29 documentation coding auditor jobs found

Job Description Job Description     PYA is seeking an Inpatient/Outpatient Facility Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will  support PYA’s Revenue and Compliance Advisory Program . RESPONSIBILITIES : Apply inpatient and outpatient facility/hospital coding and reimbursement methodologies to provide advisory services to PYA clients with a focus on the following: ICD-10-CM and PCS/CPT/HCPCS code assignment MS-DRG and other DRG validation APC validation and charge capture Clinical documentation improvement Regulatory compliance for third party payors Work in collaboration with the PYA executive team and other service lines to offer complete business solutions to clients Manage the preparation of excellent client deliverables and exhibit exceptional project management skills while balancing firm risk and compliance with appropriate professional...

Description Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina. Summary: Performs technical and administrative work reviewing, abstracting and assigning accepted medical CPT, HCPCS, and ICD-10 codes for professional services. Duties are performed in compliance with third party, state and federal regulations according to standardized procedures. Employees report to an administrative superior but independently handle assigned tasks. Responsibilities: Assigns International Classification of Diseases 10-CM diagnostic and ICD-10-PCS procedural codes accurately and productively, and other applicable codes such as MS-DRG on inpatient cases for all Health Care system cases excluding the academic medical center Groups codes and completed product into payment group. Assigns codes that affect Severity of Illness and Risk of Mortality and...

RCS Medical Coding Auditor page is loaded## RCS Medical Coding Auditorremote type: Hybridlocations: Raleigh, NCtime type: Full timeposted on: Posted 7 Days Agojob requisition id: JR10360**Position Summary**The **RCS Medical Coding Auditor** is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback.The ideal candidate brings strong hands-on experience with **professional fee coding**, deep knowledge of **E/M, surgical, and modifier use**, and the ability to translate audit findings into actionable insights.**Key Responsibilities*** Perform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedback* Validate ICD‐10‐CM, CPT(R), HCPCS, and modifier assignment against clinical documentation to...

A healthcare solutions company is seeking a skilled RCS Medical Coding Auditor to perform audits on professional fee medical coding. The ideal candidate should possess a CPC certification and 2+ years of ProFee auditing experience, with a strong focus on accuracy and compliance. Responsibilities include conducting daily quality assurance, validating coding against documentation, and providing training to improve coding practices. This position supports hybrid work and includes a competitive salary range of $57,728 to $80,243. #J-18808-Ljbffr

UNC Health Job OpportunityYour passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina.Summary: Performs technical and administrative work reviewing, abstracting and assigning accepted medical CPT, HCPCS, and ICD-10 codes for professional services. Duties are performed in compliance with third party, state and federal regulations according to standardized procedures. Employees report to an administrative superior but independently handle assigned tasks.Responsibilities include assigning International Classification of Diseases 10-CM diagnostic and ICD-10-PCS procedural codes accurately and productively, and other applicable codes such as MS-DRG on inpatient cases for all Health Care system cases excluding the academic medical center. Groups codes and completed product into payment group. Assigns codes that affect Severity of Illness and Risk of Mortality and Hierarchal...

Description Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina. Summary: Performs technical and administrative work reviewing, abstracting and assigning accepted medical CPT, HCPCS, and ICD-10 codes for professional services. Duties are performed in compliance with third party, state and federal regulations according to standardized procedures. Employees report to an administrative superior but independently handle assigned tasks. Responsibilities: Assigns International Classification of Diseases 10-CM diagnostic and ICD-10-PCS procedural codes accurately and productively, and other applicable codes such as MS-DRG on inpatient cases for all Health Care system cases excluding the academic medical center Groups codes and completed product into payment group. Assigns codes that affect Severity of Illness and Risk of Mortality and...

Medical Coding Auditor Responsible for the creation and maintenance of audit and education programs that will ensure success for all staff and employed providers based on their specific needs and support accurate, compliant coding practices for ECU Health Physicians in accordance with coding guidelines. Conducts internal auditing of medical coding activities using concurrent, prospective and retrospective models as appropriate and/or required. Reviews electronic health information to determine accuracy of coding, billing and documentation, including validation of ICD10CM, CPT, HCPCS and modifier assignment related to medical provider professional Part B services according to regulatory and institutional policy. Reports findings, both written and verbal, to leadership as necessary to include provision of corroborating regulatory or policy guidance. Maintains documentation of all audit activities and communicates the findings with leadership. Utilizes findings to generate topics...

