649 coding auditor specialist jobs found

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare...

Job Description Job Description Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri;...

Hi, we're Oscar. We're hiring a Senior Specialist, Coding Auditor to join our Payment Integrity. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About The Role You will support issue resolution in the Oscar claim environment. You will be responsible for the end-to-end claims repayment quality, process improvement and supporting root cause analysis. You will report into the VP, Payment Integrity. Work Location This is a remote position, open to candidates who reside in: Tempe, Arizona; Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; New York City, New York; Philadelphia, Pennsylvania; Salt Lake City, Utah. While your daily work will be completed from your home office, occasional travel may be...

Job Description Job Description Hi, we're Oscar. We're hiring a Senior Specialist, Coding Auditor to join our Payment Integrity. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: You will support issue resolution in the Oscar claim environment. You will be responsible for the end-to-end claims repayment quality, process improvement and supporting root cause analysis . You will report into the VP, Payment Integrity. Work Location: This is a remote position, open to candidates who reside in: Tempe, Arizona; Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; New York City, New York; Philadelphia, Pennsylvania; Salt Lake City, Utah. While your daily work will be completed from your...

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare...

Position Summary The Inpatient Coding Auditor will be responsible for the auditing of inpatient coders and auditing of offshore inpatient coding auditors to ensure coding accuracy standards are met. This role requires frequent and effective communication via phone, email, and instant messaging with various client teams and payers. The Inpatient Coding Auditor will report to the Huron Managed Services Domestic Coding team. Key Responsibilities Perform a variety of activities involving the coding of medical records, resolving coding related denials, and auditing of coders to ensure coding accuracy standards are met. Demonstrate Huron’s Vision and Values in behaviors, practices, and decisions. Utilize encoder software applications and all applicable online tools to assign ICD-CM diagnosis and procedure codes, MS-DRG, APR DRG, POA, SOI & ROM assignments. Apply coding guidelines established by CDC, CMS, AHA, AMA, AHIMA, and client procedures. Conduct quality checks/audits on...

Description WHAT IT'S LIKE AT SGMC HEALTH Purpose . No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place. Excellence . We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service. Team Spirit. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. Award Winning Performance. We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides. WHY YOU WILL LOVE SGMC HEALTH SGMC has great benefit options, depending on the role that you are going into- including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities...

A healthcare institution in Valdosta, GA is seeking a Professional Coding Auditor/Education Specialist. The ideal candidate will be a Certified Professional Coder (CPC) with expertise in medical coding including ICD-10, HCPCS, and CPT. Strong analytical skills and proficiency in Microsoft Office are essential for this full-time on-site role. Responsibilities include conducting audits, educating healthcare providers, and developing training materials to improve coding compliance and efficiency. Competitive benefits include 401(k), healthcare options, and tuition reimbursement. #J-18808-Ljbffr

Professional Coding Auditor/Education Specialist Job Location: SGMC Patient Financial Services Department: Revenue Cycle Medical Group Schedule: Full Time, 8 HR Day Shift, 8-5 on site Position Summary This position requires on-site presence at SGMC Health Main Campus. Remote work is not available for this role. The ideal candidate for the Professional Coding Auditor/Education Specialist role will be a Certified Professional Coder (CPC), with preference given to those holding a Certified Professional Medical Auditor (CPMA) or Certified Documentation Expert Outpatient (CDEO) certifications, although relevant experience may substitute for these credentials. The candidate must have a strong foundation in medical coding, including extensive knowledge of ICD-10, HCPCS, and CPT, along with expertise in multispecialty and complex coding, and experience in abstracting E/M and CPT codes. Proficiency in anatomy and physiology, medical terminology, and regulatory compliance related to...

South Georgia Medical Center seeks a Professional Coding Auditor/Education Specialist to conduct audits, educate healthcare providers, and manage coding compliance. Ideal candidates should hold a Certified Professional Coder (CPC) certification, with a strong foundation in medical coding, including knowledge of ICD-10, HCPCS, and CPT. The position is full-time, requiring on-site presence in Valdosta, Georgia, and offers benefits such as healthcare insurance, 401(k) with match, and tuition reimbursement. #J-18808-Ljbffr

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare...

Key Responsibilities Perform activity related to coding of medical records, resolve coding‑related denials, and audit coders to ensure coding accuracy standards are met. Demonstrate Huron’s Vision and Values in all behaviors, practices, and decisions. Act as Inpatient Coding Auditor, ensuring a minimum 95% accuracy for coding and DRGs. Conduct quality checks/audits on visits coded according to client SOPs. Perform calibration audits and schedule calibration sessions with offshore team counterparts and leaders. Assist in preparing audit reports, providing direct feedback to coders and auditors, and participate in client interactions and internal stakeholder meetings. Possess a firm understanding of clinical documentation guidelines. Identify and rectify coding guideline violations during audits before claims are rebilled. Analyze and present audit findings to leadership in a clear, concise, actionable format. Use encoder software applications and all available online tools for...

