20 documentation coding auditor jobs found

Sr. Recovery Resolution Analyst This position is remote in Massachusetts. You will have the flexibility to work remotely as you take on some tough challenges. Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The Sr. Recovery Resolution Analyst will be responsible for performing compliance reviews of medical and administrative documentation to identify instances of healthcare fraud and/or wasteful and abusive conduct by health care providers who submit claims for payment. This position will utilize information from claims data analysis, plan members, the...

At South Shore Health, we come together to improve the health of our family, friends and neighbors by bringing together people, caregivers and excellence in medicine. We are seeking a Coding and Compliance Auditor to evaluate medical record documentation and coding accuracy, identify opportunities for improvement, and design and deliver coding education and training programs for clinical staff, coders and other key stakeholders. In this role, you will monitor external regulatory and internal process changes and provide support to colleagues in adhering to Federal, State and local requirements. The annual pay range for this role is $73,000.00 - $104,400.00.   Responsibilities: ·        Establish, implement, and maintain a formalized process for coding compliance and a formal review (audit) process, and conduct routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPCs, PCS and ICD-10-CM codes ·        Perform prospective...

This is a remote based position. Applicants can be located nationwide Back 1d Outpatient Coding Auditor #2814 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced...

Coding & Compliance Auditor The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Compensation Pay Range: $73,000.00 - $104,400.00 Job Responsibilities Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process. Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC's, PCS and ICD-10-CM codes. Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection. Analyzes data to identify...

If you are an existing employee of South Shore Health then please apply through the internal career site. Requisition Number: R-22463 Facility: LOC0006 - 780 Main Street780 Main StreetWeymouth, MA 02190 Department Name: SHS Compliance Status: Full time Budgeted Hours: 40 Shift: Day (United States of America) The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Compensation Pay Range: $73,000.00 - $104,400.00 Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit)...

Department Description:The Critical Care Auditor/ Coder position will be working directly with the Department of Anesthesia, Critical Care and Pain Medicine and will have the opportunity to work remotely following an initial onsite training period. The incumbent will be required from time-to-time to attend billing onsite staff meetings and meetings with the physicians they support. AFS, LLC is located in Needham Heights, Massachusetts. Job Location:Virtual Job Summary:Performs professional certified coding and provides administrative and project support to the department. Analyzes surgical-medical documentation, provides the individual surgeon/physician with the application of appropriate ICD-10/CPT/HCPCS descriptor codes including the appropriate use of modifiers to ensure compliance for reimbursement. Essential Responsibilities:Analyzes evaluation and management, including critical care, procedures and other notes and documents to determine the scope and complexity of the...

Dana-Farber Cancer Institute in Boston, MA is seeking a Billing Compliance Reviewer to manage audits and ensure compliance with billing regulations. The role involves analyzing documentation, educating staff, and collaborating with various teams. Ideal candidates should have 5 years of healthcare coding experience and required certifications. The position offers a salary range of $93,800 to $106,000 and is a full-time opportunity. #J-18808-Ljbffr

Title: Certified Risk Coder Reports to: Manager, Risk Coding Classification: Individual Contributor Location: Boston (Remote) Job description revision number and date: 2.0, 01.06.2025 Organization Summary Community Care Cooperative (C3) is a 501(c)(3) non‑profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast‑growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary The Certified Risk Coder will be a part of an emerging coding team and coding service that performs...

ARMA International in Brookline, Massachusetts, is seeking a Billing Compliance Reviewer. This role entails planning and executing audits, analyzing medical documentation, and ensuring compliance with regulations. The ideal candidate will have a strong background in healthcare coding and auditing. The position offers a salary range of $93,800.00 - $106,000.00 based on experience and skills. Qualified candidates must have at least 5 years of relevant experience and appropriate certifications. #J-18808-Ljbffr

Dana-Farber Cancer Institute in Brookline is seeking a Billing Compliance Reviewer to manage audits and ensure compliance with CMS guidelines. This role focuses on analyzing billing documentation and collaborating with clinical teams to improve coding practices. Qualified candidates should have at least five years of experience in healthcare coding and possess a relevant certification. The position offers a competitive salary range of $93,800 to $106,000. #J-18808-Ljbffr

Medical Billing Specialist job at Entyre Inc. Boston, MA. Our Mission Serve Families. Our Method: Relentless Speed. Entyre Care radically supports family caregivers with financial, emotional, and expert resources. We operate with urgency, focus, and a commitment to delivering “insanely great” outcomes for families. Position Overview We are seeking a highly organized and detail-oriented Billing Specialist to join our accounting team. The Billing Specialist will be responsible for supporting the daily operations of the accounting department, ensuring the accuracy of the medical billing. This role requires a strong understanding of billing, excellent problem-solving skills, and the ability to work collaboratively across departments. Key Responsibilities Prepare and post journal entries, ensuring accuracy and compliance with company policies. Maintain and reconcile general ledger accounts. Assist with month-end, quarter-end, and year-end closing processes. Review and process...

