16 coding auditor revenue management jobs found

Description Summary: The HCC Coding Auditor will perform code audits and abstractions using the Official Coding Guidelines for ICD-10-CM and AHA Coding Clinic Guidance, following all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor will be involved with quality assurance auditing and risk adjustment code abstraction for the following programs: Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is a hybrid role. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Performs Medical Record reviews and audits based on organizational priorities. These can include prospective and concurrent Clinical Documentation Improvement (CDI) workflows and retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of...

Under minimal supervision and according to established policies and procedures, conducts retrospective inpatient coding quality review audits in compliance with the coding compliance plan and established standards. Supports the review activities that drive hospital revenue including revenue cycle initiatives, internal audit plan, reimbursement audits and data quality. Key support for the coding areas and staff. Duties and Responsibilities: Essential Functions: q Performs coding quality audits and reports results for accurate ICD-10-CM and ICD-10-PCS coding of the principal diagnosis, secondary diagnosis, principal and secondary procedures, present on admission (POA) indicators, and DRG assignment. q Identifies missed query opportunities for complete and accurate revenue within the federal, state and payer specific regulations and coding policies. q Conducts quality review of medical record abstracting and appropriate discharge disposition selection to ensure revenue...

Description Summary: The Compliance Auditor II will assist in the overall quality, compliance, and auditing activities to ensure compliance of standard operating procedures, corporate policies, industry standards, and applicable federal and state laws. Conducts audit activities, reporting and communicates audit findings. Works in conjunction with Compliance Director on compliance work plans, internal and external audits and reviews, and provides assurance that the organization is operating in an efficient and effective manner. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Manages compliance audit activities pertaining to compliance and coordinates with Corporate Compliance Director and Senior Leadership as it relates to such audits Responsible for answering inquiries related to professional documentation, coding, and billing regulatory requirements. Work with...

Job Description The Compliance Auditor, Billing and Coding Compliance is responsible for the oversight and management of auditing and monitoring billing and coding compliance activities, assist with internal compliance policies and procedures, completing compliance risk assessments, and developing risk-based educational materials to ensure compliance with federal/state laws and regulations, and UT Health San Antonio policies. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Responsibilities Provide oversight on billing compliance auditing, monitoring, and educational activities within the compliance department. Performs audits of electronic and manual documentation, coding, and billing systems. Conducts close-out meetings with senior management of audited departments. Maintain current knowledge of changes in federal and state coding and billing regulations/guidelines...

Thank you for considering a career at Ensemble Health Partners! Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture...

Job Description Job Description Specialty Senior Medical Coder – General Surgery Location: Irving, TX COMPENSATION & SCHEDULE • $35.75/hr (Non-CGSC Certified) | $42.00/hr (CGSC Certified – General Surgery) • Monday–Friday | 8:00 AM–5:00 PM • W2 | Temp to Perm • Start Date: 03/16/2026 ROLE IMPACT: The Specialty Coder Senior – General Surgery ensures accurate, compliant coding for high-dollar inpatient and outpatient professional services. This role drives revenue integrity by reducing denials, supporting clean claims, and maintaining a minimum 95% coding accuracy rate. Success is defined by precise code assignment, strong documentation review, and consistent productivity in a remote environment. Key Responsibilities • Assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes in accordance with Official Coding Guidelines and AMA CPT standards • Code inpatient and outpatient Evaluation & Management (E/M) and surgical/operative procedures, generating accurate...

Revenue Integrity Analyst (Medical Coding) The Revenue Integrity Analyst (Medical Coding) supports accurate documentation, compliant coding, and optimized charge capture within MHS GENESIS, the Military Health System's enterprise EHR. The role ensures correct configuration of revenue cycle workflows and reduces revenue leakage through data analysis, system support, and cross-functional collaboration. Responsibilities of this role are as follows, to include but not limited to: Validate, test, and troubleshoot MHS GENESIS / Cerner coding workflows, including charge capture pathways, coding forms, charge router logic, and billing system integrations. Ensure accurate mapping and configuration of ICD-10-CM, CPT/HCPCS, modifiers, clinical documentation, and charge codes across departments. Utilize HealtheAnalytics / HDI and related tools to identify system defects, data inconsistencies, and workflow gaps. Support enterprise-level remediation planning, translating findings into...

Medical Coder Lead Revenue 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. ESSENTIAL FUNCTIONS: Serve as a resource and consultant for coders on complex or specialty coding scenarios. Review and provide guidance on challenging cases to ensure coding accuracy and compliance. Partner with auditors to resolve discrepancies and identify trends in coding errors. Provide mentoring and technical support to coders promoting knowledge sharing and best practices. Assist in developing and updating coding procedures guidelines and reference materials. Collaborate with clinical...

Overview Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care. We have a rich history at Tenet. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many...

