70 coding auditor and quality coordinator days jobs found

Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. The Professional Senior Coder is a vital multifaceted role within the Coding Department. This position provides support as Professional coding subject matter expert, educator, QA reviewer, and also focuses daily efforts on Pre-A/R management and oversight. Additionally, this person works with partner departments to problem solve issues and streamline processes. The Professional Senior Coder is also required to mentor other team members and also prepare them for the role of Senior Coder. This individual possesses a strong level of Professional clinical coding expertise, expansive knowledge of professional coding guidelines, and has the ability to handle multiple priorities. This...

Registered Nurse - Utilization Management/Coder RN Bienvivir All-Inclusive Senior Health ("Bienvivir") is a community-based, patient-centered, comprehensive health care delivery system that advocates and promotes quality of life, optimum independence, dignity, and choices in a nurturing environment for frail seniors. Since 1987, Bienvivir has served the frail seniors of El Paso, Texas through the provision of the Program of All-Inclusive Care for the Elderly ("PACE"). PACE is a unique managed care benefit for frail seniors (referred to as participants) age 55 and older who are certified by the state as needing nursing home level care and who reside in a PACE service area. PACE programs coordinate and provide comprehensive medical and support services so that participants can remain independent and stay in their homes for as long as safely possible. Bienvivir is currently accepting applications for the following position: REGISTERED NURSE - UTILIZATION MANAGEMENT / CODER The...

Medical Coding Supervisor The Coding Supervisor is responsible for overseeing the daily operations of the coding team, ensuring accurate and compliant coding practices across all clinical departments. This role provides leadership, training, and quality assurance for coding staff, supports provider education, and collaborates with Revenue Cycle and Compliance teams to optimize reimbursement and maintain regulatory compliance. Team Leadership & Oversight: Supervises coding staff including Coder I and Coder II. Monitors productivity and quality metrics, ensuring standards are met or exceeded. Conducts regular team meetings and one-on-one check-ins to support performance and development. Quality Assurance & Compliance: Oversees internal/external audits and reviews coding accuracy, documentation, and billing compliance. Ensures adherence to federal, state, and payer-specific coding guidelines. Coordinates with Compliance and Revenue Cycle teams to resolve audit findings and...

Salary: $4,389.00 - $5,612.00 Monthly Location : Albany, OR Job Type: Full Time- SEIU Job Number: 26-00018 Department: Administration Program: Billing Opening Date: 04/02/2026 FLSA: Exempt Bargaining Unit: SEIU Description HEALTH SERVICES MEDICAL BILLER/CODER Administration/Billing Program (Classification 757) SEIU Represented Full-Time (37.5 hours/week) position Position Open Until Filled First review of applications will be on April 20, 2026. Any applications received after April 20 will be reviewed and considered as needed, and this posting may close at any time after that date. Linn County requires on-site work. Remote work is not available. Job Summary A person employed in this classification must possess the capability to perform the following duties to be considered for and remain in this position. The duties are essential functions requiring the critical skills and expertise needed to meet job objectives. Additional specific...

PURPOSE OF THIS POSITION This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization's operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. JOB DUTIES/RESPONSIBILITIES Duty 1: Maintains a thorough understanding and education of federal and state regulations and payer specific...

DHR Health - US:TX:McAllen - Days Summary: POSITION SUMMARY: The Inpatient coder reviews and analyzes documentation in the medical record for inpatient visits to ensure accuracy of diagnosis and procedure codes. Coder finalizes the coding and abstracting of the medical record according to ICD-10-CM/PCS, CPT, and HCPCS coding conventions and guidelines supported by the clinical documentation in the medical record. Coder analyzes diagnosis and procedure codes concurrently assigned by Clinical Documentation Specialists. The Inpatient Coder assumes primary responsibility for DRG validation/accuracy, primary role in assisting CDS and medical staff members with improving quality of clinical documentation. Sequence the diagnoses and procedures using official coding guidelines. Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges. Resolve Inpatient billing edits. Abide by the Standards of Ethical Coding as set...

Medical Claims Specialist This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization's operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. Job Duties/Responsibilities Maintains a thorough understanding and education of federal and state regulations and payer specific policies...

Job Description Job Description Description: Come and join our growing organization as a Medical Biller! Roswell Park Care Network is a recognized leader in oncology and specialty care, supporting community physician practices across New York State. We are committed to delivering exceptional patient care while advancing innovative treatment options in a collaborative and patient-focused environment. Comprehensive Benefits: Monday-Friday schedule Medical, dental, and vision coverage Employer funded Health Reimbursement Account (HRA) 401(k) with company match Generous vacation and sick time Company-paid life insurance 11 paid Holidays The Medical Biller position offers a hybrid schedule. After successfully completing on-site training, the schedule transitions to just one on-site day per week As the Medical Biller you will be responsible for entering charges and submitting medical claims to insurance companies. This role will work all open accounts...

