119 coding compliance educator jobs found

Description JOB SUMMARY: Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems. JOB RESPONSIBILITIES: • KEY RESPONSIBILITY 1: Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. o Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and observation visits for the purpose of reimbursement, research and compliance with federal and state regulations. o Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate...

Certified Professional Coder Job Category: Finance and Accounting Requisition Number: BILLI035488 Posted: June 4, 2026 Full-Time On-site Odessa, TX 79761, USA Description Key Responsibilities: Analyze patient charts, physician notes and discharge summaries Ensure documentation is complete and accurate before coding Translate diagnoses and procedures into standardized codes using: ICD-10-CM (diagnoses) CPT (procedures) HCPCS (supplies/services) Make sure codes correctly represent services provided Follow healthcare laws and regulations (HIPAA, Medicare/Medicaid guidelines) Company Policies Prevent coding errors that could lead to claim denials or audits Stay updated on coding changes and updates Work with billing teams to submit coded claims to insurance companies Verify claim accuracy to ensure proper reimbursement Fix rejected or denied claims by reviewing and correcting codes Communicate with healthcare providers and insurance companies Protect...

APC Associate Director WellMed, part of the Optum family of businesses, is seeking an APC Associate Director to join our team in Alice, TX. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting....

Join Our Caring Community Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities: Deliver coding and documentation education to providers and clinic staff within IPA clinics. Be a consultative resource and ongoing support for providers in assigned clinics. Conduct documentation audits to identify gaps, trends, and opportunities for improvement. Perform quarterly chart reviews to support coding accuracy...

Job Title Responsibilities One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $11.6 billion in 2020. In 2021, UHS was again recognized as one of the World's Most Admired Companies by Fortune; in 2020, ranked #281 on the Fortune 500; and listed #330 in Forbes ranking of U.S.' Largest Public Companies. Headquartered in King of Prussia, PA, UHS has 89,000 employees and through its subsidiaries operates 26 acute care hospitals, 334 behavioral health facilities, 39 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 38 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. At UHS and all its subsidiaries, our Human Resources departments and recruiters...

GENERAL SUMMARY Handles new claims, posting payments and appeals of lower complexity. Provides customer service and processes medical and billing record requests. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by employees in this job. Employees may be requested to perform job-related tasks other than those specifically presented in this description. Reviews, generates, and processes emergency ambulance transport medical claims Determines appropriate CPT and ICD 10 codes based on the medical data and narrative furnished in ePCR (electronic Patient Care Report) and if additional medical information of ePCR is needed to bill accordingly Serve as additional support staff to manage the numerous amount of medical claims that come from EMS related services Retrieves hospital face sheets to obtain health insurance information and reviews and researches additional health...

CSI is partnering with a leading healthcare organization to hire a Remote Outpatient Ancillary Coder to support outpatient coding and revenue cycle operations. This role is responsible for assigning accurate diagnosis codes, resolving claim edits and denials, and ensuring timely, compliant billing across outpatient, ancillary laboratory, and diagnostic services. The ideal candidate will have strong coding expertise, a detailed understanding of medical billing workflows, and a commitment to accuracy and quality. Hours: 40 hours/week Location: Remote Pay: $25-35/hr. based on relevant experience, education, and credentials Position Type: W-2 Consultant What you'll do: Assign accurate ICD-10-CM diagnosis codes for outpatient, ancillary laboratory, and diagnostic services Review medical documentation to ensure coding accuracy and compliance with coding guidelines Troubleshoot and resolve SVC (Simple Visit Coding) errors to prevent billing delays and...

Job Title Responsibilities: Performs the functions of all services of IP coding. Responsible and accountable for coding and DRG accuracy, timeliness of coding, and utilization of systems used to perform coding functions. Maintains relationship with Coding Manager/Supervisor, CDI team, Business Office and Case Management staff. Performs primary function of coding inpatient records, to include DRG assignment and validation. Maintains knowledge of outpatient coding and other areas to assist as needed. Utilizes the 3M Encoder to code and classify accurately all medical records according to ICD-10-CM/PCS. Responsible and accountable for maintaining performance skills. Qualifications 1. Three to five years coding experience required (Inpatient preferred) 2. Advanced training in medical coding (ICD10-CM/PCS, CPT and APC). 3. Medical terminology, anatomy and physiology required. 4. Computer skills. 5. Ability to read medical reports, interpret lab values pertinent to coding diagnoses,...

