14 coding compliance auditor jobs found

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Job Description Job Description Salary: $15-$17/hour Education, Experience, and Licensing Requirements: High school diploma, GED, or equivalent University/college degree, or experience medical records, claims or billing areas is an asset. CCA (AHIMA) CCS (AAPC) or greater Expectations of Role: Manages the Insurance billing and collections processes. Excellent organizational skills and attention to detail. . Processes, tracks claims, and ensures accuracy and timeliness in the billing process. Provides excellent customer service to our clients. Inputs patient information into the practices billing software. Submits claims to insurance companies and follows up on unpaid claims. Posts ERA payments, Resolves any issues that arise with claims or payments. Maintains accurate records of billing and collection activities Generates monthly reports to track billing and collection performance. Accounts for coding and abstracting of patient encounters, including...

A leading health data platform company is seeking an Inpatient Auditing Specialist to perform coding audits, provide education, and ensure compliance with regulations. The role requires 5+ years of experience and proficiency in certain coding certifications. This position offers a fully remote setup with a flexible schedule, competitive compensation, and comprehensive employee benefits. Join a dynamic team dedicated to improving healthcare through data-driven solutions. #J-18808-Ljbffr

A health data exchange company seeks an Outpatient Auditing Specialist to perform coding audits and education, maintain regulatory compliance, and improve coding workflows. Ideal candidates will have at least 5 years of coding experience, relevant certifications, and a strong commitment to customer service. This fully remote role offers flexibility and a benefits package including medical, dental, and vision coverage, along with paid time off. Pay ranges from $35 to $45 per hour depending on experience. #J-18808-Ljbffr

Outpatient Facility-Clinic Medical Coder (Multi-Specialty) Part-Time We are seeking a detail-oriented and analytical Outpatient Facility-Clinic Medical Coder (Multi-Specialty) to join our remote US-based coding team. In this role, you will be responsible for accurately assigning diagnostic and procedural codes for various medical specialties in an outpatient setting. The ideal candidate will have a strong understanding of medical coding principles and healthcare regulations. Schedule & Compensation This is a part-time position (2030 hours per week) with a pay range of $30$40 per hour. Initial training will be conducted during standard business hours (MondayFriday, 8 a.m.5 p.m.) for approximately 2030 hours per week. Following training, work hours can transition to a flexible schedule. Job Description Analyze patient medical records and assign appropriate ICD-10-CM, CPT, and HCPCS codes for outpatient services across multiple specialties Ensure coding accuracy and...

Company Description We are seeking a detail-oriented and analytical Outpatient Facility‑Clinic Medical Coder (Multi‑Specialty) to join our remote US‑based coding team. In this role, you will be responsible for accurately assigning diagnostic and procedural codes for various medical specialties in an outpatient setting. The ideal candidate will have a strong understanding of medical coding principles and healthcare regulations. Schedule & Compensation This is a part‑time position (20–30 hours per week) with a pay range of $30–$40 per hour. Initial training will be conducted during standard business hours (Monday–Friday, 8 a.m.–5 p.m.) for approximately 20–30 hours per week. Following training, work hours can transition to a flexible schedule. Job Description Analyze patient medical records and assign appropriate ICD‑10‑CM, CPT, and HCPCS codes for outpatient services across multiple specialties Ensure coding accuracy and compliance with federal, state, and insurance...

Hospital/Facility Revenue Cycle Manager Trajectory RCS joined the MedHQ family in the beginning of 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing healthcare cash flow through teamwork and collaboration. MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. MedHQ, LLC, is a 2022 Becker's Top 150 Places to Work in Healthcare company. The MedHQ LLC service line offerings have grown organically over the years, beginning by providing high quality traditional human resource, accounting, and staff...

Overview The Clinical Coder is responsible and accountable for reviewing medical record documentation and assigning codes for reimbursement and statistical purposes. Responsibilities Dependent upon level of expertise defined in the Education/Training section: Maintains a working knowledge of coding fundamentals: ICD-9-CM coding for inpatient, outpatient, and/or physician services; HCPCS coding, namely CPT-4 for surgical procedures, for outpatient and/or physician services; and/or HCPCS coding, namely Evaluation and Management, for physician services. Maintains a working knowledge of coding guidelines: Official Guidelines for Coding and Reporting, American Hospital Association’s Coding Clinics, and/or American Medical Association’s CPT Assistant. Maintains a working knowledge of reimbursement as it relates to coding: the government prospective payment systems for inpatient, outpatient, and/or home health agencies, skilled nursing facilities, inpatient rehabilitation...

