34 coding compliance auditor jobs found

HCA Healthcare is seeking a work-from-home Inpatient Coding Auditor to perform internal quality assessments on Health Information Management Service Center coders, ensuring compliance with national coding guidelines and company policies for accurate coding and reimbursement. The role supports data integrity, coding practice improvement, and accurate physician documentation, aiming for high productivity and accuracy while meeting all education requirements outlined by the company. #J-18808-Ljbffr

Serco is seeking Medical Coding Auditing Specialists to support the DHA Medical Coding Program Branch. The role involves auditing medical records across DHA Markets, supporting annual audit plans, and performing targeted coding audits to ensure compliance with official policies and regulations. Candidates must have seven years of coding/auditing experience across multiple specialties, hold the required professional certifications, and be able to work with government guidelines and revenue cycle #J-18808-Ljbffr

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...

Outpatient Coding Auditor Responsible for implementing and maintaining a compliance plan for outpatient coding and reimbursement. The Outpatient Coding auditor will assist the Coding Manager with Outpatient and Emergency Coding Services, and the development of policies and procedures. Develops education and supervises programs regarding elements of the HIM Compliance program, such as appropriate documentation and accurate coding, to all appropriate personnel, including HIM coding staff, physicians, billing personnel and ancillary departments. Coordinates and conducts continual reviews, tracking and trending following the outpatient coding audits. Educates new outpatient coders on documentation requirements including how to read an outpatient medical record and extrapolate the required documentation with regards to outpatient surgery coding. Educate outpatient coders on ICD-10-CM guidelines, coding conventions and Coding Clinics pertinent to outpatient surgery coding....

Outpatient Coding Auditor Responsible for implementing and maintaining a compliance plan for outpatient coding and reimbursement. The Outpatient Coding auditor will assist the Coding Manager with Outpatient and Emergency Coding Services, and the development of policies and procedures. Develops education and supervises programs regarding elements of the HIM Compliance program, such as appropriate documentation and accurate coding, to all appropriate personnel, including HIM coding staff, physicians, billing personnel and ancillary departments. Coordinates and conducts continual reviews, tracking and trending following the outpatient coding audits. Educates new outpatient coders on documentation requirements including how to read an outpatient medical record and extrapolate the required documentation with regards to outpatient surgery coding. Educate outpatient coders on ICD-10-CM guidelines, coding conventions and Coding Clinics pertinent to outpatient surgery coding. Educate...

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

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Become a part of our caring community The Inpatient 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 Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Posting Details Posting Number: S15474P Working Title: Medical Billing Specialist Department: UHC-Business Services About the University of Georgia: Chartered by the state of Georgia in 1785, the University of Georgia is the birthplace of public higher education in America and is the state's flagship university (https://www.uga.edu/). The proof is in our more than 240 years of academic and professional achievements and our continual commitment to higher education. UGA is currently ranked among the top 20 public universities in U.S. News & World Report. The University's main campus is located in Athens, approximately 65 miles northeast of Atlanta, with extended campuses in Atlanta, Griffin, Gwinnett, and Tifton. UGA employs approximately 3,100 faculty and more than 7,700 full-time staff. The University's enrollment exceeds 41,000 students including over 31,000 undergraduates and over 10,000 graduate and professional students. Academic programs reside in 19 schools and colleges,...

Posting Details Posting Details Posting Number S15474P Working Title Medical Billing Specialist Department UHC-Business Services About the University of Georgia Chartered by the state of Georgia in 1785, the University of Georgia is the birthplace of public higher education in America and is the state's flagship university (https://www.uga.edu/) . The proof is in our more than 240 years of academic and professional achievements and our continual commitment to higher education. UGA is currently ranked among the top 20 public universities in U.S. News & World Report. The University's main campus is located in Athens, approximately 65 miles northeast of Atlanta, with extended campuses in Atlanta, Griffin, Gwinnett, and Tifton. UGA employs approximately 3,100 faculty and more than 7,700 full-time staff. The University's enrollment exceeds 41,000 students including over 31,000 undergraduates and over 10,000 graduate and professional students. Academic programs reside in...

Lead Medical Coder and Auditor [PR0001D] Full‑time ProSidian is looking for “Great People Who Lead” at all levels in the organization. Are you a talented professional ready to deliver real value to clients in a fast‑paced, challenging environment? ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. Linking strategy to execution, ProSidian assists client leaders in maximizing company return on investment capital through design and execution of operations core to delivering value to customers. Visit www.ProSidian.com or follow the company on Twitter at www.twitter.com/prosidian for more information. ProSidian Seeks a Lead...

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

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...

Lead Medical Coder and Auditor ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. ProSidian Seeks a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land dominance, across the full range of military...

DEPARTMENT: Physician Practice Management FACILITY: Medical Office Building WORK TYPE: Full Time SHIFT: Daytime SUMMARY: Assess the educational needs of coding specialists and providers regarding coding and documentation and direct development of effective regularly scheduled educational programs that meet the needs of the health system. Serve as the primary resource to physicians for documentation and coding issues. Conduct ongoing coding and billing training programs for billing and coding specialists and providers. Creates presentations, develops learning material, handbook, and other training materials. Conducts coding and data quality reviews and prepares complex reports as required. Ensures all education activities comply with clinical billing standards and government regulation with concentration on hospital inpatient procedures, ambulatory, and specialty physician services. RESPONSIBILITIES: * Keeps abreast of pertinent federal, and state regulations...