A healthcare organization is seeking a Medical Coding Auditor for a remote position in Albuquerque, NM. The role involves auditing medical records for compliance with coding regulations, providing training to staff, and assisting management with audits. Candidates should have a high school diploma or GED with relevant certifications and at least 5 years of experience. A competitive salary and benefits package are provided, along with a sign-on bonus. #J-18808-Ljbffr

A leading healthcare intelligence company is seeking a DRG Reviewer to conduct thorough audits of medical records for payment validation. This role requires expertise in coding, clinical guidelines, and compliance with payment standards. The ideal candidate should have at least two years of inpatient auditing experience, strong analytical skills, and attention to detail. This position offers competitive compensation ranging from $90,000 to $115,000, along with additional benefits and a flexible work-from-home option. #J-18808-Ljbffr

A leading healthcare intelligence company is seeking a DRG Reviewer to conduct thorough audits of medical records for payment validation. This role requires expertise in coding, clinical guidelines, and compliance with payment standards. The ideal candidate should have at least two years of inpatient auditing experience, strong analytical skills, and attention to detail. This position offers competitive compensation ranging from $90,000 to $115,000, along with additional benefits and a flexible work-from-home option. J-18808-Ljbffr

A leading healthcare provider is seeking a Specialty Coder II to work remotely, requiring residency in Florida, Georgia, North Carolina, or South Carolina. This role involves assigning diagnosis and procedural codes, auditing documentation, and mentoring other coders. Candidates should have a Certified Professional Coder certification and at least two years of coding experience. BayCare offers competitive benefits including medical, dental, and education assistance. J-18808-Ljbffr

Stryker Corporation is seeking an inpatient coding auditor in Plymouth, Minnesota. This role involves participating in a well-established inpatient coding training program and performing retrospective coding reviews for DRG validation and compliance. The ideal candidate will have at least three years of inpatient coding experience in a high complexity facility and possess CCS, RHIT, or RHIA certification. This is a great opportunity for career advancement in coding. #J-18808-Ljbffr

AdventHealth is seeking a full-time coding expert in Orlando to perform quality reviews, educate coders, and ensure compliance with coding guidelines. You will maintain high standards of coding accuracy and collaborate with health professionals to resolve discrepancies. The ideal candidate will have 5+ years of coding experience, strong analytical skills, and proficiency in relevant software tools. Join our team to contribute to the healing ministry, while enjoying comprehensive benefits and career development opportunities. #J-18808-Ljbffr

Integrated Resources, Inc ( IRI ) is seeking a qualified professional for a position focused on leading audits of hospital billing and coding practices. Responsibilities include desk audits, bill verification, DRG validation, and credit balance reviews. The role also involves supporting audit protocol development and providing guidance on ICD-10-CM coding and auditing processes. Candidates should have experience with DRG validation, utilization review audits, and ICD-10-CM education. Preference is given to NJ, NY, PA, DE, or CT residents. #J-18808-Ljbffr

A healthcare technology firm is seeking a Nurse Coder DRG Auditor to validate coding accuracy and medical necessity of inpatient claims. The role involves applying industry standards and guidelines to perform DRG validations while collaborating within a team. Successful candidates will have an active RN license, relevant coding certifications, and experience in clinical practice. A competitive salary of $85,000 to $90,000 is offered, along with a comprehensive benefits package. #J-18808-Ljbffr

A healthcare consulting firm is seeking an Inpatient Coding Auditor in Chicago, Illinois. The role involves auditing inpatient coders and ensuring coding standards are met. Responsibilities include analyzing medical records, communicating with client teams, and conducting quality checks. Candidates should have 2+ years of auditing experience, advanced proficiency in Microsoft Office, and relevant certifications. The position requires strong analytical and communication skills, with a focus on team collaboration and compliance with coding guidelines. #J-18808-Ljbffr

UCI Health is seeking an Outpatient Coding Auditor in California. This role involves conducting coding audits, ensuring adherence to federal and state regulations, and providing educational support. Candidates should have a minimum of three years of outpatient coding experience, CCS certification, and familiarity with coding systems. Benefits include medical insurance and retirement plans. Join a team committed to high ethical standards and enhancing coding practices. #J-18808-Ljbffr

A healthcare solutions company is seeking a skilled RCS Medical Coding Auditor to perform audits on professional fee medical coding. The ideal candidate should possess a CPC certification and 2+ years of ProFee auditing experience, with a strong focus on accuracy and compliance. Responsibilities include conducting daily quality assurance, validating coding against documentation, and providing training to improve coding practices. This position supports hybrid work and includes a competitive salary range of $57,728 to $80,243. #J-18808-Ljbffr

A healthcare organization is seeking a Clinical Revenue Auditor based in New York. The role involves reviewing and verifying that billable services and procedures are accurately documented and submitted for payment. The ideal candidate will have a solid clinical background and must have 3-5 years of experience in a healthcare setting, alongside expertise in medical coding and auditing processes. This position plays a key role in ensuring compliance and financial health within the organization, and offers an annual salary range of $96,000 to $140,000. #J-18808-Ljbffr