This position plays a dual role in supporting the organization's compliance program and ensuring accurate clinical documentation and coding practices. This position is responsible for conducting audits, providing educational feedback to the providers from audited batches to ensure compliance with coding and billing requirements established by the payors, and supporting the development and implementation of compliance initiatives that align with federal and state regulations, payer requirements, and internal policies This position keeps Supervisor and Manager informed of daily progress and issues related to hospital and professional coding and compliance issues. Responsible for obtaining information for billing staff to follow-up on outstanding claims or recording of charges. Minimum Education, Experience, Training, and Licensures Required: High School Diploma or GED required Bachelor's degree preferred Certified Professional Coder - CPC Certification [or] Certified...

Overview Drees Homes is a family-owned home building company with a passion for making custom homes easy. For over 95 years, we have taken care of our employees and our customers. It's why we rank as the 21st largest privately-owned builder in the country and have a track record of long-tenured employees. We're proud of being named a 2023 and 2024 U.S. Best Managed Company, a program sponsored by Deloitte Private and The Wall Street Journal, and we've been officially certified as a Great Place to Work in both 2023 and 2024. Enrich your career at a company that values integrity, excellence, opportunity, stability and success. Headquartered in Fort Mitchell, Kentucky, Drees has operations in ten metropolitan areas: Greater Cincinnati and Cleveland, Ohio; Austin, Dallas and Houston, Texas; Indianapolis, Indiana; Jacksonville, Florida; Nashville, Tennessee; Raleigh, North Carolina; and Washington, DC. Responsibilities/Qualifications First Equity Mortgage , a subsidiary of Drees...

Overview The Clinical Coder is responsible and accountable for reviewing medical record documentation and assigning codes for reimbursement and statistical purposes. Responsibilities Dependent upon level of expertise defined in the Education/Training section: Maintains a working knowledge of coding fundamentals: ICD-9-CM coding for inpatient, outpatient, and/or physician services; HCPCS coding, namely CPT-4 for surgical procedures, for outpatient and/or physician services; and/or HCPCS coding, namely Evaluation and Management, for physician services. Maintains a working knowledge of coding guidelines: Official Guidelines for Coding and Reporting, American Hospital Association’s Coding Clinics, and/or American Medical Association’s CPT Assistant. Maintains a working knowledge of reimbursement as it relates to coding: the government prospective payment systems for inpatient, outpatient, and/or home health agencies, skilled nursing facilities, inpatient rehabilitation as well as...

Join to apply for the Clinical Coder I role at Appalachian Regional Healthcare (ARH) 2 days ago Be among the first 25 applicants Overview The Clinical Coder is responsible and accountable for reviewing medical record documentation and assigning codes for reimbursement and statistical purposes. Responsibilities Maintains a working knowledge of coding fundamentals: ICD-9-CM coding for inpatient, outpatient, and/or physician services; HCPCS coding, notably CPT-4 for surgical procedures for outpatient and/or physician services; and/or HCPCS coding, notably Evaluation and Management, for physician services. Maintains a working knowledge of coding guidelines: Official Guidelines for Coding and Reporting, American Hospital Association’s Coding Clinics, and/or American Medical Association’s CPT Assistant. Maintains a working knowledge of reimbursement as it relates to coding: the government prospective payment systems for inpatient, outpatient, and/or home health agencies, skilled...

Medical Coder At Sprinter Health, our mission is reimagining how people access care by bringing it directly into their homes. Nearly 30% of patients in the U.S. skip preventive or chronic care simply because they can't get to a doctor's office. For many, the ER becomes their first touchpoint with the healthcare systemdriving over $300B in avoidable costs every year. By using the same technologies that power leading marketplace and last-mile platforms, we deliver care where people are, especially those who need it most. So far, we've supported more than 2 million patients across 22 states, completed over 130,000 in-home visits, and maintained a 92 NPS. Our team of clinicians, technologists, and operators have raised over $125M to date from investors like a16z, General Catalyst, GV, and Accel and enjoy multi-year runway. As a Medical Coder, you will be responsible for reviewing and abstracting professional medical records to ensure accurate code assignment. You'll play a critical...