33 coding auditor senior jobs found

Coding Auditor SeniorLocation: Any PulsePoint office. St. Louis, MO preferred.Virtual: This role enables associates to work virtually full-time, except for 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 accommodation is granted as required by law.The Coding Auditor Senior is responsible for auditing diagnosis data collected from physician and hospital medical records to ensure proper ICD-9/ICD-10 coding and compliance with risk adjustment requirements.How you will make an impact:Audits diagnosis data retrieved from physician and...

Coding Auditor Senior Location : Any PulsePoint office. St. Louis, MO preferred. Virtual : This role enables associates to work virtually full-time, except for 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 accommodation is granted as required by law. The Coding Auditor Senior is responsible for auditing diagnosis data collected from physician and hospital medical records to ensure proper ICD-9/ICD-10 coding and compliance with risk adjustment requirements. How you will make an imp act: Audits diagnosis...

All inclusive preventive care in Miami, FL is seeking a Senior Medical Coding Auditor (CPC) to verify documentation before claims are submitted. This part-time role focuses on accurate E/M level selection and compliant coding for Primary Care and Gynecology services. The ideal candidate will review 300–400 encounters weekly, ensure CPT/ICD-10-CM accuracy, and collaborate with providers to minimize denials while maximizing compliant reimbursement. Remote options available. #J-18808-Ljbffr

Joining AdventHealthJoining AdventHealth is about being part of something bigger. It's 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.Benefits and PerksAll the benefits and perks you need for you and your family:Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability InsurancePaid Time Off from Day One403-B Retirement Plan4 Weeks 100% Paid Parental LeaveCareer DevelopmentWhole Person Well-being ResourcesMental Health Resources and SupportPet BenefitsJob DescriptionConduct pre-bill high-risk audits across inpatient and/or outpatient encounters targeting complex, high-acuity, and high...

Joining AdventHealth Joining AdventHealth is about being part of something bigger. It's 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. Benefits and Perks 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 Job Description Conduct pre-bill high-risk audits across inpatient and/or outpatient encounters...

Job Description Job Description Location: Miami, FL (On-site preferred; Hybrid/Remote may be considered) Employment Type: Part-Time (25–35 hours per week) About the Position We are seeking an experienced Senior Medical Coding Auditor (CPC) to join our growing multi-specialty medical practice specializing in Primary Care and Gynecology . The ideal candidate will be responsible for reviewing clinical documentation before claims are submitted to ensure accurate coding, appropriate E/M level selection, documentation compliance, and optimal reimbursement while maintaining full regulatory compliance. This position works closely with providers, clinical staff, and the billing department to improve documentation quality, reduce claim denials, maximize appropriate reimbursement, and ensure coding accuracy. Primary Responsibilities Review approximately 300 provider notes per week for coding accuracy and documentation compliance prior to claim submission....

Risk Adjustment CoderPorter 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 OverviewWe are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home...

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 in-home health...

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 Description Job Description 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...

## Risk Adjustment Coder IIIApply: Hybrid: Miami, FL: Full time: Posted 2 Days Ago: JR4418It'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 Summary**The Risk Adjustment Coder III is responsible for the accurate and timely assignment of medical diagnosis codes in accordance with established risk adjustment models, coding guidelines, and organizational standards. This role performs high-volume, production-based coding and chart review activities, following defined policies and procedures to ensure compliance and data accuracy. This position applies advanced coding knowledge but operates within established guidelines, with work subject to quality review and audit.**Duties & Responsibilities****Essential Duties & Responsibilities*** **Medical Coding and Documentation*** Assign ICD-10-CM diagnosis codes based on medical...

City/State Doral, FL Work Shift First (Days) Overview: AvMed, a division of Sentara Health Plans in the Florida market, is hiring a Risk Adjustment Nurse/Coder (RN/CPC, COC, CIC, CCS-P, CCS, RHIT, RHIA in Doral, FL! Status: Full-timepermanent position (40 hours) Standard working hours: 8am to 430pm EST, M-F Location: This is a hybrid position, 2 days onsite in AvMed Doral Office, 3470 NW 82nd Ave Suite 1100, Doral, FL 33122, and 3 days remote. Job Profile Summary Then Risk Adjustment Clinical Coder/Nurse performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for...

Become a part of our caring community The Medical Coding Coordinator confirms appropriate diagnosis related to the appropriate Outpatient CPT and ICD-10 code assignments. As a Medical Coding Coordinator, you will provide medical coding expertise and support for accurate code assignment and documentation review. Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals and often oversees work of others and/or is the primary administrative owner of a main process, program, product or technology. The Medical Coding Coordinator confirms appropriate diagnosis related to the appropriate Outpatient CPT and ICD-10 code assignments. As a Medical Coding Coordinator, you will provide medical coding expertise and support for accurate code assignment and documentation review. Decisions are regarding the daily priorities for an administrative work group and/or...

