentation, and collaborating with clinical, coding, IT, and financial teams across the Military Health System. Responsibilities of this role are as follows, to include but not limited to: Support and optimize MHS GENESIS revenue cycle configuration, including charge capture workflows, billing rules, and work queues. Validate charge accuracy, coding logic, modifiers, and payer requirements; troubleshoot system and workflow issues. Analyze financial, clinical, and operational data to identify trends, charge variances, and revenue improvement opportunities. Investigate claim edits and denials, identify root causes, and...

You will be able to work from your home location within the United States PURPOSE AND SCOPE: Conducts data quality audits of outpatient encounters to validate coding assignment is in compliance with the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. Provides feedback and education to coders. Escalates compliance, risk-related issues to expedite mitigation. PRINCIPAL DUTIES AND RESPONSIBILITIES: Consults facility leaders and staff on best practices, methodology, and tools for accurately coding. Chart Analysis, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA/AAPC). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to...

divh2Medical Coder Auditor/h2pRevenue Cycle Management is looking for a Medical Coder Auditor to join our team. Remote opportunity after 30-90 day in-person training./ppSUMMARY: The Medical Coder Auditor is responsible for reviewing coded encounters to ensure accuracy, compliance, and alignment with coding guidelines, payer rules, and organizational policies. This role provides feedback to coders, identifies trends in errors, and supports coding education and process improvement initiatives./ppESSENTIAL FUNCTIONS:/pulliConduct retrospective and prospective coding audits to ensure coding accuracy and compliance with regulations./liliReview coded documentation for completeness, accuracy, and adherence to ICD-10-CM, CPT, HCPCS, and/or ICD-10-PCS guidelines./liliIdentify coding trends, error patterns, and compliance risks and develop corrective action plans./liliProvide feedback and education to coders to improve accuracy and consistency./liliCollaborate with providers and clinical...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Job Title This position is responsible for conducting coding audits, communicating results and recommendations to providers, management, and executive administration, and providing training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, CDT, HCPCS, and ICD-10 codes on an annual basis. Responsibilities Essential Duties: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical and/or dental record notes to reported CDT, CPT, HCPCS, and ICD codes with consideration of applicable FQHC and payer/title/grant 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 the Office of the CMO and provider leadership to identify and assist providers with coding. Report findings and...

Risk Adjustment Coder Specialist 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 ourselvesone 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. While your daily work will be completed from your home office, occasional travel may be required for...

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...

Medix - 6621 Fannin Street [Medical Records Clerk] As a Coder at Medix, you'll: Analyze medical records to assign appropriate codes for billing and insurance purposes; Ensure accuracy and compliance with coding guidelines and regulations; Collaborate with healthcare professionals to clarify diagnoses and procedures; Maintain confidentiality of patient information; Update coding knowledge through continuous education and training; Assist in audits and reviews to improve coding processes and accuracy...Hiring Immediately >>

Compliance Coding Auditor Hours: Variable Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $48.140 - $62.110 - $76.080 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit...

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...

Job Details Level : Experienced Job Location : IDX Coppell TX Site - Coppell, TX 75019 Position Type : Full Time Education Level : High School Job Category : Biotech About Us Inform Diagnostics, a Fulgent Genetics Company , is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology, dermatopathology, urologic pathology, hematopathology, and breast pathology. Founded in 2011, our parent entity, Fulgent Genetics, has evolved into a premier, full-service genomic testing company built around a foundational technology platform. Through our diverse testing menu, Fulgent is focused on transforming patient care in oncology, anatomic pathology, infectious and rare diseases, and reproductive health. We believe that by providing a wide range of effective, flexible testing options in conjunction with best-in-class service and support, we can...

Experienced Multi-Specialty Surgery Coder The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours: Monday - Friday, working 40 hours a week Location: Fully Remote - U.S You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Provide coding and abstraction of physician or professional records Provide communications to Coordinator, Supervisors and Managers Complete RAI's, denials, charge hold reports, and coding edits Assist on special coding projects as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear...

HIM Coder Analyst III page is loaded## HIM Coder Analyst IIIlocations: Fort Worth, TXtime type: Full timeposted on: Posted Todayjob requisition id: JR-112592**Location:**Medical Center - Fort Worth**Department:**HIM-Coding**Shift:**First Shift (United States of America)**Standard Weekly Hours:**40**Summary:**The HIM Coder Analyst III requires superior knowledge of and skill in applying International Classification of Diseases and Procedures (ICD), and Current Procedural Terminology (CPT) code sets and associated Medicare/Medicaid rules and guidelines. Reviews and interprets patient medical record documentation to identify pertinent diagnoses and procedures and assigns ICD-9-CM, ICD-10-CM/PCS and CPT 4 codes accurately and timely to the highest level of specificity based upon physician documentation for inpatient, observation and outpatient ambulatory procedures/treatment room records. Validates the coded data to one or more Diagnosis Related Groupers (DRG) validates the...

