36 coding compliance auditor jobs found

Solventum is seeking an Ambulatory Audit Consultant to improve healthcare coding practices. You will work directly with clients to perform audits, deliver results, and implement improvements. Preference will be given to candidates with a strong background in outpatient coding and relevant certifications. This remote position offers a salary range of $96,000 - $132,000 along with comprehensive benefits. #J-18808-Ljbffr

Baylor Scott & White Health is seeking a Coding Auditor 1 to perform coding quality audits and provide feedback to coders. The role requires strong knowledge of ICD-10-CM/PCS, HCPCS, CPT, and related coding references to ensure accurate classification and DRG grouping. The candidate should have 5 years of coding experience with at least 1 year as a coding auditor, and must hold one of several coding certifications. This is a health system focused on quality and compliance. #J-18808-Ljbffr

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU). The role ensures coding accuracy, reviews medical records, and confirms compliance with state and federal requirements. Strong documentation and communication skills are essential for presenting findings to investigators and leadership. You will audit CPT/HCPCS coding, identify potential fraud or errors, and maintain thorough records. #J-18808-Ljbffr

Serco is seeking Medical Coding Auditing Specialists to perform systematic audits across DHA Markets and Military Treatment Facilities. You will develop annual audit plans, perform targeted coding reviews, and support government surveillance efforts, requiring strong proficiency in ICD-CM, CPT, and related coding standards. Candidates must have multi-certification credentials and a background in health information management. #J-18808-Ljbffr

Overview Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We help clients maximize their reimbursement and educate them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Our billing specialists receive ongoing training specific to medical specialty, and we continually update knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future – we provide the venue for individuals who have the desire and drive to grow. Career paths are supported with career development, leadership opportunities, and a productive integration of personal and professional life. With over 200 professionals across our family of Yeo & Yeo companies, you join a diverse team working to positively impact our clients and communities. Position Summary...

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...

POSITION DESCRIPTION :The Compliance Auditor / Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services.Provides professional expertise and education in CPT, ICD and HCC coding.The Compliance Auditor / Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations.This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution.Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance.ESSENTIAL JOB FUNCTIONS :Develops and leads audit projects for medical record integrity, service line or issues-related audits, identifies...

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...

Summary The Health Information Section (HIMS) Coding Auditor is responsible for coding and provider audits. Overseeing the appropriate coding assignment of ICD-10 CM, CPT-4, and HCPCS codes and various other duties assigned. Incumbent will also complete any coding assigned. **REMOTE WORK: Position is remote work eligible and is currently on an extension for the return-to-office mandate**. Learn more about this agency Duties Help Duties of the Medical Records Technician (Coder) Auditor include but are not limited to: Performs weekly or monthly audits of outpatient encounters. Reviews results of external audits and prepares education and/or audit responses. Performs monthly audits related to VHA Directives to include in-house and contract coding audits, EPRP reviews, revenue related/CPAC audits and other coding risk areas identified by Compliance, CPAC, VISN, external auditors medical center leadership and HIMs. Researches current guidelines related to...

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:...

Become a part of our caring community 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 receives guidance where needed....

Yeo & Yeo Medical Billing & Consulting Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future – we...

Job DescriptionJob DescriptionMedical Coding Compliance SpecialistCompensation :Up to $85,000 annually, determined by your experience and qualifications.Job Location :Remote (US)Job Highlights :Work-Life Balance :Monday to Friday schedule for a fulfilling personal and professional life.Competitive Compensation :Be rewarded with a generous salary and benefits package.Career Growth Opportunities :Unlock your potential and advance in your career with our support.Supportive Work Environment :Join a team that values and appreciates your contributions.Comprehensive Training :Enhance your skills and knowledge through our extensive training programs.Compliance and Peace of Mind :Work with confidence knowing that we prioritize compliance with employment laws and regulations.Paid Time Off and Holidays :Enjoy well-deserved time off to relax and recharge.Life Insurance Coverage :Protect your loved ones with our employer-paid life insurance policy.Collaborative Team Environment :Thrive in a...

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Location: Saginaw, MI (Onsite) Schedule: Monday–Friday, 8:00 AM–5:00 PM Jump Into a Hands-On Medical Billing Role with an Established Physician Practice Are you a medical billing professional who enjoys the day-to-day work of keeping the revenue cycle moving? We're seeking a Medical Billing Specialist with 1–3 years of experience who can quickly become a valuable member of our team. This is a hands-on role focused on medical billing operations, payment posting, accounts receivable follow-up, collections, and resolution of billing issues. It is not a management, supervisory, or analytical position. We are looking for someone who enjoys working directly in the billing process and takes pride in accuracy, organization, and problem-solving. What You\'ll Do Accurately posting incoming payments, including checks, ACH transactions, credit card payments, and electronic remittances Generating and distributing patient statements, invoices, and account communications Reconciling payments...

