23 coding auditor educator lead jobs found

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 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 Posting 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 inpatient 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 inpatient 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 Education/GED or equivalent: Required...

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 Posting 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 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...

Medical Billing Specialist I/IIThe 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 2.5% for completion...

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 types. Handles...

Job Posting 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 inpatient 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 inpatient 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 Education/GED or equivalent:...

Health and Information Management – PB / ProFee Coder 3 weeks ago Be among the first 25 applicants TALENT Software Services provided pay range This range is provided by TALENT Software Services. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $40.40/hr - $41.60/hr Coding Educator (Temp-to-Hire, 13 Weeks) Location: Within *** Footprint (Hybrid – Mostly Remote with Local Travel) Type: Contingent / Temp-to-Hire Overview is seeking experienced Professional Fee (Pro Fee)–focused Coding Educators to support large-scale chart review, coding accuracy validation, physician education, and documentation improvement initiatives. These roles are high-visibility and require strong communication and presentation skills to engage directly with clinicians and support Sutter's revenue cycle, audit, and education functions. Key Responsibilities Coding Education & Training Deliver physician and coder education for...

JOB SUMMARY The Health Information Coder III PD is a senior-level inpatient coder with advanced knowledge and skill set to utilize the ICD-10-CM, ICD-10-PCS, CPT, HCPCS classification systems. The skill set extends to advanced knowledge and comprehension of code sequences into Diagnoses-Related Groups. Cases are coded to comply with the official guidelines for coding and reporting, practice standards and code of ethics for HIMS coder. Cases are abstracted according to UCSF Health policies and procedures. The focus of coding and abstracting is on a range of all primary hospital services. This is a per diem position with no set schedule. OTHER FUNCTIONS AND RESPONSIBILITIES Demonstrate understanding of DRG coding mission within UCSF Health. Demonstrate understanding of DRG coding, AR, and data submission information flow. Ability to solve problems and troubleshoot computer issues. Perform data searches. Maintain patient confidentiality and IT...

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...

Join to apply for the Sr Coder role at Dignity Health 1 day ago Be among the first 25 applicants Position Summary The Senior Coder (Sr. Coder) acts as the lead coder for their designated team. This position will train staff on department policies, procedures, systems, and correct coding requirements. The Sr. Coder additionally will monitor staff workload, audit coders, fill in for out-of-office coders, and make recommendations to Physician Coding leadership to improve team efficiency. Responsibilities This position is remote. Train all new coders on department policies, procedures, and correct coding principles. Provide routine education, training, and auditing to their designated coding teams. Analyze coder's workload and make recommendations to ensure timely completion of all work. Research and guide coders and staff on coding-related questions or concerns. Create and update coder job aids for accurate coding of all services. Assist with provider education and feedback...

UCSF Health is seeking a senior coder to lead the Faculty Practice Revenue Management Operations coding team. You will manage extensive ICD-10 and CPT codes, guide a centralized team, and ensure accurate coding aligned with federal and state guidelines. The role emphasizes education, audits, and high production coding to support UCSF goals for accuracy and charge lag. A CCS, CPC, or related licensure is required and a strong revenue cycle background is essential. #J-18808-Ljbffr

Payroll Title PAT BILLER 2 Department FACULTY PRACTICE REVENUE CYCLE Hiring Pay Scale $29.68 - $36.91 / Hour Worksite Greenwich Drive Appointment Type Career Appointment Percent 100% Union EX Contract Total Openings 1 Work Schedule Days, 8-Hour Shifts, Monday - Friday #140681 Patient Biller II Filing Deadline: Fri 8/28/2026 UC San Diego values and welcomes people from all backgrounds. If you are interested in being part of our team, possess the needed licensure and certifications, and feel that you have most of the qualifications and/or transferable skills for a job opening. UCSD Layoff from Career Appointment: Apply by 08/18/26 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor. Reassignment Applicants: Eligible Reassignment clients should contact their Disability Counselor for assistance. This position is 100% ONSITE at Greenwich Drive, San Diego, CA. No option for hybrid or remote. Description UC San Diego...