Internal Reference Number: R1050337 Summary Performs validation reviews of Diagnosis Related Groups (DRG), Ambulatory Procedure Codes (APC), and Never Events (serious, preventable medical errors) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department.Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have...

Professional Senior Coder To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. The Professional Senior Coder is a vital multifaceted role within the Coding Department. This position provides support as Professional coding subject matter expert, educator, QA reviewer, and also focuses daily efforts on Pre-A/R management and oversight. Additionally, this person works with partner departments to problem solve issues and streamline processes. The Professional Senior Coder is also required to mentor other team members and also prepare them for the role of Senior Coder. This individual possesses a strong level of Professional clinical coding expertise, expansive knowledge of professional coding guidelines, and has the ability to handle multiple...

Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. Reporting to the Supervisor of Outpatient Coding, The OP Senior Coder is a vital multifaceted role within the Outpatient Coding Department. This position provides support to the Outpatient Coding Department as a OP coding subject matter expert, educator, QA reviewer, and also focuses daily efforts on A/R management and oversight. Additionally, this person works with partner departments to problem solve issues and streamline processes. The OP Senior Coder is also required to mentor other team members and also prepare them for the role of OP Senior Coder. The OP Senior Coder possesses a strong level of OP clinical coding expertise, and has the ability to handle multiple priorities....

Salary : $54,060.11 - $76,162.64 Annually Location : Ventura and may require travel throughout Ventura County, CA Job Type: Full-Time Regular Job Number: 0840HCA-25AA (NW) Department: Health Care Agency Division: Behavioral/Mental Health Opening Date: 08/27/2025 Closing Date: Continuous Description THE POSITION Under general direction (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance reimbursement requirements. IDEAL CANDIDATE The ideal candidate has specialized expertise in mental health billing, including CPT, ICD-10, and HCPCS coding for Medicare and Medi-Cal. Skilled in the Medi-Cal Provider Manual and TAR process, they ensure timely, compliant submissions that support access to behavioral health services. They communicate effectively with peers, patients, and payers, resolve billing discrepancies, and...

Department/Unit: Health Information Management Work Shift: Day (United States of America) Salary Range: $59,066.00 - $88,599.00 The Professional Coder will review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 DX codes. This position is remote. Essential Duties and Responsibilities Effectively reviews, analyzes, and validates CPT, ICD-10 diagnosis codes, HCPCS, modifiers and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes. Understands National Correct Coding Initiative (NCCI) edits and relative value units as appropriate for the role. Ensure established productivity and quality standards are met. Review denials, research and respond...

Are you a current UMass Memorial Health caregiver? Apply now through Workday. Exemption Status: Non-Exempt Hiring Range: $25.83 - $43.91 Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations . Schedule Details: Monday through Friday Scheduled Hours: 7:00am-3;30pm Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5458 Coding Services Union: SHARE (State Healthcare and Research Employees) This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can...

Auditing Team Lead Under direct supervision, the Auditing Team Lead provides day to day supervision and instruction of the auditors. The Auditing Team Lead oversees the internal and external auditing function and assists Director Inpatient Coding, Coding Audits, and Education in developing reports specific to audit findings and assists with implementing action plans. The Auditing Team Lead ensures internal audits are accurate, complete and reported on a timely basis and serves in an advisory and educator role for Coding Specialists. The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified. Provides for day to day supervision and instruction for the auditors which includes audit assignments, problem solving, monitoring productivity and scheduling. Manages time and attendance approvals....

Job Summary: Supervises team to review and request primary source information and verifications. Proactively identifies, suggests improvements to, and provides resolution for complex gaps in vendor relationships. Serves as an escalation point of contact for external queries regarding practitioner status. Evaluates applications and supporting highly complex documents. Guides team to conduct improvements to credentialing and privileging processes. Guides and supervises team to evaluate complex practitioner sanctions. Participates in surveys and audits of credentialing entities. Facilitates and implements strategic initiatives cost-effective due process. Identifies and provides leadership to resolve adverse actions/issues. Leads and evaluates audits of data between different departments. Conducts and supervises the facilitation and orientation and training to newly appointed physician leaders. Develops highly complex informational documents. Maintains working relationships with key...

