26 coding auditor facility jobs found

Note: While this role is currently remote, we are prioritizing candidates within commuting distance of our Rossford, Dublin, or Brooklyn offices to accommodate a potential future shift to a hybrid schedule. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers applicable Centers...

Description Note: While this role is currently remote, we are prioritizing candidates within commuting distance of our Rossford, Dublin, or Brooklyn offices to accommodate a potential future shift to a hybrid schedule. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers...

Description Note: While this role is currently remote, we are prioritizing candidates within commuting distance of our Rossford, Dublin, or Brooklyn offices to accommodate a potential future shift to a hybrid schedule. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers...

Join our team as an Outpatient Coding Auditor in a fully remote position! We are searching for dedicated individuals nationwide who are passionate about maintaining high standards in coding practices. About You Share your experience with Outpatient Coding Auditing. Emphasize your ability as a team player and self-motivator. Demonstrate your skills in managing multiple projects while utilizing problem-solving abilities. What makes you truly unique? We want to know! If you are committed, team-oriented, and value professionalism, trust, honesty, and integrity, we are eager to connect with you. About The Position Possess advanced knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM), Procedural Coding System (PCS), Current Procedural Terminology (CPT-4), and Healthcare Common Procedure Coding System (HCPCS). Have practical knowledge of reimbursement systems such as Prospective Payment System (PPS), Diagnostic Related...

Description Note: While this role is currently remote, we are prioritizing candidates within commuting distance of our Rossford, Dublin, or Brooklyn offices to accommodate a potential future shift to a hybrid schedule. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2675 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced knowledge...

Medical Coding and Billing Compliance Auditor Location: Remote Division: Coding Compliance About the Role: The Medical Coding Auditor is a detail-oriented position responsible for reviewing medical coding accuracy, documentation integrity, ensuring compliance with federal and state regulations, payer guidelines, and internal policies. The ideal candidate will bring strong analytical skills, extensive coding knowledge, and a passion for maintaining the highest standards of quality and compliance. The candidate will demonstrate a strong background in Microsoft Office applications including PowerPoint, Word, Excel, Outlook, TEAMS, and SharePoint. The Medical Coding Auditor will have a background in physician feedback and education on documentation integrity and coding accuracy. The ideal candidate will have extensive knowledge of CPT coding, ICD-10-CM coding, E/M coding, HCC methodologies, modifiers, telehealth, and HCPCS coding. The candidate will understand and know where to access...

Medical Claims Specialist This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization's operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. Job Duties/Responsibilities Maintains a thorough understanding and education of federal and state regulations and payer specific policies and...

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. ***** FT and PRN Openings *** Up to $5,000 Sign On Bonus ***** 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...

HSO Valuable Perks: Competitive pay with eligible incentive bonuses & yearly merit increases Structured schedules for work-life balance with Paid Time off Full Health Benefits Package, Courtesy Care Benefits &Health Savings Accountfunds Student Loan Forgiveness program & tuition reimbursement Employer contribution-driven retirement plan Complimentary scrubs A day in the life of a Senior Coding Auditor and Educator at HealthSource: Conduct regular coding audits for all HSO clinicians to verify that CPT, ICD-10, and HCPCS codes are assigned correctly and in compliance Conduct regular coding audits for all HSO coders to verify that CPT, ICD-10, and HCPCS codes are assigned correctly Detect coding discrepancies, documentation deficiencies, and billing errors Provide feedback and training to clinicians, coders, and clinical staff Assistin the preparation of reports and audits todemonstratecompliance andidentifyareas for financialimprovement...

Join Datavant, the leading data collaboration platform in healthcare, dedicated to ensuring the world's health data is secure, accessible, and actionable. Our mission drives us to provide essential data solutions for a variety of healthcare organizations, including providers, health plans, researchers, and life sciences companies. At Datavant, you will be part of a passionate team focused on transforming the future of healthcare through innovative data connectivity. What We Are Looking For: As an HCC (Hierarchical Condition Category) Auditor, you will be pivotal in reviewing medical records that have been coded in a standardized system, ensuring each patient’s conditions are accurately represented for risk adjustment and reimbursement. Your expertise will help translate clinical documentation into precise codes, reflecting the complexity and severity of patients' health statuses while confirming the accuracy of your work. What You'll Be Doing: Audit coded charts...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

Anderson Hills Pediatrics' Expectations of all Employees: Adhere to all Anderson Hills Pediatrics' Policies and Procedures Conduct self in a manner that represents Anderson Hills Pediatrics' core values at all times Maintain a positive and respectful attitude with all work-related contacts Consistently reports to work prepared to perform the duties of the position Meets productivity standards and performs duties as workload necessitates Primary Function : Assists the Billing Manager with the claims submission and revenue cycle of the practice. Major Duties and Responsibilities : • Adherence to current HIPAA regulations and federal/state laws for patient protected health information (PHI) and/or medical records; adherence to all AHP policies/procedures as they pertain to patient PHI and the medical record; maintain strict confidentiality of all patient information • Update patient demographic information including insurance coverage; make changes/corrections as...