Internal Auditor The Internal Auditor is responsible for conducting regular medical record and coding compliance reviews to ensure that organizational strategies, practices and internal controls are in place and in compliance with all legal and industry regulations. Regularly reviews appropriate federal and state regulations, industry standard policies and procedures, i.e., CMS, AHIMA, AMA, etc., to ensure compliance Conducts internal audits, following established protocols, furnishing detailed reports and periodic updates of audit findings, presenting any irregularities or exceptions, as well as pertinent recommendations for improvement, to the Provider, Auditing Supervisor, executive management, the Compliance Committee, Physician Board and others as appropriate Provides feedback and instruction to the Provider regarding documentation improvements, to include EHR best practices Essential Duties/Responsibilities: Serve as a compliance resource for all coding...

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

Comprehensive benefits include medical, dental, vision, life insurance, and generous PTO. Retirement fund with matching contributions. Tuition assistance for qualifying team members. What We Offer Comprehensive benefits include medical, dental, vision, life insurance, and generous PTO. Retirement fund with matching contributions. Tuition assistance for qualifying team members. What You’ll Do Schedule: Monday - Friday, daytime hours. Perform monthly on-site visits to assigned clinics in the Charlotte or Winston-Salem, NC areas. Review and code work queues assigned by applying coding principles for correct coding including sequencing. Query providers for clarification of incomplete or ambiguous documentation as appropriate and monitor for timely responses. Provide provider education and regular feedback on ICD-10 and correct coding issues. Evaluate and identify front-end and back-end error trends for training needs and bring them to the attention of the coding manager....

Medical Records Coder IIWork Arrangement: 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington.At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other...

Medical Coding Specialist Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States About Judi Health Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels. At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. Location:...

Risk Adjustment Coder Come explore career opportunities with Liberty Healthcare Management, a dynamic leader in the healthcare industry. Join us! We are currently seeking an experienced: RISK ADJUSTMENT CODER Job Summary: Perform code abstraction of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation Identify diagnosis and chart level impairments and documentation improvement opportunities for provider education Develop process for chart review Assist coding leadership and clinical team by making recommendations for process improvements to further enhance coding goals and outcomes Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations Consistently maintain a minimum 95% accuracy on coding quality audits Meet minimum productivity requirements Ability to work independently in a remote environment Handle other related duties as required or...

SUMMARY: Responsible for billing team leadership, subject matter expertise and performing a variety of regular tasks to ensure timely and comprehensive billing and collections for Medical and Dental services rendered by First Choice Community Health Center (FCCHC) providers. Supervises billing specialists to ensure all tasks are completed timely and accurately. The Revenue Cycle Manager is expected to devote 50% of work time to learn leadership and subject matter expert responsibilities. The Revenue Cycle Manager should proactively seek to further develop billing process competencies; and assist in implementation of process improvements. Essential Duties And Responsibilities Team Leadership Supervise and coordinate the workload of the billing staff to ensure all task are completed accurately and in a timely manner Define and communicate current and new billing tasks and definitions of the billing team Recommend and report billing issues of concern related to clinic operations...

Ultimate Staffing Services is actively seeking a CPC-A Coder to join their client's team in Greensboro, NC. This is a fully onsite position , offering a wonderful opportunity for entry-level coders or individuals who have just obtained their CPC-A certification. The ideal candidate will have a keen eye for detail and a passion for coding accuracy. Responsibilities Review medical records, provider documentation, and clinical notes to assign accurate ICD-10-CM, CPT, and HCPCS codes. Ensure coding aligns with official coding guidelines, payer-specific rules, and regulatory requirements (CMS, OIG, HIPAA). Query providers when documentation is unclear, incomplete, or inconsistent. Work collaboratively with billing and revenue cycle teams to resolve coding-related claim edits, denials, or rejections. Maintain productivity and accuracy benchmarks as defined by the organization. Participate in internal audits, compliance reviews, and quality improvement initiatives. Stay current...