Job Details Job Location: Burlingame, CA 94010 Salary Range: $42.79 - $48.75 Hourly 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. Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance. Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy. Provider Training and Clinical Documentation Improvement (CDI) Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding. Provide one‑on‑one and group training to providers and clinical staff to improve documentation quality and accuracy. Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards. Data Analysis and Reporting Analyze coding data to identify trends,...

Join to apply for the Compliance Coding Auditor , ATM role at Advanced Medical Management, Inc. Your actual pay will be based on your skills and experience. Talk with your recruiter to learn more. Base pay range: $75,000 to $80,000 per year. Role Overview As a member of AMM’s Compliance and Ethics team, the Compliance Coding Auditor is an important driver of our mission. They are responsible for supporting the Company’s Compliance & Ethics Program (the Program) auditing, tracking, and monitoring initiatives. Robust auditing, testing, and monitoring capabilities are essential to fulfilling the expectations of AMM’s key stakeholders, including patients, families, and government agencies. The Program is led by AMM’s Chief Compliance & Ethics Officer, who reports to the CEO and the Board, and oversees the AMM Compliance Committee. This role requires sound, risk‑aware judgment, productive collaboration across the Company, and demonstrated success in performing audits to...

Position Overview Under the general direction of the Revenue Manager/Associate Director, this senior coder role oversees a large range of coding combinations (approximately 1,500–5,000), applies specialized coding knowledge to manage ICD‑10 and CPT procedural codes, and guides a centralized coding team as a subject matter expert to improve accuracy and efficiency of professional fee coding. Responsibilities Lead as a subject matter expert, presenting information to the team. Audit and oversee team members’ accuracy and production. Ensure compliance with all federal, state, and local carrier guidelines. Provide education and training to coding staff and physicians. Perform high‑production coding to meet UCSF goals for accuracy and charge lag. Conduct in‑depth reviews of physician documentation and prepare documentation audits. Create coding analysis reports and online presentations with findings and recommendations. Determine methods and procedures for new assignments and...

Medical BillerWe are seeking an experienced and diligent Medical Biller who wants to make a difference in our community. We want to hear from you if you thrive in a fast-paced, caring, and compassionate environment!The Mission of South-Central Family Health Center is to improve the quality of life for the diverse community of inner-city Los Angeles by providing affordable and comprehensive health care and education in a welcoming and multi-cultural environment. To lead the way in health care in South Los Angeles, as the premier provider and employer of choice offering comprehensive, high quality, affordable, efficient and culturally responsive services.Under the supervision of the Revenue Cycle/Billing Administrator, the Medical Biller I will be responsible for the processing and responding to all patient-related billing and the submission of bills for reimbursement from various programs (i.e. Medi-Cal, CPSP, EAPC, etc.). The ideal candidate will have to perform some of the...

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...

Health and Information Management – PB / ProFee Coder 2 weeks ago – Be among the first 25 applicants Pay Range Base pay range: $40.40/hr – $41.60/hr Coding Educator (Temp‑to‑Hire, 13 Weeks) Location: Within *** Footprint (Hybrid – Mostly Remote with Local Travel) Type: Contingent / Temp‑to‑Hire Overview Seeking experienced Professional Fee (Pro Fee)–focused Coding Educators to support large‑scale chart review, coding accuracy validation, physician education, and documentation improvement initiatives. These roles are high‑visibility and require strong communication and presentation skills to engage directly with clinicians and support Sutter’s revenue cycle, audit, and education functions. Candidates must live within the *** geographic footprint and be available for occasional on‑site work and local travel. Positions are structured as 13‑week temp‑to‑hire with conversion opportunities. Key Responsibilities Coding Education & Training Deliver physician and coder...