39 coding auditor specialist jobs found

Providence Medical Foundation is seeking a skilled Coding Auditor to support patient care billing documentation and ensure compliance with CPT/ICD guidelines and federal, state, and payor policies. You will audit coding accuracy across services and collaborate with care teams to resolve issues. Based in Santa Monica, this on-site role requires national coding certifications and several years of professional coding and physician/clinic billing experience. #J-18808-Ljbffr

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...

You Matter Make a difference every day in the lives of the underserved Join a mission driven organization with a people first culture Excellent career growth opportunities Join us and find a career that supports Caring for overlooked, underserved, and vulnerable patients Diversity, equity, inclusion, and belonging Autonomy in a warm team environment Growth and training Perks and Benefits In addition to comprehensive benefits including medical, dental, vision, paid time off, and 401k, we foster a work, life balance for team members and their family to support physical, mental, and financial wellbeing including: DailyPay, receive your money as you earn it! Tuition Assistance and dependent Scholarships Employee Assistance Program (EAP) including free counseling and health coaching Company paid life insurance Tax free Health Spending Accounts (HSA) Wellness program featuring fitness memberships and product discounts Preferred banking partnership and discounted rates for...

This position operates on a hybrid work schedule. Candidate must reside in Los Angeles or Orange County. Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth. Who Are We? Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members' culture and values. Why Join Us? We're on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you'll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation. Job Summary The Risk Adjustment Coding Auditor is responsible for...

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,...

Coding Compliance Auditor 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 responsible for conducting coding and documentation audits to ensure accurate code assignment, appropriate billing, integrity of the medical record, and compliance with federal and state healthcare program requirements. The role requires a highly confident coder who can audit both facility coding and professional fees for partners, as well as audit other coders and physicians. Education Associate's Degree in Business, Information Systems, Nursing, Health Care, or a related field required Bachelor's Degree in Business, Information Systems, Nursing, Health Care, or a related field preferred Experience Experience performing medical record and billing audits/reviews, including clinical documentation, medical terminology, codes (CPT,...

A healthcare provider in San Diego is seeking a Coding Auditor to conduct audits and ensure compliance with coding standards. The role requires strong knowledge of CPT and ICD-10 codes, exceptional communication skills, and the ability to train clinical staff. The ideal candidate has 3 years of experience in a healthcare setting and holds a CPC or CCS-P certification. Competitive hourly rate offered. #J-18808-Ljbffr

This position operates on a hybrid work schedule. Candidate must reside in Los Angeles or Orange County. Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth. Who Are We? Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values. Why Join Us? We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation. Job Summary The Risk Adjustment Coding Auditor is responsible for conducting...

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:...

Job Details Location: Huntington Beach Office, Huntington Beach, CA 92647. Position Type: Full Time. Salary Range: $72,800.00 – $80,000.00. This position operates on a hybrid work schedule. Candidate must reside in Los Angeles or Orange County. Job Summary The Risk Adjustment Coding Auditor is responsible for conducting retrospective and prospective coding audits, diagnosis validation reviews, provider documentation assessments, and compliance monitoring activities to support accurate Medicare Advantage risk adjustment reporting and CMS audit readiness. This role reviews medical record documentation and ICD-10-CM diagnosis coding to ensure compliance with CMS Risk Adjustment program requirements, Official Coding Guidelines, AHA Coding Clinic guidance, and organizational policies. Functions & Responsibilities Conduct retrospective, prospective, and targeted coding audits to assess the accuracy, completeness, and compliance of ICD-10-CM diagnosis coding and HCC capture....

Job Description Job Description 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...

Medical Billing Specialist Yosemite Pathology (YP) is a private independent pathologist owned and operated surgical pathology and cytology laboratory based in Modesto, CA. YP provides comprehensive state of the art, reliable, and accurate diagnostic services to its physicians and major area hospitals in the Alameda, Amador, Calaveras, Contra Costa, Kern, Mariposa, Merced, San Joaquin, Solano, Stanislaus and Tuolumne counties. YP offers a full spectrum of tissue pathology, cytology and histology services, including examination of gynecologic specimens, body fluids and fine needle aspiration specimens. We also offer an extensive array of special stains and immunohistochemistry to assist in the management of oncologic and non-oncologic diseases. The laboratory is supported by highly qualified Histotechnologist, Cytotechnologist, Technicians and office staff who offer excellent service. Summary/Objective The Billing Specialist plays a critical role in integrating billing and revenue...

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...

Billing Specialist - Leading TX Center for over 40 years Salary: $25 - $29 per hour We are a long-standing nonprofit treatment provider with over five decades of service in the recovery community. For over 40 years, we’ve helped more than 50,000 individuals overcome health challenges through compassionate, evidence-based care. With 300+ residential beds and a dedicated team of 150+ staff, interns, and volunteers, we offer comprehensive services that promote long-term sobriety and personal growth. Benefits Medical Dental Vision 401K Growth Options 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. The ideal candidate is detail-oriented, tech‑savvy, and experienced in medical billing systems and procedures. Key Responsibilities Reconcile billing records for...

