18 coding validation coder i jobs found

Job Title Cotiviti has multiple openings for full-time coders. These roles will focus on claims audits for appeals, checking for completeness & accuracy based on coding guidelines. Experience with E&M coding & auditing is preferred. These are full-time remote positions and can be done anywhere within the continental US and will work a traditional day time schedule. Responsibilities Perform daily audits on provider appeals for completeness and accuracy based on specified coding guidelines to ensure appropriateness for reimbursement. Apply client specific coding guidelines when applicable. Learns new appeal categories as production need requires. Stays current on coding guidelines appropriate to the position. Uses the Cotiviti applications to processes CV appeals to meet both production and accuracy standards. Reviews quality feedback from QA. Submits questions for clarification as needed. Utilizes the 'QA Resolution' process when disagreement occurs...

Risk Adjustment Coder I / Coder II (RADV Audit) Position Overview: We are seeking experienced Risk Adjustment Coders to support high-volume Risk Adjustment Data Validation (RADV) audit activities in alignment with CMS RADV program requirements and internal compliance standards. This role is responsible for reviewing and validating diagnosis coding, ensuring documentation accuracy, and supporting audit readiness initiatives related to CMS HCC risk adjustment programs. Candidates may be considered for either the Coder I or Coder II level based on experience and audit expertise. Contract Duration: *This is a short term contract from June - September with a possibility of extension!* Coder I – RADV Audit Coder Responsibilities: Review inpatient and outpatient medical records to identify and validate diagnosis codes Abstract and assign ICD-10-CM diagnosis codes based on clinical documentation Apply CMS risk adjustment guidelines and HCC model rules when validating coded conditions...

Salary : $105,597.80 - $145,114.92 Annually Location : Riverside Job Type: Regular Job Number: 26-74191-01 AL Department: RUHS-Medical Center Opening Date: 03/03/2026 Closing Date: Continuous For questions regarding this position, please contact the Recruiter listed in the Supplemental Information section. ABOUT THE POSITION Riverside University Health System (RUHS)is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to...

Erlanger Health hires employees for telecommuting/remote positions in the following states: AL, AZ, GA, FL, IN, KY, LA, MD, M I, MS, MO, NC, NV, OH, PA, SC, TN, TX, VA, WI, WY REMOTE Job Summary: The Physician Coder III is responsible for coding of physician and/or mid-level provider professional services. Recognizes and completes a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follows set procedures to achieve goals. Displays professional office skills and ability to navigate a practice management system. Functions as liaison between management, the physician practices and employees working within physician practices. Coder will provide CPT, HCPCS and ICD-10-CM coding a minimum of 1-4 specialties. Specialties could include UR, Podiatry, Plastics, Pediatrics, OB, Pain Management, Ortho, Addiction, General Surgery, Internal Medicine, Urgent Care, Pulmonary, or ED. Facility Chart types could include OT, PT, Urgent Care, ED, or a...

Coding Compliance Auditor Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive...

Physician Coder I - Hybrid Position Position is responsible for coding of physician and/or mid-level provider professional services. Recognize and complete a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follow set procedures to achieve goals. Display professional office skills and ability to navigate a practice management system. Good written and oral communication skills, ability to handle multiple tasks, and work with and train other employees. Ability to serve as liaison between management, the physician practices, and employees working within physician practices. This position is involved in a team-based approach to care. Team members are trained to meet the highest level of function for their role as per the State of Tennessee/Georgia guidelines. Coder will provide CPT, HCPCS and ICD-10-CM coding a minimum of 1-4 specialties. Specialties could include UR, Podiatry, Plastics, Pediatrics, OB, Pain Management, Ortho, Addiction,...