Job Type Full-time Description Job Title: Outpatient Coder Company: Physician Care Coordination Consultants (PC3) Location: Louisville, KY Job Type: Full-time Job Classification: This is an exempt position under the Fair Labor Standards Act (FLSA) and is not eligible for overtime pay. Our Mission: Our mission is to drive financial wellness in healthcare organizations so more patients can receive the care they need. Our Vision: Our vision is a future where we help healthcare organizations thrive in a complex ecosystem by clearing a path to financial health. Our Culture: We are committed to creating a workplace where every member feels valued, empowered, and inspired to contribute their best. Together we will foster a culture that promotes work-life balance and celebrates community engagement, personal achievements, milestones, and special occasions. Values: Integrity - We do what's right, no matter what. Innovation - We use...

Job Description Job Description About Sound Founded in 2001 and headquartered in Nashville, TN, Sound Physicians is a nationally respected, physician-led medical group practicing in 400+ hospitals across 45 states. Our team of 4,000+ clinicians and 1,000+ business professionals across the country is united by one mission: to build exceptional clinical partnerships that unlock quality, affordable, dignified care for everyone – no matter who they are or where they live . With physician-led clinical teams and more than two decades of operational expertise, we’ve refined what it takes to consistently deliver exceptional care in hospital medicine, emergency medicine, critical care, anesthesia, and telemedicine. Why join us? A remote-first culture that values flexibility and collaboration Opportunities to grow your career while making a real impact A team that champions inclusivity, innovation, and excellence Whether working virtually or onsite at one of our...

Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. Reporting to the Supervisor of Outpatient Coding, The OP Senior Coder is a vital multifaceted role within the Outpatient Coding Department. This position provides support to the Outpatient Coding Department as a OP coding subject matter expert, educator, QA reviewer, and also focuses daily efforts on A/R management and oversight. Additionally, this person works with partner departments to problem solve issues and streamline processes. The OP Senior Coder is also required to mentor other team members and also prepare them for the role of OP Senior Coder. The OP Senior Coder possesses a strong level of OP clinical coding expertise, and has the ability to handle multiple priorities....

A Day in the Life of the Coding Compliance & Education Coordinator: You'll be diving into clinical documentation and coding records, performing detailed audits to ensure every code is accurate, complete, and compliant with regulatory standards. You'll analyze patterns, identify discrepancies, and provide actionable feedback that supports optimal reimbursement and quality reporting. You'll assist with developing and delivering training sessions for coding staff, clinical providers, and other stakeholders. You'll serve as the go-to expert for ICD-10-CM, ICD-10-PCS, CPT, and sequencing guidelines, helping teams stay current with evolving standards. You'll work closely with the Coding Manager and other leaders, ensuring coding practices align with organizational goals. Whether you're refining audit processes, answering complex coding questions, or creating educational materials, your work directly impacts compliance, revenue integrity, and patient care quality. Why Work...

Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. The Professional Senior Coder is a vital multifaceted role within the Coding Department. This position provides support as a Professional coding subject matter expert, educator, QA reviewer, and also focuses daily efforts on Pre-A/R management and oversight. Additionally, this person works with partner departments to problem‑solve issues and streamline processes. The Professional Senior Coder is also required to mentor other team members and also prepare them for the role of Senior Coder. This individual possesses a strong level of Professional clinical coding expertise, expansive knowledge of professional coding guidelines, and has the ability to handle multiple priorities. This...

Job Summary The Coding Supervisor is responsible for overseeing the daily operations of the coding team, ensuring accurate and compliant coding practices across all clinical departments. This role provides leadership, training, and quality assurance for coding staff, supports provider education, and collaborates with Revenue Cycle and Compliance teams to optimize reimbursement and maintain regulatory compliance. Job Specific Competencies Team Leadership & Oversight Supervises coding staff including Coder I and Coder II. b. Monitors productivity and quality metrics, ensuring standards are met or exceeded. c. Conducts regular team meetings and one-on-one check-ins to support performance and development. Quality Assurance & Compliance Oversees internal/external audits and reviews coding accuracy, documentation, and billing compliance. b. Ensures adherence to federal, state, and payer-specific coding guidelines. c. Coordinates with Compliance and Revenue...

HEALTH SERVICES MEDICAL BILLER/CODER Administration/Billing Program (Classification 757) SEIU Represented Full-Time (37.5 hours/week) position Position Open Until Filled First review of applications will be on April 20, 2026. Any applications received after April 20 will be reviewed and considered as needed, and this posting may close at any time after that date. Linn County requires on-site work. Remote work is not available. A person employed in this classification must possess the capability to perform the following duties to be considered for and remain in this position. The duties are essential functions requiring the critical skills and expertise needed to meet job objectives. Additional specific details of these essential functions may be provided by the specific office or department job announcement, if applicable. * Strong working knowledge of CPT, ICD-10, HCPCS, modifiers, coding and documentation guidelines. * Reviews and verifies documentation supporting diagnoses,...