97 coding auditor facility jobs found

Job Description Job Description PYA is seeking an Inpatient/Outpatient Facility Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue and Compliance Advisory Program . RESPONSIBILITIES : Apply inpatient and outpatient facility/hospital coding and reimbursement methodologies to provide advisory services to PYA clients with a focus on the following: ICD-10-CM and PCS/CPT/HCPCS code assignment MS-DRG and other DRG validation APC validation and charge capture Clinical documentation improvement Regulatory compliance for third party payors Work in collaboration with the PYA executive team and other service lines to offer complete business solutions to clients Manage the preparation of excellent client deliverables and exhibit exceptional project management skills while balancing firm risk and compliance with appropriate professional...

Summary This position is located in the Health Information Management (HIM) section at the Orlando VA Medical Center. MRTs (Coder) Auditor are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. Responsibilities Auditors serve as experts of current coding conventions and guidelines related to professional and facility coding, perform audits of encounters to identify areas of non-compliance in coding. Duties include but are not limited to: Reviews, analyzes and reports performance monitors for PTF, PCE, VERA and Non-VA medical Care (purchased care) coding. Audits accurate and complete assignment of ICD-10-CM and ICD-10-PCS codes, MS-DRG, POA status, and discharge disposition values for inpatient health records. Reviews coding and assist coders in improving coding accuracy, provides coding guidance to various levels of staff...

Auditor Duties Auditors serve as experts of current coding conventions and guidelines related to professional and facility coding, perform audits of encounters to identify areas of non-compliance in coding. Duties include but are not limited to: Reviews, analyzes and reports performance monitors for PTF, PCE, VERA and Non-VA medical Care (purchased care) coding. Audits accurate and complete assignment of ICD-10-CM and ICD-10-PCS codes, MS-DRG, POA status, and discharge disposition values for inpatient health records. Reviews coding and assist coders in improving coding accuracy, provides coding guidance to various levels of staff to promote consistency in practice and compliance with coding rules and regulations, and initiates various reports and analyzes data. Facilitates improved overall quality, completeness and accuracy of coded data. Performs audits of coded data, developing criteria, collecting data, graphing and analyzing results, creating reports and communicating...

Auditor Duties Auditors serve as experts of current coding conventions and guidelines related to professional and facility coding, perform audits of encounters to identify areas of non-compliance in coding. Duties include but are not limited to: Reviews, analyzes and reports performance monitors for PTF, PCE, VERA and Non-VA medical Care (purchased care) coding. Audits accurate and complete assignment of ICD-10-CM and ICD-10-PCS codes, MS-DRG, POA status, and discharge disposition values for inpatient health records. Reviews coding and assist coders in improving coding accuracy, provides coding guidance to various levels of staff to promote consistency in practice and compliance with coding rules and regulations, and initiates various reports and analyzes data. Facilitates improved overall quality, completeness and accuracy of coded data. Performs audits of coded data, developing criteria, collecting data, graphing and analyzing results, creating reports and...

Our promise to you: Joining AdventHealth is about being part of something bigger. Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 900 HOPE WAY...

Risk Adjustment Coder Porter is hiring a Risk Adjustment Coder to join our team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home health assessments. The ideal candidate will have a strong understanding of CMS...

Job Title Summary/Objective: Obtain accurate reimbursement for healthcare claims. Essential Functions Reviews and resolves all assigned charges thoroughly based on coding guidelines, chart documentation and related charges in billing system. Audits task manager work files with charges reviewed by Claims Manager that were found to have coding errors/omissions. When appropriate communicates approved coding changes and/or questions to Physician's and their office staff. Also alerts providers of missing or late charges. Alerts management to coding trends discovered while working daily charges/edits. Stays informed and up to date on coding issues by attending seminars. Possesses a comprehensive understanding of carrier specific State of Florida billing guidelines. Consistently stays within the department production goal set for your area Requirements Required Education and Experience: High School Graduate or Equivalent. Must be a certified coder either through AAPC or an...

It's rewarding to be on a team of people that truly believe in making an impact!We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.Job SummaryThe Risk Adjustment coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations.Duties & ResponsibilitiesEssential Duties & ResponsibilitiesReview medical record information to identify all appropriate coding based on CMS HCC categoriesPrepare the medical charts and track patient information via Excel spreadsheets.Complete appropriate paperwork/documentation/system...

Become a part of our caring community Become a part of our caring community and help us put health first The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while...

Physician Billing & Coding Specialist I The Physician Billing & Coding Specialist I is responsible for supporting the professional billing lifecycle, including physician coding, charge review and reconciliation, billing, and A/R follow-up. This role reviews clinical documentation for accurate ICD-10, CPT, and HCPCS code assignment; ensures compliance with regulatory and payer requirements; resolves patient and third-party account issues; and serves as a liaison between providers, payers, and patients to promote timely, accurate reimbursement. Education High school diploma or equivalent required Associate's or Bachelor's degree preferred (Health Information Management, Business, or related field) Experience Minimum of two (2) years' experience in healthcare coding, billing, patient accounting, or revenue cycle operations Hospital or physician billing experience preferred Certifications (Required) CPC, CCS-P, CCSP, or equivalent coding certification...

Overview Become a part of our caring community and help us put health first. The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide, including MSO‑contracted independent providers. As the primary coding and documentation resource for assigned providers, you will support accuracy, compliance, and performance in risk adjustment and value‑based care initiatives. You will analyze trends, triage, and answer questions in real‑time, research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, you will be assigned a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS leaders and champions to identify STARS gaps...

Join Our Caring CommunityBecome a part of our caring community and help us put health first. The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS...