CenterWell Senior Primary Care is seeking a Medical Coding Coordinator in The Villages, FL to review records, assign ICD-10-CM, CPT, and HCPCS codes, and ensure compliant documentation. This onsite role involves collaboration with internal teams, audits, and maintaining coding quality. TPM requirements include CCS/CRC/CPC certification and EMR proficiency. The position supports a patient-centered care model and requires 40 hours weekly, with opportunities to contribute to process improvements #J-18808-Ljbffr

Job Description Job Description Position Summary: The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through pre and post payment medical records review and appeal records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines, coverage policies and regulatory and contract requirements. Qualifications:  Medical Coder certification from accredited source (e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) required. Prior experience in Medicaid claims role and/or post payment medical coding auditor role preferred. Knowledge of Medicaid rules, claims processing, medical terminology and coding principles and practices. Knowledge of auditing, investigation, and research. Knowledge of...

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...

Medical Clinic Biller/CoderNorthwest 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 productivity rates as determined by department manager. Maintains accurate records. Audits methods and procedures of accounts...

Risk Adjustment Coder III 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 Summary The Risk Adjustment Coder III is responsible for the accurate and timely assignment of medical diagnosis codes in accordance with established risk adjustment models, coding guidelines, and organizational standards. This role performs high-volume, production-based coding and chart review activities, following defined policies and procedures to ensure compliance and data accuracy. This position applies advanced coding knowledge but operates within established guidelines, with work subject to quality review and audit. Duties & Responsibilities Essential Duties & Responsibilities Medical Coding and Documentation Assign ICD-10-CM diagnosis codes based on medical records, clinical documentation, and encounter data in...

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...

Join Our Caring CommunityThe Medical Coder confirms appropriate diagnosis related group (DRG) assignments. As a Medical Coder, you will provide medical coding expertise and support for accurate code assignment and documentation review. Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals and often oversees work of others and/or is the primary administrative owner of a main process, program, product or technology.ResponsibilitiesReview medical records, clinical documentation, and related source materials to assign appropriate diagnosis and procedure codesApply ICD-10-CM, CPT, HCPCS, and other applicable coding systems in accordance with official coding guidelines and company standardsEnsure coding is accurate, complete, timely, and compliant with regulatory and organizational requirementsAnalyze, enter, update, and maintain coding-related...

Become a part of our caring community The Medical Coder confirms appropriate diagnosis related group (DRG) assignments. As a Medical Coder, you will provide medical coding expertise and support for accurate code assignment and documentation review. Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals and often oversees work of others and/or is the primary administrative owner of a main process, program, product or technology. Responsibilities Review medical records, clinical documentation, and related source materials to assign appropriate diagnosis and procedure codes Apply ICD-10-CM, CPT, HCPCS, and other applicable coding systems in accordance with official coding guidelines and company standards Ensure coding is accurate, complete, timely, and compliant with regulatory and organizational requirements Analyze, enter, update,...

Become a part of our caring community The Medical Coder confirms appropriate diagnosis related group (DRG) assignments. As a Medical Coder, you will provide medical coding expertise and support for accurate code assignment and documentation review. Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals and often oversees work of others and/or is the primary administrative owner of a main process, program, product or technology. Responsibilities Review medical records, clinical documentation, and related source materials to assign appropriate diagnosis and procedure codes Apply ICD-10-CM, CPT, HCPCS, and other applicable coding systems in accordance with official coding guidelines and company standards Ensure coding is accurate, complete, timely, and compliant with regulatory and organizational requirements Analyze, enter, update, and maintain...

Please only submit an application if you live in one of these states: FL, VA, TX, NY, MO About Us At Greenbrook Medical, we believe seniors deserve more from the healthcare system—more time, more care, more coordination, and more heart. We provide high-touch, relationship-based primary care to seniors, built around one simple idea: deliver the kind of care we’d want for our own parents. Founded by two brothers inspired by their father’s pioneering work in Medicare Advantage, Greenbrook is deeply personal and proudly modern. We quarterback our patients through their healthcare journey, making sure they’re never alone in a complex system. Our business model is designed around patient outcomes, not volume—so we only succeed when our patients thrive. With roots in Tampa Bay and a partnership with Tampa General Hospital, we’re growing thoughtfully to bring our model to more communities. Our team is the heart of it all: mission-driven, values-oriented, and relentlessly committed to...

CVS Health Corporation in the United States is seeking a Certified Professional Coder (CPC) Manager to oversee a team of medical coders within the SIU, ensuring compliant coding practices through reviews of records across medical, behavioral, transportation, and other providers. You will lead and mentor CPCs, perform audits, set goals, manage workloads, collaborate with Medical Directors, and develop training programs. #J-18808-Ljbffr