28 coding compliance educator jobs found

Certified Coder The Certified Coder will play a key role in converting diagnoses and treatment procedures into ICD-10, CPT and HCPCS codes. The Coder will review and accurately code office and hospital procedures for reimbursement. Essential Functions Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Reviews and verifies documentation supports diagnoses, procedures, and treatment results. Identifies diagnostic and procedural information. Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes. Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing...

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 and help us put health first 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. 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...

Hiring Department University Physicians Job Description This position is a dual post linked to Job ID 59698 - MCS-C and the department will be hiring for two positions. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records to identify potential problems with coding and reimbursement, such as edits, denials, and appeal letters. Act as liaison between third-party payers and assigned departments to coordinate all aspects of professional coding. Provide assistance to faculty, residents, and department staff in standards of medical record documentation and coding. Assist in the presentation of training sessions for faculty, residents, and staff to inform them of changes made to Medicare billing, federal laws and regulations, and other specific standards...

Job Description Job Description Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation in the medical record utilizing knowledge of anatomy, physiology, medical terminology, and pathology. Review the discharge summary, history and physical, physician progress notes, consultation reports, radiology, laboratory, pathology, operative records, emergency room record to accurately assign diagnosis and / or procedure. Determine diagnoses that were treated, monitored, and evaluated and procedures done during the episode of care and assign appropriate codes. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations. Ensure the diagnoses and procedures are sequenced in order of their clinical significance to accurately assign the appropriate DRG, APC or payment tier under the Prospective Payment system to guarantee accurate reimbursement. Review coding for accuracy and...

Company Overview Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast‑growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Job Summary Alignment Health is seeking a remote Risk Adjustment Compliance Auditor to support auditing and compliance activities related to risk adjustment data submitted to CMS. In this role, you will conduct provider and coder‑level audits, review medical record documentation and coding accuracy, identify compliance risks and...

Job Details Job Location: Epworth - Webster - St. Louis, MO 63119 Position Type: Full Time Education Level: High School Travel Percentage: None Job Shift: Day Job Category: Accounting Epworth seeks an experienced Medical Billing Specialist to lead disciplined revenue cycle execution and bring billing functions in-house. This role will be responsible for accurate and timely claims submission, state and local government program invoicing, denial management, payment posting, billing process control, and continuous improvement in reimbursement performance, with particular emphasis on Medicaid, managed care, and state and local government‑funded program billing. This is a hands‑on role for an experienced professional who combines strong technical billing knowledge with rigorous process discipline and a focus on strengthening reimbursement performance and cash realization. Primary Responsibilities Manage day‑to‑day billing and revenue cycle execution for Medicaid, managed care...

Opportunities At Change Healthcare Opportunities at Change Healthcare, part of the Optum family of businesses. We are transforming the health care system through innovative technology and analytics. Find opportunities to make a difference in a variety of career areas as we all play a role in accelerating health care transformation. Help us deliver cutting-edge solutions for patients, hospitals and insurance companies, resulting in healthier communities. Use your talents to improve the health outcomes of millions of people and discover the meaning behind: Caring. Connecting. Growing Together. Job Description: The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours:...

Coder Reimbursement Specialist - Hospital Full‑time position. The Coding and Reimbursement Specialist (CCS) is responsible for coding and abstracting clinical data from the medical record, including inpatient, outpatient, commercial, Medicare, Medicaid, Illinois Public Aid, and all other payor types. Accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis and DRG in accordance with rules and regulations and coding methodologies, resulting in reimbursement and billing compliances as set forth by the Office of Inspector General. The CCS manages workload, assigns work to three inpatient and two outpatient coders, and oversees day‑to‑day operations of the coding/reimbursement area. The CCS monitors regulatory sources to keep HIM coding and other staff informed and trained on coding rules, regulations and related issues, works closely with patient financial services to resolve claim denials, assists in...