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. Title: Compliance Auditor& Billing Data Analyst - Oncology Hub Locations : Atlanta, GA; Columbus, OH; Dallas, TX (Preferred) Onsite/Remote/Hybrid: REMOTE position Certification : Active CPC/COC/or ROCC certification (REQUIRED) Industry Experience : Healthcare background (REQUIRED) Experience : 4+ years healthcare coding experience using CPT, ICD10CM,...

divh2Medical Coder Lead/h2pRevenue Cycle Management is looking for a Medical Coder Lead to join our team! Remote opportunity after 30-90 day in-person training SUMMARY The Medical Coder Lead is responsible for serving as a subject matter expert in coding processes providing advanced technical guidance and ensuring coding accuracy compliance and productivity standards are met. The position supports coders and auditors through consultation mentoring and expertise on complex coding scenarios./ppESSENTIAL FUNCTIONS:/pulliServe as a resource and consultant for coders on complex or specialty coding scenarios./liliReview and provide guidance on challenging cases to ensure coding accuracy and compliance./liliPartner with auditors to resolve discrepancies and identify trends in coding errors./liliProvide mentoring and technical support to coders promoting knowledge sharing and best practices./liliAssist in developing and updating coding procedures guidelines and reference...

Job Description Job Description At Broadway Ventures , we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider—we're your trusted partner in innovation. Position Summary We are seeking an experienced Certified Coder to support medical review activities through complex coding validations and quality assurance efforts. This role requires deep expertise in Medicare coding guidelines, DRG validation, and CMS FFS RAC Program requirements. Education High School Diploma required Associate degree or higher preferred Licensure / Certifications Certification from an accredited...

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 THIS IS NOT A REMOTE POSITION We are hiring a Medical Records Clerk/Coder to assign procedure, and diagnosis codes for insurance billing, review claims data, research, and correspond with insurance companies to obtain accurate reimbursement for healthcare claims. This person will also be responsible for analyzing, abstracting, compiling data, and generating reports. This position must provide customer service excellence when dealing with internal and external contacts. Duties include but are not limited to: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place before submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims...

Job Description Job Description About Legent Health At Legent Health , our mission is simple yet profound: “To provide first-class health care that puts YOU first.” Our vision reflects our commitment to excellence: “Through robust physician partnerships, become a nationwide leader in compassionate, quality healthcare focused on the patient and available to everyone.” Our values, also known as our brand pillars, define how we stay true to our identity in the healthcare industry and the communities we serve. These values are central to everything we do: Respect: We honor the time and trust of both patients and physicians by delivering organized, efficient services that ensure a seamless healthcare experience. Service: We are committed to highly personalized care for patients, their families, and the physicians who serve them, driving optimal outcomes for all. Leadership: We strive to be a trusted leader through innovation, clear communication, and unwavering...

A healthcare organization is seeking a Senior Compliance Coding Auditor to perform coding audits and ensure adherence to regulatory standards. The ideal candidate will conduct chart reviews, identify discrepancies, and educate medical staff on coding practices. Preferred qualifications include a CPC or CCS certification, 4 years of experience, and knowledge of the Epic EHR system. This full-time role offers a competitive salary reflecting industry standards for healthcare compliance professionals. #J-18808-Ljbffr

Overview This position is responsible for conducting coding audits, communicating results and recommendations to providers, management, and executive administration, and providing training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, CDT, HCPCS and ICD‐10 codes on an annual basis. Responsibilities Essential Duties: • Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical and/or dental record notes to reported CDT, CPT, HCPCS, and ICD codes with consideration of applicable FQHC and payer/title/grant 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 the Office of the CMO and provider leadership to identify and assist providers with coding.• Report findings and recommendations to...

Overview This position is responsible for conducting coding audits, communicating results and recommendations to providers, management, and executive administration, and providing 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. The Senior Compliance Coding Auditor will have dotted line reporting to the Chief Compliance & Risk Officer. 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....

Senior Professional Fee Coder - San Antonio Division: CHRISTUS Children's Hospital - San Antonio Work Arrangement: Onsite only | Location: San Antonio, TX | Salary: $63,052 to $80,000 | FLSA Status: Nonexempt | Work Schedule: Monday – Friday, 8 a.m. – 5 p.m. Summary Baylor College of Medicine- CHRISTUS Children’s in San Antonio is seeking a highly motivated and competent professional to serve as a Senior Professional Fee Coder with primary responsibilities for managing and supporting the day‑to‑day functions of the revenue cycle under the direction of the Lead, Revenue Cycle. The candidate must be skilled in performing complex tasks required in healthcare services within the revenue cycle, to include documentation reviews, denial analysis, and educational initiatives but not limited to coding and provider education. The ideal candidate will have strong operational skills and ability to gain the confidence of faculty, staff, leaders, colleagues, etc. Will have experience with...