Job Description Job Description Senior Medical Coder – Urology/Nephrology Location Irving, TX | Onsite Compensation & Schedule • $35.75/hour – Non-Urology Certified Coder | $42.00/hour – Certified Urology Coder (CUC) • Full Time |8:00 AM - 5:00 PM • Temp to Perm (W2) • Start Date: March 16, 2026 Role Impact: The Senior Medical Coder ensures accurate, compliant coding for high-dollar and specialty professional fee accounts within Urology and Nephrology. This role directly supports clean claims, optimized reimbursement, and reduced denials by maintaining a minimum 95% coding accuracy rate. Success is defined by precision in ICD-10-CM, ICD-10-PCS, and CPT code assignment, strong collaboration with HIM (Health Information Management) and CDI (Clinical Documentation Improvement) teams, and consistent productivity performance. Key Responsibilities • Assign diagnosis and procedure codes in accordance with ICD-10-CM/PCS Official Guidelines and AMA CPT guidelines...

Job Description Job Description Specialty Senior Medical Coder – General Surgery Location: Irving, TX COMPENSATION & SCHEDULE • $35.75/hr (Non-CGSC Certified) | $42.00/hr (CGSC Certified – General Surgery) • Monday–Friday | 8:00 AM–5:00 PM • W2 | Temp to Perm • Start Date: 03/16/2026 ROLE IMPACT: The Specialty Coder Senior – General Surgery ensures accurate, compliant coding for high-dollar inpatient and outpatient professional services. This role drives revenue integrity by reducing denials, supporting clean claims, and maintaining a minimum 95% coding accuracy rate. Success is defined by precise code assignment, strong documentation review, and consistent productivity in a remote environment. Key Responsibilities • Assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes in accordance with Official Coding Guidelines and AMA CPT standards • Code inpatient and outpatient Evaluation & Management (E/M) and surgical/operative procedures, generating accurate...

Become a part of our caring community Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities: You will deliver coding and documentation education to providers and clinic staff within IPA clinics. You will be a consultative resource and ongoing support for providers in assigned clinics. You will conduct documentation audits to identify gaps, trends, and opportunities for improvement. You will...

Become a part of our caring community Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities: You will deliver coding and documentation education to providers and clinic staff within IPA clinics. You will be a consultative resource and ongoing support for providers in assigned clinics. You will conduct documentation audits to identify gaps, trends, and opportunities for improvement. You will...

Certified Professional Coder Think of yourself as someone who will provide world-class service to our customers or clients in an accurate, efficient, and respectful manner on every call as measured by different performance metrics, so not everyone can qualify for this role. We make sure we get the best of the best, after all, we are a ridiculously good company so we make sure our employees are top-notch. So come on, now we need your full concentration because it's time to imagine what it's like being a Certified Professional Coder. As a Certified Professional Coder you will... Audit charts to ensure accurate ICD-10 CM and CPT code assignment as well as documentation integrity to prevent claim denials. Use critical and logical thinking skills in chart-auditing based on the guidance set forth by the client. Uphold netiquette and professionalism in any interaction with the TaskUs team, other vendors and the client. Job Summary: The CPC will be responsible for reviewing...

Job Description Job Description Exciting Opportunity For Medical Coding Specialist at University Health in San Antonio! Are you ready to make an impact in healthcare and be part of a nationally recognized, top-tier health system? University Health in San Antonio, Texas, is seeking a dynamic Coding Specialist to join our outstanding team. This position offers an exciting chance to work at one of the most innovative and award-winning hospitals in the region. Why University Health? Top 10% in the Nation  for clinical excellence, recognized by U.S. News & World Report. Magnet® Recognized Hospital  – the highest national honor for nursing excellence. A Leader in Patient Care  – providing exceptional healthcare to our community with compassionate service. Top-Tier Benefits  – comprehensive health plans, generous paid time off, tuition reimbursement, and more! Cutting-Edge Technology  – work with the Epic EHR system and collaborate with experts across clinical,...

