27 documentation coding auditor jobs found

Baylor Scott & White Health is seeking a Physician Compliance Auditor II to audit documentation and ensure compliance within a fully remote environment. This role entails evaluating documentation across multiple specialties including Cardiology and Orthopedics. The ideal candidate will have at least 4 years of auditing experience and hold an active coding certification, such as CPC or CCS-P. This position offers compensation ranging between $26.66 and $40.00, depending on qualifications. #J-18808-Ljbffr

Alignment Health is a remote company focused on senior care. The Medical Risk Adjustment (MRA) Coding Auditor role supports departmental quality assessment audits of internal coding analysts and vendors to ensure accurate and complete data submission to CMS. General Duties / Responsibilities Supports regular quality assurance audits of the internal Coding Analyst Team to validate and confirm coding & abstracting quality (95% HCC accuracy), ensuring coding quality and performance improvement standards are maintained. Tracks and reports progress of QA audits performed on coding vendors to verify coding accuracy and quality of data submitted to AHP for CMS submission. Works with Risk Adjustment Management on any MRA data validation or coding audit to ensure completeness and coding accuracy of all CMS submissions; this may include data reconciliation, data flow integrity, UAT testing, review of high‑cost/low‑risk score members, retrospective chart reviews, or other related data...

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...

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...

E2E Alignment Healthcare USA, LLC is seeking a Risk Adjustment Compliance Auditor. This fully remote role involves auditing and compliance activities related to risk adjustment data submitted to CMS. The ideal candidate should have strong knowledge of risk adjustment, HCC coding, and compliance auditing. Responsibilities include conducting audits, reviewing medical documentation, and monitoring coding accuracy. Applicants must have a minimum of 3 years of professional coding experience and hold a relevant certification. #J-18808-Ljbffr

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...

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....

Coding Auditor - Professional Coder Auditor-Professionals are responsible for auditing of coding assignment with providers and coders, training of coding professional staff, pro-fee based coding includes the assignment of Assigns ICD-CM, CPT, HCPCS codes, E&M assignment, modifiers, and charge posting. Interacts with medical staff, nursing, ancillary departments, provider offices, and outside organizations. Department: Physician coding Hours: Full-Time, 40 hours a week required Required: High School Diploma, CPC, CEMA within 6 months of hire, CPMA within 1 year of hire Pay: Based one experience, starting at $23.87/hour Location: Remote or onsite: At this time, you must reside in one of the following locations: Alabama, Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, New Mexico, Ohio, Oklahoma, South Carolina, Tennessee, Texas Responsibilities: Assists coders with coding...

Coder Reimbursement Specialist - Hospital Tech Tammina LLC Job Description The Coding and Reimbursement Specialist, CCS is responsible for coding and abstracting thoroughly, clinical data from the medical record. This includes both inpatient, outpatient, commercial, Medicare, Medicaid, and Illinois Public Aid, plus any other payor types. This accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis, grouped to the 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. Manages workload and assigns work to three inpatient and two outpatient coders and oversees the day to day workings of the coding/reimbursement area. Monitors various regulatory sources to keep HIM coding and other staff informed and trained on various coding rules, regulations and related issues. Works closely with patient...

Position Summary Verifies and ensures the accuracy, completeness, specificity and appropriateness of diagnosis codes on services rendered. Complete appropriate paperwork/documentation/system entry regarding claim and encounter information. Support and participate in process and quality improvement initiatives. Assist with clinician billing and documentation training. Education Requires an associate degree from Accredited Health Information Technology program, Bachelor's degree preferred. Coding certificate with AHIMA approval status. RHIA, RHIT, CCS or CCS-P certification status required. Experience Three (3) years' experience as a Certified Medical Biller/Coder Experience at a Federally Qualified Health Center (FQHC) preferred. Lab coding experience required. Skills and Abilities Strong written and verbal communication skills, strong analytical skills, organizational and time management skills. Knowledge and experience in a healthcare environment of billing and reimbursement of...

