22 documentation coding auditor jobs found

Job Summary The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards. This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program integrity. Job Summary The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards. This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program integrity. Key Responsibilities Perform bi-directional retrospective and prospective medical record reviews to validate, clarify, and accurately capture risk adjusted diagnoses (HCCs) in accordance with CMS guidelines and MEAT documentation requirements. Ensure documentation...

SIU ICD10 Professional Coder - Healthcare Fraud, Waste and Abuse Department - Hybrid 2 days in office SIU ICD10 Professional Coder - Healthcare Fraud, Waste and Abuse Department - Hybrid 2 days in office Location US-MA-Worcester Job ID 8406 # Positions 1 Category Professionals Location US-MA-Worcester Job ID 8406 # Positions 1 Category Professionals Overview About us: Fallon Health is a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability,...

JOB SUMMARY: The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards. This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program integrity. KEY RESPONSIBILITIES: • Perform bi-directional retrospective and prospective medical record reviews to validate, clarify, and accurately capture risk adjusted diagnoses (HCCs) in accordance with CMS guidelines and MEAT documentation requirements. • Ensure documentation supports coded conditions in accordance with ICD-10-CM, CMS, and payer-specific guidelines. • Identify unsupported diagnoses, over coding, under-coding, and documentation gaps. • Provide detailed audit findings and recommendations to coding teams, providers, and leadership. • Monitor compliance with CMS Risk Adjustment Data Validation (RADV)...

JOB SUMMARY: This position is responsible for reviewing a patient's medical records after a Clinic visit and translating the information into codes that insurers use to process claims for patients. Duties include confirming treatments with medical staff, identifying missing information, and submitting information to insurers for reimbursement. RESPONSIBILITIES (ESSENTIAL FUNCTIONS): Accurately assigns and sequences codes (ICD-10-CM, CPT, HCPCS/modifiers as necessary) for each patient encounter, following proper coding guidelines and legal requirements to ensure compliance with federal and state regulations. Ensures professional/physician billing CPT codes/ICD-10 codes are assigned correctly and sequenced appropriately as per government and insurance regulations. Queries providers or other Clinic team members when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Assigns and enters...

Job Description Posted Monday, August 17, 2026 at 4:00 AM Koniag Advisory Business Solutions, LLC, a Koniag Government Services company, is seeking a Medical Records Technician Coder V-Supervisor to support KABS and our government customer in Oklahoma, OKC. This position requires the candidate to be able to obtain a Public Trust. This position is covered under the Service Contract Act. We offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, paid holidays, paid Vacation, paid sick leave and more. including health, dental and vision insurance, 401K with company matching, paid holidays, paid Vacation, paid sick leave and more. Join Our Team Where Precision, Integrity, and Leadership Matter. Koniag Advisory Business Solutions (KABS) is seeking an experienced, highly skilled, and mission-focused Medical Records Coder V (Supervisor) to lead a coding team supporting a large-scale healthcare...

Surg/Op CoderFully Remote • Home Office - Oklahoma City, OK 73134OverviewPosition Type Full Time Job Shift Day Education Level Certification Travel Percentage Occasional Category Health Information Management (HIM)DescriptionJOB PURPOSE: This position is for an Outpatient Coder with Emergency Dept and Ambulatory Surgery coding experience. The coder will code Surgery, Emergency department, and Ancillary records. Emergency Dept coding includes injection & infusion coding as well as the assignment of the E&M Professional fee. Coder will demonstrate competency by meeting productivity standards and achieving an accuracy rate of 95% on all chart types coded.Will abstract and code every account compliantly, accurately, and completely, to ensure accurate and timely reimbursement and reporting. Verifies, reviews, analyzes, and abstracts medical information; researches missing clinical information; assigns accurate codes; appropriately queries physicians when required; elevates...

