43 coding auditor provider educator jobs found

Job Description Job Description Overview The Sr Compliance Coding Auditor performs complex coding audits across a range of services, including those delivered in correctional settings and through third-party billing vendors. This role serves as a subject matter expert on coding and documentation guidelines, identifying risks and preparing detailed audit findings. The position works closely with leadership to develop corrective actions and deliver education to providers and coders. This role also supports regulatory audits and provides guidance and mentorship to compliance staff. Responsibilities Plan and conduct complex coding audits using risk-based sampling and established methodologies. Review provider documentation, coding, and modifier usage to ensure compliance with coding standards and payer rules. Analyze findings, prepare detailed audit reports, and present results to providers, coders, and leadership. Support corrective action planning, education efforts,...

Become a part of our caring community The 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 Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

Coder The Coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM, ICD-10-PCS, and CPT codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Abides by the standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to all official coding guidelines. Verifies that all ICD-10-CM and CPT codes are correctly captured. Verify that physician is correctly abstracted. Keeps abreast of coding guideline changes by self-study, assigned education, coding meeting attendance or related in-services. Participates in internal and external quality review meetings. Performs other duties as assigned. Resolves billing related errors and assists with workflow changes and process improvement projects. Meets ongoing productivity and quality standard of 95% accuracy rate or better....

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. Ensure all...

Who We Are BioMarin is a global biotechnology company that relentlessly pursues bold science to translate genetic discoveries into new medicines that advance the future of human health. Since our founding in 1997, we have applied our scientific expertise in understanding the underlying causes of genetic conditions to create transformative medicines, using a number of treatment modalities. Using our unparalleled expertise in genetics and molecular biology, we develop medicines for patients with significant unmet medical need. We enlist the best of the best – people with the right technical expertise and a relentless drive to solve real problems – and create an environment that empowers our teams to pursue bold, innovative science. With this distinctive approach to drug discovery, we’ve produced a diverse pipeline of commercial, clinical and preclinical candidates that have well-understood biology and provide an opportunity to be first-to-market or offer a substantial benefit over...

Overview Opportunities for you! Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek Free Continuing Education and certification Tuition reimbursement, education programs and scholarships Vacation time starts building on Day 1, and builds with your seniority Free money toward retirement with a 403(b) and matching contributions Great food options with on-demand ordering Free parking and electric charging Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page. Responsibilities The Coding Compliance Auditor is a member of the Compliance Office and contributes to the Community Health System's mission to better the lives of all those we serve. As a Coding Compliance Auditor, you will be...

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 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...

Coding Compliance Auditor In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments and accuracy and completeness of all ICD-10-CM, CPT, and HCPCS codes assigned by professional revenue coders and providers. All assigned codes must be supported by professional documentation contained within the medical record and must be in compliance with federal coding compliance regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also, provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics Re: coding accuracy rates, compliance rates, denial analytics, etc. Recommend education topics based on audit findings and assist in the continuing education of professional coders and providers. Understands coding/billing computer systems...

Coding Compliance Auditor Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience...

Coder III Coder III is responsible conducting clinically based concurrent and retrospective reviews of inpatient medical records. This review is to evaluate that the clinical documentation is reflective of quality of care outcomes and reimbursement compliance for acute care services provided. The CDS will work closely with the medical staff to facilitate appropriate clinical documentation of patient care. The CDS/Coder III abstracts and codes the diagnostic and procedural information for Inpatient Services and Surgery medical records utilizing the current version of International Classifications of Diseases in accordance with regulatory agencies and hospital specific guidelines. The CDS/Coder III enters the coded data and other abstracted data from the medical record into the electronic information system. This position assumes primary responsibility for clarifying ambiguous documentation, DRG optimization with the primary role in assisting medical staff members with improving...

