59 coding auditor educator jobs found

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 Auditor & Provider Educator NAH reserves the right to make hiring decisions based on applicants' state of residence if outside the state of Arizona. NAH currently hires for remote positions in the following states: Alabama Arizona Florida Georgia Idaho Indiana Kansas Michigan Missouri North Carolina Ohio Oklahoma Pennsylvania South Carolina Tennessee Texas Virginia The Coding Auditor & Provider Educator is a critical role responsible for ensuring the accuracy, completeness, and compliance of medical coding (CPT, HCPCS, ICD-10-CM) for professional services. This individual will conduct thorough coding audits, identify areas for improvement in documentation and coding practices, and develop and deliver targeted educational programs to physicians, advanced practice providers (APPs), and clinical staff. The primary goal is to optimize revenue integrity, mitigate compliance risks, and foster a culture of accurate and compliant documentation and...

Professional Coding Auditor And Educator - Remote This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation...

Job Description A healthcare employer in Houston, TX is seeking a Coding Auditor to join their growing team. This position is remote but candidates must live in the following states: TX, OK, LA, TN, and GA. This position will audit and educate our coders (internal and onsite coders approx.. 40+ coders). The person in this position will audit 80-85% of the time with education to the coders based on auditing results. They will be focused on non-surgical coding within the following specialties: Urology, Bariatrics, Interventional Cardiology, OB/GYN and Neurology. They will specifically be auditing E/Ms with a heavy focus diagnosis codes and modifiers. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color,...

We've learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas®. Job Summary The Coder-Outpatient is responsible for the ICD-10-CM, ICD-10-PCS, CPT and modifier assignment of diagnosis and procedures of an outpatient visit. Reports to: Job Specific Responsibilities Daily assignments may include but are not limited to: • Assign and sequence diagnostic and procedural codes for patient care, utilizing ICD-10, CPT, and HCPCS coding systems. • Ensure accurate and compliant coding of medical services and procedures based on clinical documentation. • Review patient records and physician documentation to validate coding accuracy and completeness. • Work collaboratively with healthcare providers and staff to clarify and address documentation discrepancies. • Maintain knowledge of current coding guidelines, insurance regulations, and compliance standards. • Assist in audits and reviews to ensure...

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...

Responsibilities HIM/Medical Records Analyst/Coding Specialist Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility is fully accredited and included a 16-bed residential treatment center for adult chemical dependency. We offer a broad range of behavioral health programs for children, adolescents and adults. Treatment is offered at multiple levels of care including inpatient, partial hospitalization and intensive outpatient. We are available 24 hours a day, seven days a week to assist you and answer your questions about treatment options and insurance coverage. The hospital is easily accessible off the Southwest Freeway near the Galleria. Visit us online at: https://westoakshospital.com/ West Oaks Hospital is seeking a dynamic and talented HIM/Medical Records Coding Specialist to join our team of compassionate, dedicated professionals. The HIM/Medical...

Medical Coder Multi-Specialty (Hospital & Clinic) Location: Kingwood-Hybrid Employment Type: Full-Time Reports To: Revenue Cycle Manager Position Summary We are seeking a highly skilled, detail-driven, and high-producing Certified Medical Coder with multi-specialty experience to join our growing healthcare organization. This role requires strong proficiency in both hospital and outpatient clinic coding, with specialty expertise in: Cardiology Urology Dermatology General Surgery Pulmonology The ideal candidate has 2+ years of coding experience, maintains current certification (AAPC or equivalent), and consistently demonstrates accuracy, productivity, and strong clinical understanding across multiple service lines. This is a high-impact role within a performance-driven, collaborative organization focused on compliance, precision, and revenue integrity. Core Responsibilities Coding & Documentation Review Accurately assign ICD-10-CM, CPT, and HCPCS Level...

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...

Compliance Auditor & Billing Data Analyst - Oncologyhub 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 - Oncologyhub Locations: Atlanta, GA; Columbus, OH; Dallas, TX (Preferred) Onsite/Remote/Hybrid: Remote Position Position Description: Under minimal supervision, the Health Care Coding & Billing Data Analyst is responsible for performing data-driven coding and...