Company Overview :Upward Health is an in-home, multidisciplinary medical group providing 24 / 7 whole-person care.Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help.Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients.We are able to treat a wide range of needs - everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals - because we know that health requires care for the whole person.It's no wonder 98% of patients report being fully satisfied with Upward Health!Job Title & Role Description :The Certified Medical Coder is responsible for analyzing provider documentation to accurately select ICD-10 and CPT / HCPCS codes, ensuring compliance with coding guidelines, third-party reimbursement policies, and accreditation standards.This role...

Join Our Caring CommunityBecome a part of our caring community and help us put health first. The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS...

Coding SpecialistLocation: Miramar, FloridaAt Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.SummaryReviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance.ResponsibilitiesCommunicates with insurance companies about coding errors and disputes (physician billing). Abstracts pertinent data points for billing and quality reviews. Communicates with various departments as needed to ensure accuracy of patient data.Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing).May assign and sequence basic CPT (Current Procedural...

Risk Adjustment Coder Porter is hiring a Risk Adjustment Coder to join our team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in...

Job Title: Medical Clinic Biller/Coder Location: Northwest Florida Community Hospital – Chipley, FL Position Type: Full-Time Position Summary: Northwest Florida Community Hospital is seeking a detail-oriented and experienced Medical Clinic Biller/Coder to join our team. This position is responsible for accurate coding, billing, and claims processing for clinic services to ensure timely reimbursement and compliance with federal regulations and payer requirements. The ideal candidate will have strong knowledge of medical terminology, coding systems, and insurance billing procedures. Responsible for all activities in the Clinic accounts receivable function. Manages billing and collection activities such as sending follow-up inquiries, negotiating with past due accounts, and referring accounts to collection agencies. Codes and sequences all diagnoses and procedures using established ICD-10-CM coding rules for each patient encounter; coding will be subject to accuracy and...

Job Description Job Description Description: The Professional Fee (ProFee) Coder is responsible for reviewing provider documentation and assigning accurate CPT, HCPCS, and ICD-10-CM codes for physician services. This role supports compliant coding, accurate charge capture, and overall revenue integrity across a variety of specialties and client environments. Coders may support single-specialty or multi-specialty engagements depending on client needs and experience. Requirements: Core Responsibilities (Sage Standards) Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes Ensure documentation supports coded services and identify discrepancies Apply appropriate modifiers, NCCI edits, and payer-specific coding rules Ensure compliance with CMS, AMA, and payer guidelines Maintain =95% coding accuracy and meet established productivity standards Identify documentation gaps and escalate for clarification when needed Participate in quality...

Job Description Job Description Description: At Sage Clinical RCM, you'll code high-acuity inpatient encounters across a national portfolio of health systems, from academic medical centers to community hospitals. No two client environments are identical, and that's the point. You'll sharpen your skills across specialties, payers, and documentation styles instead of coding the same census for years. What You'll Do Review inpatient encounters and assign accurate ICD-10-CM/PCS codes and DRGs that hold up to audit. Read documentation critically. When it doesn't support the coded services, flag it and escalate the gap. Code in full compliance with CMS requirements, payer-specific rules, and official coding guidelines. Move confidently between client workflows, systems, and audit expectations. Hold the line on quality (95% accuracy or better) while meeting realistic productivity standards. Requirements: What You Bring Active RHIA, RHIT, and/or CCS credential....

Physician Billing Coder Specializing In Anesthesia We are seeking an experienced Physician Billing Coder specializing in Anesthesia to support accurate coding, charge capture, and reimbursement for professional anesthesia services. Reviews and analyzes medical records to assign appropriate diagnostic and procedural codes in compliance with established coding guidelines and organizational policies. Collaborates with healthcare providers to clarify documentation and resolves coding discrepancies, ensures the integrity of coded data for billing and reporting purposes. Maintains current knowledge of coding standards such as ICD, CPT, and HCPCS, and supports the billing department by providing precise coded information for claims submission. Includes auditing coded data, training staff on coding procedures, and monitoring coding productivity and quality metrics to enhance departmental performance. Job Responsibilities: Reviews and analyzes medical records to assign appropriate...

A health services organization in Maitland, Florida is seeking a Certified Professional Coder (CPC) to support managed care operations. This hybrid role focuses on auditing fee schedules, resolving reimbursement discrepancies, and helping maintain payer compliance across Medicare, Medicaid, and commercial plans. About the Opportunity: Shift: Day shift Schedule: Monday to Friday Hours: Standard business Setting: Remote Responsibilities: Audit and reconcile fee schedules against payer contracts, allowable amounts, and internal charge masters Identify discrepancies between billed charges, contracted rates, and actual reimbursements Collaborate with coding, billing, and contracting teams to resolve fee schedule errors and underpayments Maintain and update fee schedule databases to reflect contract changes, CMS updates, and new payer agreements Prepare audit reports and present findings to managed care leadership Qualifications: 3 to 5 years of...

Job Description For a complete understanding of this opportunity, and what will be required to be a successful applicant, read on. Job Description Benefits: 401(k) matching Competitive salary Dental insurance Health insurance Paid time off About Us We are a fast-growing, innovative medical billing company committed to transforming the healthcare revenue cycle through technology, transparency, and top-tier customer service. Our team is passionate about simplifying the complexities of medical billing so healthcare providers can focus on what matters most—patient care. We're seeking a highly motivated and experienced Charge Posting (Coder) Supervisor to join our leadership team and help us continue delivering exceptional results to our clients across the country. Job Overview As the Medical Coder Supervisor, you will lead group of certified coders to accurately review and approval encounters using industry coding guidelines, optimize workflow efficiency, and oversee a high-performing...

Medical Coding Professional 2 The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS leaders and champions to identify STARS gaps and deficiencies....