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 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...

Supervisor Medical Coding Compliance Quality Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers applicable Centers for Medicare/Medicaid Services (CMS) and Health and Human Services (HHS) regulatory guidance and expectations to assigned team. Ensures areas of concern with chart documentation are addressed and that quality and productivity metrics are met and/or exceeded. Maintains cross-functional relationships with other departments as well as vendors to assure timely chart collection efforts and accurate documentation guidelines are communicated and facilitated. Supervises staff that perform medical record retrieval and quality assurance of documentation and/or coding. Documents...

Summary of Position To aid and assist in providing direction, instruction, and guidance to a team of individuals with the purpose of training and developing staff. Works with the CBO A/R Manager to manage projects and develop process improvements, while providing the daily guidance and assistance needed to maintain optimal performance and productivity within the team. Provides supervisory guidance to the team as directed by the A/R Manager and perform all functions with a high level of discretion and professionalism. Nature and Scope An effective Senior Team Lead will provide guidance to their team based on management direction, will use their experience and knowledge of the tools the team uses (e.g., EPIC), policies, and guidelines to educate team members, will identify areas for improvement systematically and within their team, and will communicate directly with management the status of resolved and outstanding issues/roadblocks within the team. Principal Duties and...

PURPOSE OF THIS POSITION This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization's operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. JOB DUTIES/RESPONSIBILITIES Duty 1: Maintains a thorough understanding and education of federal and state regulations and payer...

Phoenix Retail Trade Compliance Auditor/Data Analyst PHOENIX Retail, LLC is a retail platform operating the Express and Bonobos brands worldwide. Express is a multichannel apparel brand dedicated to a design philosophy rooted in modern, confident and effortless style whether dressing for work, everyday or special occasions. Bonobos is a menswear brand known for being pioneers of exceptional fit and a personalized, innovative retail model. Customers can experience our brands in over 400 Express retail and Express Factory Outlet stores, 50 Bonobos Guideshops, and online at and . The Trade Compliance Auditor/Data Analyst is a dual-function role that provides critical audit and analytical support to the trade compliance department. This role combines compliance auditing with data analytics to ensure data integrity across all trade systems and using analytics to drive compliance and identify cost recovery opportunities. This position conducts regular internal audits of customs...

Candidate should ideally be located in Columbus, OH or Cleveland, OH Monro’s family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach.  Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company’s regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color.  Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto service in the industry.  Do you have what it...

Administrative/Clerical Summary of Position To aid and assist in providing direction, instruction, and guidance to a team of individuals with the purpose of training and developing staff. Works with the CBO A/R Manager to manage projects and develop process improvements, while providing the daily guidance and assistance needed to maintain optimal performance and productivity within the team. Provides supervisory guidance to the team as directed by the A/R Manager and perform all functions with a high level of discretion and professionalism. Nature and Scope An effective Senior Team Lead will provide guidance to their team based on management direction, will use their experience and knowledge of the tools the team uses (e.g., EPIC), policies, and guidelines to educate team members, will identify areas for improvement systematically and within their team, and will communicate directly with management the status of resolved and outstanding issues/roadblocks within the team....

PURPOSE OF THIS POSITION This position is responsible for all medical claims including pre‑billing and follow‑up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre‑claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization’s operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow‑up activities and collection of accounts. Job Duties/Responsibilities Maintains a thorough understanding and education of federal and state regulations and payer specific policies and...

Based in Akron, Ohio, SummaCare provides Medicare Advantage, individual, family, and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5‑Star rating for 2025 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits. Position Summary Performs chart retrieval, medical record review, HCC identification and data quality oversight for risk mitigation and revenue recovery for both Medicare and ACA services. Assists in the development and management of activities in support of HCC coding while ensuring compliant practices for revenue management and reducing risk. Helps in the preparation with all Risk Adjustment Data Validations (RADV) audits as well as serving as the CMS liaison for coding questions/issues. Determines...