62 coding auditor educator jobs found

Job Description Job Description WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits...

Community Health Partners is seeking a skilled Medical Coder Auditor to ensure accurate documentation and compliant coding across practices in Fresno, CA. The role emphasizes reviewing medical records and validating ICD-10, CPT, and HCPCS modifiers. You will collaborate with clinical departments and Revenue Cycle Services to enforce coding guidelines, provide education to staff, and support compliant charge capture and timely claim submissions. #J-18808-Ljbffr

Risk Adjustment Coding Specialist II Department: Quality - Risk Adjustment Employment Type: Full Time Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Reporting To: Yuvone Washington-Oshon Compensation: $70,000 - $85,000 / year Description We are currently seeking a highly motivated Risk Adjustment Coding Specialist. This role will report to a Sr. Manager - Risk Adjustment and enable us to continue to scale in the healthcare industry. The staff is required to frequently travel to provider sites depending on projects. What You'll Do Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company Review medical record information on both a retroactive and prospective basis to identify,...

Job TitleJob TitleJob DescriptionLocated 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 acute hospital outpatient emergency department (ED), medical oncology, adult outpatient rehab including cardiac rehab patient records including charge capture/entry to identify the diagnosis and procedure codes performed during the patient's stay are valid and in accordance with coding conventions and guidelines. Record types include ED including charge capture/entry, medical oncology cancer and adult outpatient rehab including cardiac rehab encounter types. Handles...

Job Title Job Title 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 acute hospital outpatient emergency department (ED), medical oncology, adult outpatient rehab including cardiac rehab patient records including charge capture/entry to identify the diagnosis and procedure codes performed during the patient's stay are valid and in accordance with coding conventions and guidelines. Record types include ED including charge capture/entry, medical oncology cancer and adult outpatient rehab including cardiac rehab encounter...

Job Description Job Description The Certified Cardiology Coder plays a critical role in accurately translating cardiology medical records into standardized codes used for billing and documentation. This position requires expertise in cardiology procedures and coding standards to ensure compliance and data integrity. The coder works closely with clinicians and utilizes specific coding software alongside manual coding processes to support effective claims processing and reporting.   Responsibilities Assign accurate codes based on cardiology medical records Review and audit medical records for coding compliance Ensure data accuracy and adherence to coding guidelines Generate reports related to coding and billing activities Analyze patient data for completeness and coding accuracy Conduct coding audits to identify discrepancies and improve processes Collaborate with clinicians to clarify documentation and coding queries Process claims efficiently to support timely...

Job Description Job Description Overview Opportunities for you! Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek Free Continuing Education and certification Tuition reimbursement, education programs and scholarships Vacation time starts building on Day 1, and builds with your seniority Free money toward retirement with a 403(b) and matching contributions Great food options with on-demand ordering Free parking and electric charging Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page. Responsibilities The Coding Compliance Auditor is a member of the Compliance Office and contributes to the Community Health System’s mission to better the lives of all those we serve. As a Coding Compliance...

Physician Coding Educator — ConsultantLocation: Remote, United States Schedule: Remote | PST Timezone Support | 26-week engagement | Requirements: CPC (AAPC) or CCS or CCS-P (AHIMA) certification required 3+ years experience in Professional Fee coding across physician, ASC, surgical, or outpatient settings Experience with physician-facing education and ability to deliver 1:1 and group training Experience conducting chart reviews, coding audits, and documentation accuracy validation Knowledge of documentation standards, compliance requirements, and audit readiness practices Ability to analyze coding trends, variances, and risk areas and translate into education plans Proficiency in communicating with physicians, clinical staff, and revenue cycle stakeholders Ability to work independently in a remote environment while collaborating cross-functionally Physician Coding Educators with surgical specialty backgrounds Preferred Requirements: Experience with Critical Care coding (NICU,...

Job TitleCoderJob DescriptionLocated 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 SDS and OBV 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 same day surgery and observation 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...

The Certified Medical Coder is responsible for accurate, compliant, and timely coding of professional and facility pain management services, with a strong emphasis on Workers' Compensation and Functional Rehabilitation Programs (FRP). This role supports interventional pain evaluation and management, rehabilitation services, and ancillary procedures, while ensuring compliance with state-specific WC rules, payer-specific billing guidelines, and other payer requirements. Performs review of all coding related holds for Boomerang Health Care (BHC) to ensure consistency in documentation needed to meet compliance guidelines for appropriate and effective reimbursement. *This is a remote role. We are only hiring in the following states: AZ, CA, NM, NV, OR, TX and WA. What you will do: Assign accurate CPT, HCPCS, and ICD-10 codes for all services performed at BHC facilities. Apply appropriate modifier usage based on payer and service requirements. Ensure documentation supports...

1.0 FTE Full time Day - 08 Hour R2658919 Remote USA 108610021 Admin Compliance Business & Administration Day - 08 Hour (United States of America) This is a Stanford Health Care job. A Brief Overview Billing and Coding Compliance Auditors conduct audits and monitoring activities to identify and address compliance risks related to billing and coding practices. They review and evaluate healthcare regulatory compliance, focusing on the detection of documentation, coding, and billing errors. Responsibilities include assessing the adequacy and accuracy of documentation supporting billed services, including ICD, CPT, HCPCS, and other third-party payer codes, as well as adherence to Teaching Physician guidelines, Evaluation & Management criteria, DRG and APC assignments, medical necessity, and reimbursement accuracy. Auditors serve as a communication channel, partnering with Billing and Coding Compliance Educators to address compliance issues. They are responsible for conducting...

Anticipated End Date: 2026-08-31 Position Title: DRG Coding Auditor - MS-DRG and APR-DRG Job Description: DRG Coding Auditor - MS-DRG and APR-DRG Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development . Alternate locations may be considered if candidates reside within a commuting distance from an office Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its...