AAPC Certified Medical Coder - Remote Join a dedicated healthcare team serving a broad regional community in the Midwest. This role is perfect for a detail-oriented medical coder who thrives in a remote work environment and is passionate about accurate and ethical coding practices. General Summary The medical coder ensures that services are billed correctly according to the American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. This position involves insurance credentialing and educating providers and staff on coding and billing standards. Routine chart audits are conducted to maintain compliance and accuracy. Essential Duties and Responsibilities Assign ICD-10-CM, CPT, and HCPCS Level II codes to finalized medical documentation to create accurate medical claims. Abstract specific data from patient records to determine appropriate claim modifiers. Query providers for clarification when documentation is unclear or incomplete,...

At Houston Methodist, the Lead Outpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to outpatient encounters based on documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. FLSA Status Non-exempt...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. We’re looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the...

Job Opportunity It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Summary: Performs periodic and ongoing audits of claims to ensure accuracy of coding and billing, and sufficiency of supporting documentation. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Audits specified number of records per coder as defined in the system coding audit plan. Prepares audit reports that are issued to key stakeholders, as appropriate. Develops corrective action plans to address opportunities for coding, billing and documentation improvement. Identifies trends and educational opportunities. Prepares and presents educational programs related to coding. Assists in the management of the coding and billing auditing and monitoring program to address high risk compliance areas. Performs other duties as assigned. EDUCATION Bachelor's degree in business, healthcare or related field, or equivalent years of experience and education EXPERIENCE Three...

**Date Posted:**2026-01-26**Country:**United States of America**Location:**US-CA-REMOTE**Position Role Type:**Remote**U.S. Citizen, U.S. Person, or Immigration Status Requirements:**U.S. citizenship is required, as only U.S. citizens are authorized to access information under this program/contract.**Security Clearance Type:**DoD Clearance: Secret**Security Clearance Status:**Active and existing security clearance required after day 1RTX Corporation is an Aerospace and Defense company that provides advanced systems and services for commercial, military and government customers worldwide. It comprises three industry-leading businesses – Collins Aerospace Systems, Pratt & Whitney, and Raytheon. Its 185,000 employees enable the company to operate at the edge of known science as they imagine and deliver solutions that push the boundaries in quantum physics, electric propulsion, directed energy, hypersonics, avionics and cybersecurity. The company, formed in 2020 through the...

It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Qualifications: Ideal candidate has experience with inpatient coding and auditing. RHIT, RHIA, and CCS are preferred certifications. ? Remote work: This position is eligible for remote work in accordance with SSM policies. Note that remote work is not permissible in some states; Human Resources should be consulted for additional information and guidance. * Candidates to reside in MO, IL, OK, or WI (additional states my be considered) Job Summary: Performs periodic and ongoing audits of claims to ensure accuracy of coding and billing, and sufficiency of supporting documentation. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Audits specified number of records per coder as defined in the system coding audit plan. Prepares audit reports that are issued to key stakeholders, as appropriate. Develops corrective action plans to...

A healthcare organization in Kansas City is seeking a Compliance & Coding Audit Specialist to safeguard accuracy, integrity, and regulatory compliance. The role involves conducting audits and providing education related to coding, billing, and clinical documentation practices. Candidates should have a high school diploma, relevant credentials, and a minimum of three years of coding experience. Strong communication and organizational skills are essential. The position is full-time with a standard work schedule from Monday to Friday. #J-18808-Ljbffr

Job Type Full-time Description PURPOSE STATEMENT The Certified Coder will play a key role in converting diagnoses and treatment procedures intoICD-10, CPT and HCPCS codes. The Coder will review and accurately code office and hospital procedures for reimbursement. ESSENTIAL FUNCTIONS Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Reviews and verifies documentation supports diagnoses, procedures, and treatment results. Identifies diagnostic and procedural information. Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes. Assigns codes for reimbursements,...