Analyst Coder I Zimmerman Associates, Inc. (ZAI) is seeking an Analyst Coder I to support adverse event reporting and safety data management activities within the FDA Adverse Event Reporting System (FAERS) database, including the Data Management Platform (DMP). This position is responsible for coding and quality review of Individual Case Safety Reports (ICSRs), ensuring accuracy, consistency, and compliance with established taxonomies, policies, and Standard Operating Procedures (SOPs). The ideal candidate will possess strong analytical skills, attention to detail, and experience working with safety reporting systems and healthcare-related data. Duties / Functional Responsibilities Ensure the accuracy of data entered into critical fields according to the Standard Operating Procedures (SOPs). Code Individual Case Safety Reports (ICSRs) according to appropriate taxonomies, and established policies and SOPs. Resolve problems related to data entry. Performs data entry...

We’re Hiring: Nurse DRG Auditors (Payment Integrity) + Inpatient & RN Coders | Remote We’re growing and looking for detail-driven, high-impact healthcare professionals to join our team! If you’re passionate about coding accuracy, DRG validation, and revenue integrity, this is your opportunity to work with a collaborative, forward-thinking organization. Featured Role: Nurse DRG Auditor – Payment Integrity Salary: $95,000 – $105,000 Location: Remote What You’ll Do: Perform DRG validation and quality audits to ensure coding accuracy and appropriate reimbursement Analyze clinical documentation and coding for payment integrity opportunities Apply Medicare/CMS guidelines to validate claims and identify discrepancies Partner with coding, CDI, and compliance teams to drive accuracy and outcomes What You Bring: RN Required National Coding Certification (CIC, CCS, etc.) 2+ years of recent DRG Quality Auditing experience (hospital or health plan) Strong expertise in ICD-10-CM/PCS Deep...

Medical Coder I Miami, FL 33126 Description At ClareMedica, exceptional is the standard. Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the ClareMedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we're working together to help seniors live happier, healthier, fuller lives. That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees' growth and wellness and where their full potential and value are realized. At ClareMedica, we're excited about great people like you. We're even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities. Opportunity awaits – welcome to ClareMedica. ESSENTIAL FUNCTIONS: We are seeking an accurate, detailed oriented...

Physician Coder I - Hybrid Position Position is responsible for coding of physician and/or mid-level provider professional services. Recognize and complete a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follow set procedures to achieve goals. Display professional office skills and ability to navigate a practice management system. Good written and oral communication skills, ability to handle multiple tasks, and work with and train other employees. Ability to serve as liaison between management, the physician practices, and employees working within physician practices. This position is involved in a team-based approach to care. Team members are trained to meet the highest level of function for their role as per the State of Tennessee/Georgia guidelines. Coder will provide CPT, HCPCS and ICD-10-CM coding a minimum of 1-4 specialties. Specialties could include UR, Podiatry, Plastics, Pediatrics, OB, Pain Management, Ortho, Addiction,...

Physician Coder III, Remote Erlanger Health hires employees for telecommuting/remote positions in the following states: AL, AZ, GA, FL, IN, KY, LA, MD, MI, MS, MO, NC, NV, OH, PA, SC, TN, TX, VA, WI, WY. Job Summary: The Physician Coder III is responsible for coding of physician and/or mid-level provider professional services. Recognizes and completes a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follows set procedures to achieve goals. Displays professional office skills and ability to navigate a practice management system. Functions as liaison between management, the physician practices and employees working within physician practices. Coder will provide CPT, HCPCS and ICD-10-CM coding a minimum of 1-4 specialties. Specialties could include UR, Podiatry, Plastics, Pediatrics, OB, Pain Management, Ortho, Addiction, General Surgery, Internal Medicine, Urgent Care, Pulmonary, or ED. Facility Chart types could include OT, PT, Urgent...

Job Description Physician Coder III, Remote ( 43806 ) - Erlanger Baroness Hospital Chattanooga, TN Regular - Non-exempt - Full-time - Standard Hours 37.5 Description Erlanger Health hires employees for telecommuting/remote positions in the following states: AL, AZ, GA, FL, IN, KY, LA, MD, MI, MS, MO, NC, NV, OH, PA, SC, TN, TX, VA, WI, WY. REMOTE Job Summary The Physician Coder III is responsible for coding of physician and/or mid-level provider professional services. Recognizes and completes a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follows set procedures to achieve goals. Displays professional office skills and ability to navigate a practice management system. Functions as liaison between management, the physician practices and employees working within physician practices. Coder will provide CPT, HCPCS, and ICD-10-CM coding a minimum of 1-4 specialties. Specialties could include UR, Podiatry, Plastics, Pediatrics, OB, Pain...