Job Description Job Description Description: Job Title: Certified Medical Coder/Biller Location: Richmond Hill, GA | Hybrid Remote Employment Type: Full-time Reports to: Billing Manager Department: Revenue Cycle Management Job Summary: The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key Responsibilities: 1. Claims Processing: · Prepare and submit accurate and timely insurance claims for services rendered. · Verify patient insurance coverage...

Certified Medical Coder/Biller The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key responsibilities include: Prepare and submit accurate and timely insurance claims for services rendered. Verify patient insurance coverage and ensure correct billing to the appropriate payer. Review and process Explanation of Benefits (EOBs) and insurance payments. Ensure that all medical services are accurately coded according to current guidelines (CPT, ICD-10, HCPCS). Work closely with...

Monday–Friday schedule (no weekends) Experienced Medical Biller (RCM2) – Full-Time Revenue Cycle Management Department Locations: Carrollton, Newnan, or Peachtree City, GA Work Setting: In-Office) About Our Practice West Georgia Dermatology, Newnan Dermatology, and Peachtree City Dermatology are physician-led, fast-growing dermatology practices serving communities across West Georgia. We provide comprehensive medical, surgical, and cosmetic dermatology services, including in-house Mohs surgery and dermatopathology. Our Revenue Cycle Management (RCM) team plays a vital role in the financial health of the practice and in supporting high-quality patient care. We value accountability, efficiency, teamwork, and continuous improvement. We are seeking an experienced Medical Biller who is confident working independently and ready to take ownership of assigned revenue cycle responsibilities. Position Overview The Experienced Medical Biller (RCM2) is responsible for managing assigned billing...

Emory Healthcare Job Opportunity Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs And more Job Description This position ensures the accuracy, completeness, and compliance of medical coding and clinical documentation for professional coding services. The role supports accurate coding practices, appropriate reimbursement, and regulatory compliance by reviewing patient records and collaborating with healthcare providers, coding teams, and compliance staff. Responsibilities • Ensures the...

Professional Coding Auditor & Educator The Professional Coding Auditor & Educator works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Responsibilities: Responsible for reviewing and analyzing all aspects of the department clinical documentation and care to ensure timely, accurate, and compliant charge capture and submission Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges Collaborates with Coding Supervisor to ensure clinical documentation in high-risk areas is consistent and complete Identifies...

Job Description Job Description Job Title: Specialty Inpatient Coder Location: Remote Shift (EST): MondayFriday or SundayThursday; 1st or 2nd shift (flexible) Pay: $29+ (DOE) Essential Job Duties & Responsibilities: Review and code complex inpatient and outpatient records for high-priority service lines Assign accurate ICD-10-CM, ICD-10-PCS, and CPT codes based on physician documentation Focus on specialty areas including cardiovascular, transplant, orthopedic spine, invasive GI, and interventional radiology Use CAC systems (e.g., 3M CAC 360) and UHDDS guidelines for coding accuracy Abstract and enter clinical data into coding systems Ensure documentation supports all coded procedures and services Query providers to clarify incomplete or unclear documentation when needed Identify and correct coding and billing errors from audits and edits Monitor for medical necessity issues and potential non-covered services Maintain productivity, accuracy, and...

Job Description Job Description Join the WellStreet Urgent Care Revenue Cycle Team! WellStreet Urgent Care is seeking an experienced Certified Medical Coder to support our growing Revenue Cycle team. In this role, you will accurately assign ICD-10-CM, CPT, HCPCS, and Evaluation & Management (E&M) codes for urgent care encounters while ensuring compliance with coding guidelines, quality standards, and productivity expectations. This is an excellent opportunity for a detail-oriented coding professional with Epic experience who enjoys working in a collaborative, fast-paced healthcare environment. What You'll Do Code patient encounters for WellStreet Urgent Care Centers using internal coding software. Accurately assign ICD-10-CM, CPT, HCPCS, and E&M codes based on provider documentation. Apply current coding guidelines and regulatory requirements to ensure coding accuracy and compliance. Utilize coding encoders and other coding resources to...

Medical Coder A Medical Coder for WellStreet Urgent Care is responsible for supporting all aspects of the Revenue Cycle for our Urgent Care Centers. Responsibilities Coding for our Urgent Care Centers using our internal software Knowledge of ICD-10 Coding and compliance Experience using an encoder Setting up insurance plans within our software Working with the Revenue Cycle Management to identify & resolve issues related to coding and the process flow Interfacing with clinic staff on billing & coding issues. Comply with all legal requirements regarding coding procedures and practices Conduct audits and coding reviews to ensure all documentation is accurate and precise Assign and sequence all codes for services rendered Collaborate with billing department to ensure all bills are satisfied in a timely manner Communicate with insurance companies about coding errors and disputes Contact physicians and other health care professionals with questions about...

Compliance Auditor The Compliance Auditor reports directly to the Vice President of Compliance to conduct compliance audits for Health Care Centers, Hospice, Home Health and/or SOURCE/CCSP service lines. The CA performs routine and focused internal compliance investigations, audits and assessments throughout the organization and develops detailed reports of findings. Key Responsibilities: 1. Demonstrates good analytical and organizational skills and the ability to collect, analyze and utilize data. 2. Possesses good people skills for effective liaison with department, company and agencies while maintaining objectivity, accuracy, and confidentiality. 3. Demonstrates knowledge of state and federal laws and regulations that apply to Home Health, Hospice and HCC operations and billing requirements. In addition to state policies related to community services. 4. Demonstrates knowledge of organizational processes, policies, procedures, and systems related to compliance audits and...