Job Description Job Description Inpatient Coder – Acute Care Hospital Location Sherman, TX | Onsite COMPENSATION & SCHEDULE • $40.00+ per hour (Based on Experience) • Monday - Friday | 8:00AM - 5:00 PM • Employment type: W2 | Temp to Hire ROLE IMPACT The Inpatient Medical Coder ensures accurate code assignment and reimbursement integrity for acute care hospital services. This role translates complex clinical documentation into compliant ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) and ICD-10-PCS (Procedure Coding System) codes. Performance directly impacts MS-DRG (Medicare Severity Diagnosis Related Group) accuracy, audit readiness, and overall revenue cycle performance. Key Responsibilities • Review and analyze acute care inpatient medical records to assign accurate diagnosis and procedure codes • Apply ICD-10-CM and ICD-10-PCS codes in accordance with official coding guidelines and payer regulations • Ensure...

Overview The Revenue Cycle Medical Billing Specialist is responsible for the overall account resolution of patient accounts within the revenue cycle management (RCM) process. Ensures timely billing of claims to payers and follows up on denials, appeals, recoupments, and balance management. Ability to audit and provide feedback on the billing process and outcomes. Works cooperatively with other departments to ensure timely billing, reporting and patient account management. Supports the organization's strategic plan and workplace inclusion initiatives. Abides by the organization's mission in performing job duties. Demonstrates an understanding and commitment to PPGT's culture of quality, safety and risk awareness. Responsibilities Reviews submission of claims by third party billing team to the clearinghouse to ensure accuracy. Processes reimbursements and payment adjustments with attention to detail, timeliness, and accuracy. Makes corrections and prepares appeals related to claim...

Sr Speciality Coder Longview, Texas Job Title: Sr Specialty Coder Location: Longview, Texas Job Type: Full-Time Apply Job details Sr Speciality Coder Location: Longview, Texas Salary: $78,000 to $84,000 FullTime,Permanent Are you an experienced coder with a passion for accuracy and compliance in medical billing? Verovian Healthcare Recruitment Agency is seeking a detail-oriented senior specialty Coder to join a prestigious healthcare facility in Longview, Texas. As a senior specialty Coder, you will play a critical role in ensuring precise coding and documentation for specialized medical services, which will directly impact reimbursement processes and regulatory compliance. If you're interested in leveraging your coding expertise to support a dynamic healthcare team, we encourage you to apply for this rewarding opportunity. Job specification Candidate requirements Job specification Accurately assign ICD-10-CM, CPT, and HCPCS...

DHR Health - US:TX:Edinburg - Days Summary: MISSION STATEMENT: Our Mission is to improve the well-being of those we serve with a commitment to excellence: every patient, every encounter, every time. VISION: Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence. POSITION SUMMARY: Under general supervision, analyzes patient medical records to assure that documentation by providers conforms to legal and procedural requirements. Assigns specified codes to medical diagnoses and/or clinical procedures. Interacts with physicians and other providers regarding billing and documentation policies and procedures. Audits medical charts and records for compliance with federal coding regulations and guidelines. Provides a second level review of codes assigned to medical diagnoses and clinical...

JOB SUMMARYSupport and provide coding and compliance training to clinical personnel, billing, and / or other client staff.Establish effective communication with clinical staff, and / or hospital staff to address documentation, coding, and reimbursement issues.Use knowledge of coding and compliance guidelines to identify potential billing / reimbursement issues.Participate in special audits and system administration as necessary.ESSENTIAL DUTIES AND RESPONSIBILITIESInclude the following.Others may be assigned.Performs diagnosis data submissions to Client, Vendors and internal StakeholdersDevelop monthly productivity and revenue projectionsResponsible for chart assignment oversight and monitoring accounts on holdPrepares data collection reports for leadershipMonitors diagnosis submission progress; Audit diagnosis submission files to ensure accuracyReviews, analyzes and oversight of prebill / post bill reviews and pending accountsWorks to resolve workflow, systems and complex matters...

Job Description Job Description Certified Medical Coder Certified coder is responsible for assigning the correct universal medical alphanumeric code to describe the type of service a patient receives in a healthcare facility. Medical coders help ensure the codes are applied correctly and are supported by documentation during the medical billing process. Additionally, the position supports the company’s overall operations and client services by effectively and efficiently driving the Revenue Cycle Management process and delivering successful outcomes. Responsibilities: Assign CPT and ICD-10 codes to billable encounters. Identify trends and issues, and communicate to management. Utilize ICD, CPT/HCPCS to investigate coding issues. Understand and communicate Medicare billing rules to staff, management, and physicians. Monitor services to ensure all encounters are coded and billed timely. Conduct billing audits for code accuracy. Stay updated on changes...

Job Description A client of Innova Solutions is immediately hiring for a HIM Coder . Position type: Full-time, Contract Duration: 5+ Months Location: Remote (looking for candidates based out in HI, CA, WA or OR) As a HIM Coder, you will: Review inpatient and outpatient medical records daily to identify and assign accurate diagnosis and procedure codes. Abstract clinical data and ensure coding is completed within required productivity and compliance timelines. Apply ICD-10-CM, CPT, and HCPCS Level II guidelines to ensure proper code selection and sequencing. Communicate with physicians and internal teams to clarify documentation, diagnoses, and procedures when needed. Monitor coding accuracy, resolve discrepancies (including DRG‑related issues), and maintain adherence to coding standards and policies. Required Skills & Qualifications 2+ years of recent hospital coding/abstracting experience within the last 5 years (inpatient and/or outpatient). Certified Coding...