St. Luke's Hospital in Chesterfield is seeking a Coding Specialist III responsible for abstracting clinical data and assigning ICD-10-CM and HCPCS codes. The successful candidate will promote teamwork with the healthcare team and ensure compliance with reporting requirements. This role requires a High School Diploma or equivalent along with RHIA, RHIT, or CCS certification. St. Luke's offers a day one benefits package, including pension plan & 401K, competitive compensation, and education assistance. #J-18808-Ljbffr

POSITION TITLE: Compliance Auditor REPORTS TO: Director of Compliance CLASSIFICATION: Non-Exempt POSITION SUMMARY: The Compliance Auditor is responsible for developing and executing audit plans based on research and regulatory guidelines and conducting internal and external audits of departments and their policies. They review programs, records, and systems to ensure adherence to regulations and to support an effective compliance program that prevents illegal, unethical, or improper conduct at the health center. Additionally, they compile and present audit findings to department leadership, assist in implementing procedural changes to resolve compliance issues, and may be reassigned duties as needed for accommodation or staffing reasons. ESSENTIAL FUNCTIONS: The following information is considered the definition of essential functions, but does not restrict the tasks that may be assigned. The Compliance Auditor may be reassigned duties and responsibilities...

It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Experience : 2+ years of professional coding experience is required. Come join us as a remote Coder II Professional at SSM Health! You will play a crucial role in accurately coding and abstracting medical records for billing and reimbursement purposes. You will be responsible for reviewing patient information, assigning appropriate codes, and ensuring compliance with coding guidelines and regulations. This is a remote position, allowing you to work from the comfort of your own home while contributing to the success of SSM Health. ? Remote work: This position is eligible for remote work in accordance with SSM policies. Note that remote work is not permissible in some states; Human Resources should be consulted for additional information and guidance. * Candidates to reside in MO, IL, OK, or WI (additional states my be considered) Job Summary: Primarily focuses on...

It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Come join us a Coder I, Professional at SSM Health! You will play a crucial role in ensuring accurate and timely coding of medical records. You will be responsible for reviewing patient information, assigning appropriate codes, and ensuring compliance with coding guidelines and regulations. This is a remote position, allowing you to work from the comfort of your own home while contributing to the success of our organization. ? Remote work: This position is eligible for remote work in accordance with SSM policies. Note that remote work is not permissible in some states; Human Resources should be consulted for additional information and guidance. * Candidates to reside in MO, IL, OK, or WI (additional states my be considered) Job Summary: Primarily focuses on coding of moderate complexity, such as outpatient or inpatient evaluation and management and minor procedures....

COMPANY OVERVIEW Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG currently bidding on a contract with the Federal Government for several coding positions. You would be a W-2 employee for HPMG and NOT a government employee. SUMMARY Responsible for assignment of accurate ICD codes for diagnoses and procedures. Medical Severity - Diagnostic Related Group (MS-DRG) is automatically assigned by the grouper software for inpatient stays. Inpatient coders may also be responsible for the assignment of accurate ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities from medical record documentation (paper or electronic) for inpatient professional services (a.k.a., rounds or IBWA encounters). Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities. MANDATORY KNOWLEDGE AND SKILLS Position requires...

Join a dedicated healthcare team serving the heart of the Midwest region. This role is perfect for a detail-oriented medical coder who thrives in a remote work environment and values accuracy and compliance. General Summary The medical coder ensures accurate billing by assigning appropriate ICD-10-CM, CPT, and HCPCS Level II codes in accordance with American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. This position involves insurance credentialing and educating providers and staff on coding and billing standards. Routine chart audits and timely documentation review are essential components of this role. Essential Duties and Responsibilities Assign ICD-10-CM, CPT, and HCPCS Level II codes to finalized medical documentation to create accurate medical claims. Abstract relevant data from patient records to determine appropriate claim modifiers. Communicate with providers to clarify unclear or incomplete documentation and...

It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Qualifications: Ideal candidate has experience with inpatient facility coding, ideally with Trauma level 1 or 2, and strong ICD-10-PCS and CM experience. Experience working with Clinical Documentation Improvement (CDI) is also preferred. RHIT, RHIA, or CCS are preferred certifications. Come join us as a Coder, Hospital Inpatient at SSM Health! You will be responsible for accurately coding and abstracting medical records for inpatient hospital stays. Your expertise in coding will ensure that our organization maintains compliance with all coding guidelines and regulations. This is a remote position, allowing you to work from the comfort of your own home while contributing to the success of SSM Health. ? Remote work: This position is eligible for remote work in accordance with SSM policies. Note that remote work is not permissible in some states; Human Resources should be...