Job Opportunity Job ID:51909 Positions Location: Lansing, MI Job Description General Purpose of Job: Advanced Description: Positions Location: Lansing, MI Job Description General Purpose of Job : Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows...

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:...

A leading health data platform company is seeking an Inpatient Auditing Specialist to conduct coding audits and provide coder education. This fully remote role requires 5+ years of inpatient coding experience and CCS certification preferred. The successful candidate will excel in organizational and customer service skills while ensuring compliance and accuracy in coding. Competitive pay and a supportive work environment are offered. #J-18808-Ljbffr

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Job Description Job Description The Coding and Reimbursement Specialist is responsible for reviewing, analyzing, and accurately coding ambulatory and/or hospital-based encounters. This role performs initial charge review for E/M visits, diagnostic tests, and procedures across multiple specialty departments to determine the appropriate assignment of CPT, ICD-10, HCPCS codes, and modifiers for reporting physician services to third-party payers. The Specialist ensures all coding aligns with established coding standards, regulatory requirements, and reimbursement policies. Essential Duties and Responsibilities: Analyzes provider documentation to assure the appropriate Evaluation & Management levels are assigned using the correct CPT and current Evaluation and Management Guidelines Interprets outpatient office visit notes and charge documents to determine services provided and accurately assign CPT , Modifiers, and ICD-10 coding to these services. Performs comprehensive...

Job Description Job Description Description: CPC-As are not being considered at this time. We're coding rebels with a cause. KODE is a health-tech company developed by medical coders for medical coders looking to change the way things are done in the industry. Our company may be young but we're growing rapidly. That also means we're not buried in outdated policies and bureaucracies.Coders play a critical role in healthcare, but have you ever felt like you're just a cog in the machine? At KODE there are no cogs, there are people. We aren't looking for a coder to fill an open position simply. We're looking for a new teammate passionate about professional coding who wants to join our collective mission to be awesome.We're serious about two things: coding and treating you like the professional you are. If this intrigues you, please keep reading. About this Role We're looking for a Facility Inpatient Coder to join our company! Responsibilities: Review medical records...

Senior Medical Records Coder Are you an experienced inpatient coder who thrives in fast-paced, academic environments and wants to make a lasting impact beyond the chart? This Senior Medical Records Coder role sits at the heart of two dynamic Family Medicine Residency programsCorewell Health Troy Beaumont and CHMG EastGrosse Pointesupporting highly productive faculty physicians, community preceptors, and more than 24 residents and medical students. In this highly visible and influential position, you'll serve as both coding expert and educator, guiding providers through complex documentation, billing, and compliance requirements while helping shape the next generation of primary care physicians through audits, one-on-one education, resident orientation, and ongoing regulatory review. Under general supervision and according to established procedures, provides technical support to the Inpatient Coding Staff and coordinates daily workflow based on the needs of the department. On a...

Metro Vein Centers is seeking a Senior Medical Coder to serve as a clinical coding expert within our Revenue Cycle team. You will mentor coders, perform audits, guide on complex coding scenarios, and partner with Coding Leadership to maintain accuracy, compliance, and operational excellence. This fully remote role includes occasional travel to West Bloomfield, Michigan for training and departmental initiatives, with a strong emphasis on coaching, documentation quality, and payer liaison #J-18808-Ljbffr

DATE: July 20, 2026 POSITION: Risk Adjustment Compliance Coder DEPARTMENT: Finance-Risk Adjustment RATE: $28.86 per hour, with potential for additional compensation based on qualifications. POSITION SUMMARY: The Risk Adjustment Compliance Coder is responsible for enhancing the accuracy, quality, and integrity of coding data that supports Medicare and Medicaid reimbursement. This role conducts risk adjustment coding audits, performs compliance research, responds to coding inquiries, and serves as a subject matter expert in risk adjustment coding and compliance. The position supports Medicare and Medicaid risk adjustment programs through the development, implementation, and ongoing evaluation of program initiatives. Highly collaborative and operational in nature, this role partners closely with providers and internal stakeholders and requires strong communication, education, and relationship-management skills. This is not a traditional production-focused coding...