Oklahoma Arthritis Center Billing SpecialistOklahoma Arthritis Center (OAC) is an Equal Employment Opportunity employer and considers all applicants without regard to race, religion, color, sex, national origin, age, disability, veteran status, or any other legally protected status.Job Summary:Reviews billing data from medical office or hospital records to ensure amounts and account numbers are accurate, responsible for account posting, collections, and verifying patient benefits. Responsible for accurate diagnose and procedure coding. Responsible for insurance pre-certifications, pre-authorizations, pre-determinations and other required insurance notifications for procedures performed in the clinic.Essential Functions:Review and analyze patient records and physician documentation for completeness and accuracy, focusing on areas such as radiology reports, neurological procedures, office visit notes, and laboratory results.Assign precise CPT, ICD-10, HCPCS (and when applicable,...

Job DetailsJob Location: Home Office - Oklahoma City, OK 73134Position Type: Full TimeEducation Level: CertificationTravel Percentage: OccasionalJob Shift: DayJob Category: Health Information Management (HIM)JOB PURPOSE: This position is for an Outpatient Coder with Emergency Dept and Ambulatory Surgery coding experience. The coder will code Surgery, Emergency department, and Ancillary records. Emergency Dept coding includes injection & infusion coding as well as the assignment of the E&M Professional fee. Coder will demonstrate competency by meeting productivity standards and achieving an accuracy rate of 95% on all chart types coded. Will abstract and code every account compliantly, accurately, and completely, to ensure accurate and timely reimbursement and reporting. Verifies, reviews, analyzes, and abstracts medical information; researches missing clinical information; assigns accurate codes; appropriately queries physicians when required; elevates documentation issues...

Inpatient Coder - Part Time Fully Remote • Home Office - Oklahoma City, OK 73134 Overview Position Type Full Time Job Shift Day Education Level Certification Travel Percentage Occasional Category Health Information Management (HIM) Description JOB PURPOSE: To abstract and code compliantly, accurately and completely as well as group each account to the appropriate DRG to facilitate data quality and ensure accurate and timely reimbursement. Verifies reviews, analyzes, and abstracts medical information; researches missing medical information; assigns accurate codes; appropriately queries physicians when required; elevates documentation issues to management; ensures valid orders are on the record prior to coding; communicates with HIM Director regarding obstacles with orders, charges, physician documentation. Demonstrates proficiency in the coding and grouping of inpatient accounts. ESSENTIAL FUNCTIONS INCLUDE BUT NOT LIMITED TO: Assures data quality by capturing codes...

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 Records Technician Coder IIIKoniag Advisory Business Solutions LLC, a Koniag Government Services company, is seeking a Medical Records Technician Coder III to support KABS and our government customer in Oklahoma, OKC. This position requires the candidate to be able to obtain a Public Trust.This position is covered under the Service Contract Act. We offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, paid holidays, paid vacation, paid sick leave and more.Join our team where precision, integrity, and expertise matter. Koniag Advisory Business Solutions (KABS) is seeking detail-oriented, highly capable, and motivated Medical Records Coder III professionals to support a large-scale healthcare mission serving hospitals and clinics. This is an opportunity to contribute to a team responsible for coding and billing more than 300,000 patient visits, where accuracy, compliance, accountability,...

Job Title: Remote Ambulance Coder Work Location: Pafford Medical Services, Inc. - Oklahoma City Division/Department: PMBS Reports To: Coding Supervisor Full-Time Nonexempt The Ambulance Coder is responsible for reviewing ambulance patient care reports (PCRs) and accurately assigning diagnosis, procedure, level-of-service, and other required billing codes based on the clinical documentation provided. This position evaluates the patient's condition, services rendered, medical necessity, origin and destination, and transport circumstances to support accurate and compliant ambulance billing. The Ambulance Coder applies Medicare, Medicaid, commercial payer, and other applicable regulatory requirements when determining the appropriate level of service and coding for ambulance transports. Essential Duties And Responsibilities Review ambulance patient care reports and supporting medical documentation for completeness and coding accuracy. Interpret clinical documentation,...