Who We Are SouthNewHampshireHealth has been a cornerstone of the region since 1893, delivering high‑quality, compassionate care close to home. Anchored by SouthernNewHampshireMedicalCenter—a 188‑bed, DNV‑accredited hospital in downtown Nashua with a LevelIII‑N trauma center, LevelII Special Care Nursery, and Magnet® designation for nursing excellence—we offer a full spectrum of services from primary care to advanced diagnostics and specialized treatments. Our medical staff includes over 500 providers from Foundation Medical Partners and local practices. Foundation Medical Partners, our multi‑specialty group, spans 70+ practices across southern New Hampshire and northern Massachusetts, providing coordinated, patient‑centered care to thousands each year. About The Job The Coding Specialist – Professional Based (PB) is responsible for analyzing professional (physician and advanced practice provider) encounters and related documentation to assign accurate ICD‑10‑CM, CPT, and HCPCS...

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. What We're Looking For We're looking for experienced and credentialed inpatient 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...

Mass General Brigham in Somerville is looking for a Medical Coder to ensure proper coding compliance and documentation accuracy. This role involves coding patient encounters, ensuring adherence to guidelines, and supporting coding audits. Qualified candidates should have 3-5 years of medical coding experience, preferably with knowledge of ICD-10 and CPT systems. The position offers remote work options and a competitive pay range of $22.22 – $31.71 per hour. #J-18808-Ljbffr

Community Behavioral Health Center Clinical Supervisor (Adult) job at Boston Medical Center. Boston, MA. Position Summary The Clinical Supervisor oversees and supervises master's level clinicians who are responsible for evaluating, treating, and providing behavioral health services for patients of BMC Department of Psychiatry. Responsibilities will include: overseeing daily onsite clinical activities, providing regular clinical and programmatic supervision to clinicians, providing clinical back-up and support to the teams as needed; performance management of Master’s level clinicians; payroll and timekeeping for program staff; and reviewing cases and documentation to ensure staff are compliant with approved protocols and procedures. In addition, the Clinical Supervisor also provides direct clinical care through individual, group, couples, and family psychotherapy using an anti-oppression and health equity lens. The position consults with, collaborates, and communicates with a wide...

Ambulatory Surgery Outpatient Coder - On-Site (Boston, MA) Experienced Ambulatory Surgery Outpatient Coder needed in Boston, MA - on-site role for certified medical coders (CPC/CCS) with Epic and 3M experience. Join a dynamic healthcare team in the heart of Boston, Massachusetts (zip code 02215). This on-site outpatient coder opportunity is ideal for medical coders focused on ambulatory surgery, outpatient surgical coding, and revenue cycle integrity at a leading Boston medical facility. Job Details Position Type: Full-Time, On-Site (Ambulatory Surgery Coder / Outpatient Coder) Number of Openings: 3 Contract Duration: 13 weeks Start Date: June 1, 2026 Shifts Per Week: 5 Shift Duration: 8 hours Weekly Estimated Pay: $1,310 - $1,560 Location: 330 Brookline Boston Ave, Boston, MA 02215 (Boston medical coding jobs) Required Qualifications Minimum 3+ years of ambulatory surgery / outpatient coding experience Strong...

Title: Certified Risk Coder Reports to: Manager, Risk Coding Classification: Individual Contributor Location: Boston (Remote) Job description revision number and date: 2.0, 01.06.2025 Organization Summary: Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Quality Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary: The Certified Risk Coder will be a part of an emerging coding team and coding service that...

Medical Office Coder Shift details: Per diem Job Summary: The Medical Coder complies with all legal requirements regarding coding procedures and practices. Conducts audits and coding reviews to ensure all documentation is accurate and precise, assign and sequence all codes for services rendered and collaborate with the business office to ensure all bills are satisfied in a timely manner. Essential Duties: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims. Adhere to coding policies and procedures consistent with the industry standard guidelines for CPT, ICD-9 and ICD-10. Westborough...

Medical Office Coder Shift details: Per diem Job Summary: The Medical Coder complies with all legal requirements regarding coding procedures and practices. Conducts audits and coding reviews to ensure all documentation is accurate and precise, assign and sequence all codes for services rendered and collaborate with the business office to ensure all bill are satisfied in a timely manner. Essential Duties: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims. Adhere to coding policies and procedures consistent with the industry standard guidelines for CPT, ICD-9 and ICD-10....

Billing Compliance Curriculum Development Specialist Dana-Farber Cancer Institute Boston, MA Full Time The Billing Compliance Curriculum Development Specialist is responsible for the design, development, implementation, and evaluation of enterprise-wide billing compliance education programs at Dana-Farber Cancer Institute (DFCI). This role serves as a subject-matter expert in professional and technical billing compliance, with a strong emphasis on oncology services, regulatory requirements, and risk-based education strategies. The position partners closely with Billing Compliance leadership, Revenue Cycle, HIM, Clinical Operations, and Compliance to ensure education is standardized, scalable, evidence-based, and aligned with CMS, OIG, NCCI, payer guidance, and institutional risk priorities. Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united...