31 coding auditor educator jobs found

Compliance Auditor/EducatorThe Compliance Auditor/Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services. Provides professional expertise and education in CPT, ICD and HCC coding. The Compliance Auditor/Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations. This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution. Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance.Develops and leads audit projects for medical record integrity, service line or issues-related audits, identifies problems and uses...

Job Title Employment Type: Full time Description Purpose: Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization's strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge. Note: "patients" refers to patients, clients, residents, participants, customers, members Essential Functions Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program...

Employment Type: Full time Shift: Description: Purpose Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization’s strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge. Note: “patients” refers to patients, clients, residents, participants, customers, members Essential Functions Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency &...

POSITION DESCRIPTION :The Compliance Auditor / Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services.Provides professional expertise and education in CPT, ICD and HCC coding.The Compliance Auditor / Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations.This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution.Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance.ESSENTIAL JOB FUNCTIONS :Develops and leads audit projects for medical record integrity, service line or issues-related audits, identifies...

Trinity Health in Michigan seeks an experienced Health Information Management professional to lead coding audits and education for complex services. The role emphasizes accuracy, compliance, and improving documentation and coding practices. You will analyze coding patterns, provide actionable feedback to providers and coders, and develop targeted training based on regulatory updates with focus on CPT, ICD-10, HCPCS and payer policies. #J-18808-Ljbffr

Yeo & Yeo Medical Billing & Consulting Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future we provide...

Job Opportunity Positions Location: Lansing, MI Job Description General Purpose of Job: Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine Sparrow policies and procedures and maintains required quality and productivity standards....

Job Description Job Description The PB Coder is responsible for reviewing, analyzing, and accurately coding ambulatory and/or hospital-based encounters. This role performs initial charge review for E/M visits, diagnostic tests, and procedures across multiple specialty departments to determine the appropriate assignment of CPT, ICD-10, HCPCS codes, and modifiers for reporting physician services to third-party payers. The PB Coder ensures all coding aligns with established coding standards, regulatory requirements, and reimbursement policies. Essential Duties and Responsibilities: Analyzes provider documentation to assure appropriate Evaluation & Management (E/M) levels are assigned using the correct CPT and current Evaluation and Management Guidelines Analyzes provider documentation to assure that appropriate CPT codes are assigned for surgeries and other diagnostic procedures. Ensures that all coding aligns with coding standards, regulatory requirements and other...

CoordinatorThe Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review, ensuring accurate capture of diagnosis codes, and educating providers. This role partners closely with providers, clinical staff, coding teams and operational leadership to optimize HCC capture and improve documentation integrity.Qualifications: Professional coding certification; Certified Risk Adjustment Coder (CRC) strongly preferred or required within 12 months of hireExperience with risk adjustment programs preferred.Prior provider education or clinical collaboration experience preferred.Excellent communication skills for provider education and stakeholder collaborationEmployment Type: Full TimeShift: Mon-Thrs- 8am-4:30pm Fri- 8a-12pWeekly Scheduled Hours: 36Wage Range: $23.30 - $34.95 per hourWeekend Requirements: NARequirements:- High school diploma/GED or higher...

Are you an experienced inpatient coder who thrives in fast‑paced, academic environments and wants to make a lasting impact beyond the chart? This Senior Medical Records Coder role sits at the heart of two dynamic Family Medicine Residency programs—Corewell Health Troy Beaumont and CHMG East–Grosse Pointe—supporting highly productive faculty physicians, community preceptors, and more than 24 residents and medical students. In this highly visible and influential position, you’ll serve as both coding expert and educator, guiding providers through complex documentation, billing, and compliance requirements while helping shape the next generation of primary care physicians through audits, one‑on‑one education, resident orientation, and ongoing regulatory review. Responsibilities Provides technical coding support to the Inpatient Coding Staff and coordinates daily workflow based on the needs of the department and as directed by the Manager of Coding. Submits departmental statistics...

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Back-End Medical Biller Full-Time, Temp to Hire Opportunity - Onsite Hours: 8 am to 4:30 pm M-F (30-minute lunch) $19-$20 per hour DOE Professional Summary This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities General Responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days Accurately post all insurance payments by line item Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely*...

Medical Billing Specialist Administration - Flint, MI 48502 Overview Position Type Full Time Education Level High School Category Health Care Description This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third-party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities. General responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks. Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days. Accurately post all insurance payments by line item. Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely* Collects...

Yeo & Yeo Medical Billing & ConsultingCome grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding.Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies.Our people are our future – we provide the...

Yeo & Yeo Medical Billing & Consulting Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future – we...

Health Information Management Coding Specialist Outpatient The Health Information Management Coding Specialist Outpatient provides timely and accurate clinical and administration data to ensure optimal reimbursement for facility outpatient, ambulatory surgery, observation, recurring accounts to support the facility coding needs. This may include coverage on some Rehab or Skilled Care accounts. Primary patient contact is only social. Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation. Responsibilities Contributes to organization success targets for patient satisfaction. Formulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients, and other department staff members. Adhere to...

Huron Gastro, P.C. is an adult medical gastroenterology practice specializing in the diagnosis, treatment, and management of disorders that affect the esophagus, stomach, small intestine, large intestine (colon), rectum, liver, gallbladder, bile ducts, and pancreas. Our practice includes 25 physicians who are board-certified in gastroenterology by the American Board of Internal Medicine, 9 Advances Practice Providers, and an outstanding staff of clinical and administrative personnel. Huron Gastro has been a leader in the field for over 5 decades, with expertise in every leading-edge technology that is currently available for the practice of gastrointestinal medicine. Huron Gastro is committed to high quality, efficient, compassionate, cost-conscious care. We value our culture which holds high the values of dignity and respect, and we focus much time and effort on continuing education for our health care professionals. We currently have an opportunity for a Certified...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Job OpportunityPositions Location: Lansing, MIJob DescriptionGeneral Purpose of Job: Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine – Sparrow policies and procedures and maintains required quality and productivity standards.Essential...

Position Description & Qualifications Serco is excited to continue our support to the Defense Heath Agency (DHA) Medical Coding Program Branch (MCPB). The DHA is a joint, integrated Combat Support Agency that enables the Army, Navy, and Air Force medical services to provide a medically ready force to Combatant Commands in both peacetime and wartime. The essential mission of the DHA Medical Coding Program Branch (DHA-MCPB) is to improve the accuracy and quality of medical coding and documentation across DHA in support of the DHA mission. Medical Coding Auditing consists of a systematic, unbiased, independent examination of medical documentation and coding to validate that all codes entered into the Military Health System (MHS) systems are in conformity with official coding policies, regulations, requirements, and standards. The auditing task involves developing or following a disciplined, systematic process that defines what is to be audited and why, how errors are defined and...

Datavant is seeking a Profee Auditing & Education Specialist for a fully remote role with a flexible schedule. You will perform professional fee coding audits, develop education programs, and present coding and compliance topics to diverse healthcare stakeholders. A 2,500 sign-on bonus is offered, and the base pay range is $35–$45 per hour. Ideal candidates bring 5+ years in coding/auditing, 3+ years in coding education, and proficiency with Epic/Cerner EMRs. #J-18808-Ljbffr

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...