Description Are you looking for a career that will make an impact? The Leidos Military and Veterans Health Solutions Operation has an opening for a Clinical Informaticist / Clinical Coder to join the Operational Readiness Directorate at the Naval Health Research Center in San Diego, CA. This position will provide support to the Epidemiology and Data Management Support Department and involves clinical coding and data abstraction to support research on the physical and mental health of military personnel to improve overall health and readiness. The person in this position will work closely with department professionals in records management, information technology, and research teams to ensure alignment of clinical coding with research needs. Are you ready for unique and exciting work? This is a full-time position in San Diego. The candidate for this position must be located within commuting distance of San Diego to work on-site at the Naval Health Research Center as needed. The...

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...

Job Type: Full-time Description 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...

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...

Certified Professional Coder, Outpatient Billing Full Time Corporate 3 days ago Requisition ID: 4107 Salary Range: $27.00 To $35.00 Hourly Position Summary This role is responsible for ensuring accurate, compliant, and complete coding of professional outpatient encounters in a high-volume urgent care environment. This role reviews provider documentation, validates and corrects CPT® and ICD-10-CM code selection, queries providers for missing or unclear documentation, and ensures all claims meet CCI, payer, and outpatient coding requirements prior to billing. This role also plays a key role in supporting provider coding and documentation audits and manual coding activities required during system downtime or special operational needs. Key Responsibilities Documentation Review & Coding Validation Review clinical documentation to confirm all services rendered are documented completely and accurately prior to billing. Validate provider-selected CPT® and ICD-10-CM codes to...

Description Columbia Orthopaedic Group Fast-paced. Detail-driven. Team-focused. Every claim, code, and detail matters in delivering accurate, compliant, and timely patient care behind the scenes. If you take pride in precision and enjoy working in a collaborative healthcare environment, this role is for you. Why This Role Is Different This is not just a coding role-it is a key part of the revenue cycle that directly impacts the success of orthopaedic care delivery. Your work ensures providers are accurately represented, claims are clean, and reimbursement flows efficiently. You'll partner closely with physicians, billing, and administrative teams in a highly collaborative environment where accuracy, communication, and compliance are essential. About the Role The Medical Coder is responsible for accurately coding orthopaedic services to support timely and compliant claim submission. This role ensures documentation integrity, supports revenue cycle...

Job Description Must Haves: Minimum of 2 years in medical coding Familiarity with ICD-10 codes and procedures Highly proficient at Excel Associate’s degree in medical coding or CPC Certification Plusses: Fertility billing background preferred Working knowledge of medical jargon and anatomy preferred Day to day: A client of Insight Global is seeking a full-time, competent and knowledgeable Medical Coder/Biller. The new hire will possess a strong knowledge base of revenue cycle management, insurance and cash based revenue and first-class customer service skills. Assign codes to diagnoses and procedures, using ICD (International Classification of Diseases) HCPCS (Healthcare Common Procedure Coding System) and CPT (Current Procedural Terminology) codes. Make judicious decisions on which codes to assign in each instance and function to a high level of accuracy Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations Follow up...

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...

The Chronicle Of Higher Education, Inc. is hiring a Medical Coding Specialist in Columbia Township, Missouri. This role entails reviewing clinical documentation for accurate coding, assisting in medical record audits, and serving as a liaison with third-party payers. The candidate must complete a coding certification program and may substitute one year of related experience. The position offers a competitive salary range of $20.58 - $32.49 hourly and is eligible for a comprehensive benefits package including medical, dental, and retirement plans. #J-18808-Ljbffr

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 58429-MCS-C- University Physicians, 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 in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of changes made...

Hiring Department University Physicians Job Description #upjobs 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 in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of changes made 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

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...

Medical Coding Specialist Full Time St. Louis, MO, US Join Us to Build Healing and Hope Together! As leaders in children's mental health and wellness, St. Louis Children's and KVC Health Systems Youth Mental Health Care have partnered to create one of the nation's most innovative and transformative youth mental health and wellness campuses. The partnership includes a 77-bed acute care hospital and outpatient programs. Located on the KVC Missouri Children's Mental Wellness Campus conveniently located in Webster Groves, Missouri, the peaceful environment and broad continuum of care allow children and families to access the appropriate level of treatment throughout their healing experience. The new campus is slated to open in late 2026. Learn more at stlouischildrenskvc.org. Join us and be a part of this journey of healing and hope for thousands of children and teens. Job Summary The Medical Coding Specialist is KVC's Hospitals subject matter expert on medical coding. They...