Health Coder - Hcc & Risk Adjustment Burlingame, CA 94010 Overview Salary Range $42.79 - $48.75 Hourly Description 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....

The Medical Coder is primarily responsible for performing chart reviews and coding audits; reviewing appropriate ICD-10 diagnoses codes, and CPT and HCPCS procedure codes assigned for evaluation and management of the patient. Additional responsibilities include supporting pre-or post-payment coding audit for benchmark and/or reimbursement recovery, and other coding-related activities such as pre-appointment chart audits for HCC or risk adjustment, appeals of denied claims, providing information or education to providers for specificity of documentation to align with the coding guidelines to comply with federal, state, and regulatory requirements. ESSENTIAL JOB FUNCTIONS: Performs pre-appointment HCC or risk adjustment chart reviews, coding audits, or other coding-related projects Acts as internal resource for all coding inquiries from providers, Billing, Laboratory, Radiology, and other departments. Provides real time coding consultation and review and evaluation of...

Professional Surgical CoderAt NorthBay, the Professional Surgical Coder will play a crucial role in accurately translating medical procedures and diagnoses into ICD 10, CPT and HCPCS codes in an accurate and timely manner for professional surgery charges in the outpatient and inpatient settings. The coder is dedicated, knowledgeable individual with a strong understanding of medical terminology, coding guidelines, regulations, and proficiency in utilizing an EHR/encoder system. Can effectively communicate with providers via email, query, phone call or in person to educate or discuss coding requirements. Work is performed using the approved classification Coding systems to include the modifiers. All work carried out in accordance with the rules, regulations and coding conventions of the AAPC/AMA CPT Guidelines, AAPC/AMA. American Hospital Association (Coding Clinic), ICD 10-CM CMS, HCAI, and NorthBay Healthcare coding guidelines.Primary Job ResponsibilitiesThe coder independently...

Cottage Health seeks a HIM Coder IIIfor their CH Health Information Management department responsible for coding and abstracting 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. Qualifications QUALIFICATIONS: All job qualifications listed indicate the minimum level necessary to perform this...

Job Description Cottage Health seeks a HIM Coder III for their CH Health Information Management department responsible for coding and abstracting 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 Qualifications QUALIFICATIONS: All job qualifications listed indicate the minimum level...

HIM Coder IIICottage Health seeks a HIM Coder III for their CH Health Information Management department responsible for coding and abstracting 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 activitiesQualificationsAll job qualifications listed indicate the minimum level necessary to perform this job...

Medical Billing Specialist I/II - Behavioral Health Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5369990) Apply  Medical Billing Specialist I/II - Behavioral Health Salary $47,840.00 - $69,546.52 Annually Location Oxnard, CA Job Type Full-Time Regular Job Number 0838HCA-26AA (VM) Department Health Care Agency Division Behavioral/Mental Health Opening Date 06/15/2026 Description Benefits Questions Description How to Submit a Successful Application video: https://hr.venturacounty.gov/how-to-apply/application THE DEPARTMENT: As a vital department of Ventura County Health Care Agency (HCA), Ventura County Behavioral Health (VCBH) provides comprehensive mental health and substance use treatment services tailored to meet the needs of our community. From mobile crisis response to outpatient treatment, our array of programs ensures individuals receive the support they need at every stage of their...

Medical Billing Specialist I/II The Department: As a vital department of Ventura County Health Care Agency (HCA), Ventura County Behavioral Health (VCBH) provides comprehensive mental health and substance use treatment services tailored to meet the needs of our community. From mobile crisis response to outpatient treatment, our array of programs ensures individuals receive the support they need at every stage of their journey. The Position: Under general supervision at the (I) level, or direction at the (II) level, the incumbent is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance reimbursement requirements. What We Offer: The County of Ventura offers an attractive compensation and benefits package. Aside from our base salary range, an employee within this position will also be eligible for the following: Educational Incentive - An educational incentive of...

Position Overview We are seeking a meticulous and detail-oriented Medical Coder specializing in professional services, experience coding General and Orthopedic surgery with emphasis on spine and sports medicine. The ideal candidate will possess a strong understanding of coding guidelines, regulations, and reimbursement methodologies relevant to professional services in healthcare. Responsibilities Accurately assign CPT, HCPCS, and ICD-10 codes for professional services. Review medical documentation to ensure coding compliance with regulatory and organizational guidelines. Collaborate with healthcare providers and coding auditors to resolve coding discrepancies or documentation issues. Maintain proficiency in current coding practices, regulations, and industry updates to ensure accurate and up-to-date coding. Support internal teams by providing coding insights, education, and training on best practices related to professional services coding. Identify and communicate...

Conducting medical records and coding related reviews to validate the integrity of coded procedures. Work closely with clinical departments and Revenue Cycle Services within Community Health Partners to ensure compliance with coding guidelines, government, payer, and internal charge capture policies. Provide education and training to clinical providers and staff within the practices on proper documentation and coding guidelines, practices, and procedures. Requirements High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required 2 years of professional coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCS modifiers required One of the following is required: CCS - Certified Coding Specialist, CPC - Certified Professional Coder, CPMA - Certified Professional Medical Auditor, RHIT - Registered Health Information Technician, RHIA - Registered Health Information Administrator. Core...

Medical Coder II Community health is about more than just vaccines and checkups. It's about giving people the resources they need to live their best lives. At Neighborhood, this is our vision: a community where everyone is healthy and happy. We're with you every step of the way, with the care you need for each of life's chapters. At Neighborhood, we are Better Together. As a private, non-profit 501(C) (3) community health organization, we serve over 500,000 medical, dental, and behavioral health visits from more than 100,000 people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance. Since 1969, our employees have been making this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If this sounds like an...