Medical Billing Specialist I/II - Behavioral Health Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5369990) Apply  Medical Billing Specialist I/II - Behavioral Health Salary $47,840.00 - $69,546.52 Annually Location Oxnard, CA Job Type Full-Time Regular Job Number 0838HCA-26AA (VM) Department Health Care Agency Division Behavioral/Mental Health Opening Date 06/15/2026 Description Benefits Questions Description How to Submit a Successful Application video: https://hr.venturacounty.gov/how-to-apply/application THE 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...

Medical Billing Specialist I/II The 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...

Facility: Copley Drive City San Diego Department Job Status Regular Shift Day FTE 0.9 Shift Start Time Shift End Time Certified Professional Coder (CPC) - AAPC; H.S. Diploma or Equivalent Hours : Shift Start Time: 6 AM Shift End Time: 2:30 PM AWS Hours Requirement: 8/80 - 8 Hour Shift Additional Shift Information: 0600-0900 Start, 1430-1730 End Weekend Requirements: No Weekends On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $30.370 - $37.950 - $42.510 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.? The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will...

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...

Hcc Risk Adjustment Auditor/Coder We are looking for HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities include the following: Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use...

Salary : $96,119.04 - $129,531.36 Annually Location : Los Angeles County, CA Job Type: Full time Job Number: C0684L Department: PUBLIC WORKS Opening Date: 07/02/2026 Closing Date: 7/15/2026 5:00 PM Pacific Position/Program Information EXAM NUMBER C0684L FILING PERIOD We will be accepting online applications from Monday July 6, 2026, at 8:00 a.m. (PT) until Wednesday July 15, 5:00 PM (PT). All applications must be received before 5:00 p.m. (PT) on Wednesday July 15, 2026, to be accepted. TYPE OF RECRUITMENT We welcome applications from anyone. Why work for us? With more than 10 million residents, Los Angeles County has the largest population of any county in the nation! As the largest employer in Southern California, with more than 39 diverse departments and over 2,100 different job descriptions, the County offers a lifetime of opportunities and careers. We are Los Angeles County Public Works, the largest municipal Public Works agency...

Billing Specialist - Leading TX Center for over 40 years Salary: $25 - $29 per hour Job Details The billing specialist ensures accurate and timely billing for services provided. This role is responsible for preparing, reviewing, and submitting claims, resolving denied or unpaid claims, and maintaining compliance with local, state, and federal billing regulations. Key Responsibilities Daily Billing Operations – Reconcile billing records for accuracy, including authorizations, eligibility, diagnoses, and modifiers. Analyze daily billing reports and flag discrepancies. Auditing & Compliance – Conduct monthly audits of billable claims, submit claims, and follow up on outstanding or denied submissions. Collaboration & Communication – Work with the Billing Supervisor to resolve audit findings and claim issues; coordinate with agencies and the Clinical Department to verify documentation. Documentation & Tracking – Maintain admissions tracking for new clients, discharges,...

Position Overview We are seeking a meticulous and detail-oriented Medical Coder specializing in professional services, experience coding General and Orthopedic surgery with emphasis on spine and sports medicine. The ideal candidate will possess a strong understanding of coding guidelines, regulations, and reimbursement methodologies relevant to professional services in healthcare. Responsibilities Accurately assign CPT, HCPCS, and ICD-10 codes for professional services. Review medical documentation to ensure coding compliance with regulatory and organizational guidelines. Collaborate with healthcare providers and coding auditors to resolve coding discrepancies or documentation issues. Maintain proficiency in current coding practices, regulations, and industry updates to ensure accurate and up-to-date coding. Support internal teams by providing coding insights, education, and training on best practices related to professional services coding. Identify and communicate...

We are looking for experienced HCC Risk Adjustment Auditors/Coders, Sr. to join our team! Position Summary The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use of diagnosis and procedure codes. Interface...

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...

Position Summary Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivering coding presentations to diverse audiences including physicians and other staff. Schedule & Location Schedule: 9/80 work schedule - hybrid Location: 7898...

Coding Compliance Auditors (Administrative Services Manager I) Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at...