Join to apply for the Physician Coder III, Remote role at Erlanger 3 days ago Be among the first 25 applicants Join to apply for the Physician Coder III, Remote role at Erlanger Erlanger Health hires employees for telecommuting/remote positions in the following states: AL, AZ, GA, FL, IN, KY, LA, MD, M I, MS, MO, NC, NV, OH, SC, TN, TX, VA, WI, WY REMOTE Job Summary: The Physician Coder III is responsible for coding of physician and/or mid-level provider professional services. Recognizes and completes a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follows set procedures to achieve goals. Displays professional office skills and ability to navigate a practice management system. Functions as liaison between management, the physician practices and employees working within physician practices. Coder will provide CPT, HCPCS and ICD-10-CM coding a minimum of 1-4 specialties. Specialties could include UR, Podiatry, Plastics, Pediatrics, OB,...

Salary : $70,044.85 - $104,320.89 Annually Location : Riverside Job Type: Regular Job Number: 26-13390-01 Department: RUHS-Medical Center Opening Date: 05/08/2026 For questions regarding this position, please contact the Recruiter listed in the Supplemental Information section. ABOUT THE POSITION The County of Riverside - Riverside University Health System - Medical Records Department is seeking to fill a Certified Medical Records Coder position located in Riverside. Under general supervision, performs advanced coding and abstracting of inpatient medical record entries according to the most current edition of International Classification of Diseases - Clinical Modification System (ICD-CM), Procedure Coding System (PCS) and Current Procedural Terminology (CPT); performs other related duties as required. The Certified Medical Records Coder - Inpatient classification performs the most complex coding and abstracting of a high volume of patient records in the...

Salary : $64,311.76 - $95,813.52 Annually Location : Riverside Job Type: Regular Job Number: 26-13451-01 Department: RUHS-Medical Center Opening Date: 04/23/2026 For questions regarding this position, please contact the Recruiter listed in the Supplemental Information section. ABOUT THE POSITION The County of Riverside - Riverside University Health System- Medical Records Department is seeking to fill multiple Certified Medical Records Coder positions. The incumbents will be responsible for performing advanced coding and abstracting of outpatient medical record entries according to the most current edition of International Classification of Diseases Clinical Modification System (ICD-CM) and Current Procedural Terminology (CPT); performs other related duties as required. The Certified Medical Records Coder - Outpatient classification performs coding and abstracting of a high volume of patient records in the Medical Records Department and reports to an...

Remote / Work from Home / Virtual / Hybrid Location Shadeland Station, Shadeland Ave, Indianapolis, IN 46256, United States Responsibilities Timely, accurate, and complete review of patient charts following patient encounters, utilizing a variety of technical platforms to complete workflows. Validating diagnosis codes representing patient conditions along with necessary MEAT documentation. Ensuring coding is consistent with guidelines from regulatory entities. Conducting audits to meet compliance with ACA standards. Creating post‑visit queries with follow up. Collaborating with CDI team members, particularly with clinical findings. Contributing to the provider education body of work, participating in pre‑encounter reviews as needed. Qualifications Applicants for this position should be able to collaborate with others in a team setting, have excellent communication skills, and a positive attitude toward problem‑solving. Critical thinkers. High School diploma or GED is...

Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing whole-person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 6,000 health care providers, including primary and specialty care physicians, hospitals and ancillary providers. We have operated in the Arizona market for more than 13 years, based in Chandler, Arizona, and are an affiliate of Heritage Provider Network. As a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost. The HCC Coder I is a highly organized, team-oriented individual who possesses the ability to quickly understand and carry out verbal and written directions. The Coder I will be responsible for identifying and reporting all HCC diagnoses from outpatient and inpatient charts. Position Duties & Responsibilities Review and analyze...