At Houston Methodist, the Senior Outpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to day surgery and observation encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory guidelines. FLSA STATUS Non-exempt QUALIFICATIONS EDUCATION Associate’s or higher degree in a Comission on Accreditation for Health Informatics and Information Managment accredited program or additional two years of experience (in addition to the minimum experience requirements listed below) in lieu of degree EXPERIENCE Three years of relevant outpatient coding experience or successful completion of the Houston Methodist Senior Outpatient Coder Transition Program LICENSES AND CERTIFICATIONS Required Must have one of the following:•RHIT - Certified Health Information Technician (AHIMA)•RHIA - Registered Health Information...

Job Summary (Par time-Potential for Fulltime) The Certified ER Medical Coding Auditor is responsible for auditing emergency department medical records to ensure accurate coding, compliance, and optimal reimbursement. This role also includes training and mentoring offshore coding teams to maintain high-quality standards and consistency across operations. Key Responsibilities Audit ER charts for accurate assignment of ICD-10-CM, CPT, and HCPCS codes Validate E/M level selection for emergency department visits Ensure compliance with payer guidelines and regulatory standards (CMS, HIPAA) Identify under coding, over coding, and documentation deficiencies Prepare detailed audit reports with corrective recommendations Provide education and feedback to coders and providers Train and mentor offshore coding teams on ER coding guidelines and audit findings Conduct regular quality review sessions and calibration meetings with offshore staff Develop and update training materials,...

At Houston Methodist, the Senior Outpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to day surgery and observation encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory guidelines. FLSA STATUS Non-exempt QUALIFICATIONS EDUCATION Associate’s or higher degree in a Comission on Accreditation for Health Informatics and Information Managment accredited program or additional two years of experience (in addition to the minimum experience requirements listed below) in lieu of degree EXPERIENCE Three years of relevant outpatient coding experience or successful completion of the Houston Methodist Senior Outpatient Coder Transition Program LICENSES AND CERTIFICATIONS Required Must have one of the following:•RHIT - Certified Health Information Technician (AHIMA)•RHIA - Registered Health Information...

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...

UTHealth Houston is hiring a Professional Coder II & III for Revenue Cycle (Charge Capture). The role focuses on reviewing documentation, selecting CPT/HCPCS/ICD-10-CM codes, and ensuring regulatory compliance for inpatient and outpatient services. Telework is available with an onsite training period in Texas; strong coding background and AHIMA/AAPC certifications are highly valued. The department emphasizes accuracy, education, and timely coding. #J-18808-Ljbffr

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings...

Job Number: 180041, Job Title: Risk Adjustment Coder II, Salary: $27.69 - $34.62 JOB SUMMARY The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization. JOB SPECIFICATIONS AND CORE COMPETENCIES Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions,...

Coding Specialist To provide the advanced skills necessary for proper coding of all pertinent diagnoses and procedures and to provide optimal DRG assignment after thorough review of medical record and analysis of DRG options. Selects records from EPIC WQ according to priority. Reviews all federally insured and other patient discharge encounters for accurate coding and sequencing of diagnoses and procedures. Correctly assigns ICD-10 -CM diagnoses and I C D - 1 0 - P C S procedure codes and enters appropriate codes into EPIC Encoder. Identifies responsible staff and resident physicians for each procedure coded. Always protects confidentiality of patient information. Participates in section meeting and office in-services. Attends and participates in coding education sessions. Keeps coding knowledge and skills current through attending continuing education activities and reviewing pertinent literature. Obtains required CEU's for certification and completes any required...

Risk Adjustment Coder II The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization. Job Specifications and Core Competencies: Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions, utilizing ICD-10 coding guidelines for Commercial and Medicare risk...

HIM/Medical Records Coding Specialist Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility is fully accredited and included a 16-bed residential treatment center for adult chemical dependency. We offer a broad range of behavioral health programs for children, adolescents and adults. Treatment is offered at multiple levels of care including inpatient, partial hospitalization and intensive outpatient. The hospital is easily accessible off the Southwest Freeway near the Galleria. West Oaks Hospital is seeking a dynamic and talented HIM/Medical Records Coding Specialist to join our team of compassionate, dedicated professionals. The HIM/Medical Records Coding Specialist will be responsible for assigning diagnostic and procedures codes and abstracts data to outpatient and/or inpatient encounters based upon documentation within the medical record while maintaining compliance...