Location: Virtual Employee PRIMARY PURPOSE Conducts audits of medical record coding to ensure compliance with established guidelines, provides results of audits, and assists with educational activities related to findings to promote adherence to state/federal laws and regulatory requirements. MINIMUM SPECIFICATIONS Education: - Must be a graduate of a Health Information Management program or must have successfully completed an approved Coding educational program. Experience - Must have six (6) years of proven coding experience in an acute care setting. Equivalent Education and/or Experience - May have an equivalent combination of education and experience in lieu of specified requirements. Certification/Registration/Licensure - Because of the lag in SCCE, HCCA, NCRA, and AHIMA updating the status of certifications, current employees whose certification is granted through one of these associations are allowed up to seven (7) calendar days, after expiration, to...

POSITION SUMMARY This position is responsible for accurately coding at least one main outpatient work type accounts (Observation, Same Day Surgery, and/or ER) as well as assisting with the coding of other outpatient work types as needed. All accounts should be completed within 5 days following discharge. POSITION REQUIREMENTS Minimum Education Required: Completion of college level course work in Medical Terminology and Anatomy and Physiology. Preferred: Minimum education level of Associates Degree. Minimum Work Experience Required: A minimum of two (2) years coding experience in an acute care hospital. Required Licenses/Certifications Required: CCA credentials (Certified Coding Associate) or CPC credentials (Certified Professional Coder) Required Skills, Knowledge, and Abilities Required: A through working knowledge of Medicare billing rules, regulations and local medical review policies as they impact reimbursement under APCs and DRGs. Preferred Qualification...

Job Posting Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials. Job Responsibilities/Duties: Chart Analysis IP, 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). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to Standards of...

Description Summary: Selected by CHRISTUS Health Coding Leadership, to focus coding skills and expertise on designated Inpatient or Outpatient high dollar or specialty account types. Specialty Coder is responsible for maintaining current and high-quality ICD-10-CM, ICD-10-PCS and/or CPT coding for the Inpatient and or/ Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Specialty Coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding and Reporting and AMA CPT Guidelines. Coder will work collaboratively with various CHRISTUS Health departments, including but not limited to the HIM and Clinical Documentation Specialists, to ensure accurate and complete physician...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This is a work from home position that requires the selected candidate to have a permanent address and live in New Mexico or be willing to relocate to New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217 Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical...

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 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,...

Business, Managerial & Finance UTMB Health Minimum Qualifications: Two years of medical billing or related experience, or related training from a non-accredited program or accredited agency. Preferred Qualifications: Knowledge of coding guidelines, anatomy and physiology, biology and microbiology, medical terminology and medical abbreviations. Required Licenses, Registrations, or Certifications: One of the following: CCA Certified Coding Associate (AHIMA) or CCS Certified Coding Specialist (AHIMA) or CCS-P Certified Coding Specialist Physician Based (AHIMA) or RHIA Registered Health Information Administrator (AHIMA) or RHIT Registered Health Information Technician (AHIMA) or CIC Certified Inpatient Coder (AAPC) or COC Certified Outpatient Coder (AAPC) or CPC Certified Professional Coder (AAPC) or CPC-A Certified Professional Coder Apprentice (AAPC) or CRC Certified Risk Adjustment Coder (AAPC) Job Summary: Properly codes and/or audits...

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...

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...

DRG Coding Auditor Principal 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. 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. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case...

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...

Hours of Work : 8 AM -4:30 PM Days Of Week : M-F Work Shift : Job Description : Your Job: In this highly technical and fast-paced position, you will collaborate with multidisciplinary team members to provide the very best care for our patients. The Coder 3 performs pre-bill (secondary) audits on inpatient, ambulatory care and observation records to ensure accurate ICD10-CM, ICD10 PCS and/or CPT codes for optimal reimbursement and provide data and clinical information to management, medical STAFFnd various hospital departments. The reviewer also codes and abstracts inpatient, ambulatory and observation records for diagnosis and procedures to determine optimal reimbursement. Your Job Requirements: • Associate's degree in Health Information Management or Certification as a Coding Specialist; Bachelor's degree in Health Information Management preferred • RHIA, RHIT, or CCS preferred • Minimum of 3 years of DRG-based coding experience in an acute care hospital...

Professional Coder 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 appropriately and timely. Perform audits as determined by management. Assist with all levels of application testing for...