Overview Make a Difference. Grow in Your Career. Thrive with Us. About the Role At Mindpath Health , we’re on a mission to make mental health care more accessible and more human. As a national leader in mental health services, we empower our clinicians, support our teams, and prioritize care that helps people truly thrive. The Certified Professional Coder (CPC) is responsible for performing professional coding services for theRCM Team, while following AMA and CMS medical coding guidelines . The primary function of thisposition is to utilize CPT, ICD-10-CM, HCPCS and coding guidelines to ensure accurate coding asrelates to medical documentation. A Certified Professional Coder will provide research and assist inresolving rejections, denials, and any coding/carrier related inquiries. This role reviews, analyzes, andcodes diagnostic and procedural information that determines Medicare, Medicaid, and private insurancepayments. The Certified Professional Coder must work to remain up to...

Carolina Oncology Specialists has been providing compassionate, patient-centered care since 1983, delivering high-quality oncology and hematology services tailored to each individual's needs. Patients benefit from the convenience of receiving chemotherapy treatments in our clinics, along with expert diagnosis, treatment, and management of a wide range of blood disorders. Why Join Us? We are seeking talented, compassionate, and highly motivated individuals who are passionate about making a difference. At Carolina Oncology Specialists, you'll have the opportunity to support the meaningful work of community oncology while helping provide exceptional care and hope to the patients and families we serve. Join a team dedicated to clinical excellence, collaboration, and improving lives every day. Job Summary Certified Coding Specialist (Remote) Organization: Carolina Oncology Specialists Location: Fully Remote (U.S.-based candidates only, preference for NC residents) Department: Billing...

Medical Coder SpecialistAt Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health.This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington.*Now offering a $10,000 sign-on...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Willing to pursue your passion for caring with the Patient Revenue Management Organization, the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Virginia, South Carolina, Tennessee, Florida, and Texas. Occ Summary The Medical Coder Specialist will have frequent and daily interactions with internal and external clients, including but not limited to physician and non‑physician surgical providers. Responsibilities include primary...

Medical Coding Specialist Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States About Judi Health Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels. At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. Location:...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Medical Claims Supervisor ALL Full-Time Gastonia, NC, US 3 days ago Requisition ID: 4991 Job Summary and Specifications Job Title : Medical Claims Supervisor FLSA Status : Exempt Salary Range: See Pay Scale Job Summary: The Medical Claims Supervisor manages the Medical Authorization team and is responsible for overseeing medical claims processing activities, monitoring pending and aged claims inventories, researching claim issues, and ensuring timely and accurate adjudication of claims in accordance with health plan benefits, provider contracts, regulatory requirements, and internal performance standards. The position reports directly to the Director of Finance. This position works closely with claims operations, finance, compliance, quality, IT, provider relations, member services, contracted providers, facilities,...

Job TitleHybrid work opportunity. Comprehensive benefits include medical, dental, vision, life insurance, and generous PTO. Retirement fund with matching contributions. Tuition assistance for qualifying team members. Reimbursement for AAPC or AHIMA membership fee.Job DescriptionSchedule: Monday – Friday, daytime hours. Perform monthly site visits with assigned clinics. Perform surgical, critical care and trauma coding. Review and code work queues assigned by applying coding principles for correct coding including sequencing. Query providers for clarification of incomplete or ambiguous documentation as appropriate and monitor for timely responses. Provide provider education and regular feedback on ICD-10 and correct coding issues. Evaluate and identify front-end and back-end error trends for training needs and bring them to the attention of the coding manager. Communicate and participate in departmental meetings and initiatives involving coding and the revenue cycle enhancement...

Medical Records Coder IIAt Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington.*Now offering a $10,000 sign-on bonus...

Summary Join the Indian Health Service and make a meaningful impact in Native communities. In this role, you will support vital healthcare operations that ensure patients receive timely, high-quality care. If you're looking for a rewarding career where your work directly supports patient services and community well-being, we encourage you to apply. Duties Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final diagnoses accurately reflect care provided. Reviews provider documentation to ensure appropriate Evaluation and Management (E/M) levels and correct CPT code assignment. Assigns and sequences ICD, CPT, HCPCS, CDT, and DSM codes based on documented diagnoses and procedures. Ensures diagnostic and procedural terminology aligns with current medical nomenclature and...