Description Under direction of the Coding Supervisor and Coding Manager, performs coding audits of patient care billing documentation to ensure adherence with CPT and ICD coding guidelines and federal, state, and commercial payor billing and payment policy for all services provided by Providence Medical Foundation. Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we Providence know that to inspire and retain the best people, we must empower them. Required qualifications: Upon hire: National Certification from American Academy of Professional Coders. Or Upon hire: National Certified Coding Associate - American Health Information Management Association. Or Upon hire: National Certified Coding Specialist - American Health Information Management...

Sherman Oaks Hospital Coder Auditor At Sherman Oaks Hospital, our dedicated team of professionals are committed to our core values of quality, compassion, and community. Sherman Oaks Hospital is a 153-bed, not-for-profit, acute-care community hospital located in Sherman Oaks, California. Staffed with over 500 employees and an extraordinary team of physicians, the hospital is recognized for advanced technology and compassionate care and provides 24/7 emergency care in addition to a full range of specialized medical, surgical, and diagnostic services to improve and save lives. Responsibilities The Coder Auditor reviews and analyzes documentation present in the medical record for both inpatient and outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the assignment of...

Certified Coder Professional Reporting to the Manager Physician Coding Services, the Certified Coder Professional will be responsible for reviewing and evaluating clinical documentation within medical records to ensure high quality and compliant coding. The Certified Coder Professional will provide training, consultation, and feedback to clinicians on their documentation and coding to ensure Emanate Health Medical Group receives appropriate reimbursement and conforms to applicable guidelines and regulations. Collaborates with Emanate Health's Compliance team and with all third party billing and reimbursement requirements including, but not limited to, the requirements of Medicare and Medicaid programs. Serves as the coding subject matter expert for the physicians. Minimum Education Requirement: Associate degree preferred; college degree preferred, knowledge of Medical Terminology, Anatomy & Physiology and Computer experience. Minimum Experience Requirement: Minimum of 2+...

JOB SUMMARY The Health Information Coder III PD is a senior-level inpatient coder with advanced knowledge and skill set to utilize the ICD-10-CM, ICD-10-PCS, CPT, HCPCS classification systems. The skill set extends to advanced knowledge and comprehension of code sequences into Diagnoses-Related Groups. Cases are coded to comply with the official guidelines for coding and reporting, practice standards and code of ethics for HIMS coder. Cases are abstracted according to UCSF Health policies and procedures. The focus of coding and abstracting is on a range of all primary hospital services. This is a per diem position with no set schedule. OTHER FUNCTIONS AND RESPONSIBILITIES Demonstrate understanding of DRG coding mission within UCSF Health. Demonstrate understanding of DRG coding, AR, and data submission information flow. Ability to solve problems and troubleshoot computer issues. Perform data searches. Maintain patient confidentiality and IT...

Position Overview Under the general direction of the Revenue Manager/Associate Director, this senior coder role oversees a large range of coding combinations (approximately 1,500–5,000), applies specialized coding knowledge to manage ICD‑10 and CPT procedural codes, and guides a centralized coding team as a subject matter expert to improve accuracy and efficiency of professional fee coding. Responsibilities Lead as a subject matter expert, presenting information to the team. Audit and oversee team members’ accuracy and production. Ensure compliance with all federal, state, and local carrier guidelines. Provide education and training to coding staff and physicians. Perform high‑production coding to meet UCSF goals for accuracy and charge lag. Conduct in‑depth reviews of physician documentation and prepare documentation audits. Create coding analysis reports and online presentations with findings and recommendations. Determine methods and procedures for new assignments and...

Default Work Shift: Day (United States of America) Hours: 40 Salary range: $23.97 - $36.42 Schedule: Full Time Shift Hours: 8 Employee Department: Patient Financial Services Job Objective Responsible for performing revenue cycle integrity audits within the Charge Descriptive Master and other revenue cycle charge capture and reconciliation processes. Job Description Education: Required: High school diploma, GED or higher level degree if hired after March 1, 2025. Preferred: Medical coding coursework or bachelor’s degree in related field. Licensure/Certification: Required: Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) within one (1) year if hired into position after January 1, 2021. Experience: Required: Two (2) years of medical billing, charge capture, coding or patient account auditing experience. Preferred: Revenue cycle experience, hospital/clinical experience. Reports To: Manager or Director. Supervises: N/A. Ages of Patients: N/A. Blood Borne...

Job Description Align yourself with an organization that has a reputation for excellence! Cedars Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company’s Workplace of the Year. This annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We provide an outstanding benefit package that includes health care, paid time off and a 403(B). Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals. What you will be doing in this role: The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. In this role, the Coder II reviews ICD-10-CM diagnosis coding and Current Procedural Terminology (CPT) procedure...

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. Job Summary Reviews SDS and OBV 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 same day surgery and observation 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 Associate’s/Technical Degree or equivalent combination of education/related experience: Preferred Working knowledge of hospital Cerner EMR (electronic medical record):...

Current Emanate Health Employees - Please log into your Workday account to apply Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as individuals. On Glassdoor's list of "Best Places to Work" in 2021, Emanate Health was named the #1 ranked health care system in the United States, and the #19 ranked company in the country. J ob Summary Reporting to the Manager Physician Coding Services, the Certified Coder Professional will be responsible for reviewing an evaluating clinical documentation within medical records to ensure high quality and compliant coding. The Certified Coder Professional will provide training, consultation, and feedback to clinicians on their documentation and coding to ensure Emanate Health Medical Group receives appropriate...

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:...