Medical Records Technician Coder IV-LeadKoniag Advisory Business Solutions, LLC, a Koniag Government Services company, is seeking a Medical Records Technician Coder IV-Lead to support KABS and our government customer in Oklahoma, OKC. This position requires the candidate to be able to obtain a Public Trust.This position is covered under the Service Contract Act. We offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, paid holidays, paid vacation, paid sick leave and more.Join Our Team Where Precision, Integrity, and Expertise Matter. Koniag Advisory Business Solutions (KABS) is seeking highly skilled, self-directed Medical Records Coder IV (Lead) professionals to support a large-scale healthcare mission serving hospitals and clinics. This is an opportunity to bring your expertise to a team responsible for coding and billing more than 300,000 patient visits, where accuracy, compliance, sound...

Indian Health Service is seeking a Medical Records Technician to review and code patient records, ensuring accuracy and compliance with current guidelines. The role focuses on documentation adequacy, coding accuracy, and proper sequencing of diagnoses and procedures to support high-quality patient care. The position requires knowledge of coding standards, ability to audit records, and adherence to privacy regulations. A CPC is preferred and federal employment processes apply. #J-18808-Ljbffr

Position Title:Professional Coder - Radiology Department:Revenue Integrity Job Description: New to OU Health? Ask your recruiter about our competitive wages and total rewards package. Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment. SPECIALTY AREA: Neuro Interventional Radiology Looking for a coding team to love at OU Health? This is it! While this role is specifically searching for an experienced Neuro Interventional Radiology coder, we also cover multiple specialties so there's opportunities to learn and grow . 100% remote. Flexible shifts once training is complete. Opportunity to work four 9 hour days, and one 4 hour day. So if you're work-from-home ready, work well independently, and have strong coding skills we just may be the right fit for you! ***The ideal candidate would have teaching hospital or trauma center coding experience and familiarity with CT, MRI and Ultrasounds. While...

This position may be filled prior to the posted deadline. Interested candidates are encouraged to apply as soon as possible. Koniag Advisory Business Solutions, LLC, a Koniag Government Services company , is seeking a Medical Records Technician Coder IV-Lead to support KABS and our government customer in Oklahoma, OKC. This position requires the candidate to be able to obtain a Public Trust. This position is covered under the Service Contract Act. Benefits include medical, dental, and vision insurance, 401(k) retirement plan, paid time off, paid parental leave, life and disability insurance, flexible spending accounts, commuter benefits and tuition reimbursement. Join Our Team Where Precision, Integrity, and Expertise Matter. Koniag Advisory Business Solutions (KABS) is seeking highly skilled, self-directed Medical Records Coder IV (Lead) professionals to support a large-scale healthcare mission serving hospitals and clinics. This is an opportunity to bring your expertise...

Job Title: Remote Ambulance Coder Work Location: Pafford Medical Services, Inc. – Oklahoma City Division/Department: PMBS Reports To: Coding Supervisor Full-Time Nonexempt The Ambulance Coder is responsible for reviewing ambulance patient care reports (PCRs) and accurately assigning diagnosis, procedure, level-of-service, and other required billing codes based on the clinical documentation provided. This position evaluates the patient's condition, services rendered, medical necessity, origin and destination, and transport circumstances to support accurate and compliant ambulance billing. The Ambulance Coder applies Medicare, Medicaid, commercial payer, and other applicable regulatory requirements when determining the appropriate level of service and coding for ambulance transports. Essential Duties and Responsibilities Review ambulance patient care reports and supporting medical documentation for completeness and coding accuracy. Interpret clinical...

Job Purpose The Lead Coder will code all patient types as needed; inpatient, swing bed, same‑day surgery, ancillary, ambulatory and provider‑based clinics, and will mentor, train, and assist coding staff, including newly hired staff. They must review documentation to assign appropriate CPT/HCPCS and ICD‑10‑CM‑PCS diagnosis codes and procedures for hospital and physician (professional) services for inpatient and outpatient records based on knowledge of coding systems. Essential Functions Ensures that coding compliance initiatives are met with all record types. Conducts regular internal coding audits and quality assurance reviews to monitor coding accuracy, identify areas for improvement, and implement corrective measures and education as needed. Assists with productivity reporting and reducing DNFC. Coding complex outpatient or inpatient accounts utilizing encoder software and references in the assignment of ICD‑10‑CM/PCS, CPT/HCPCS codes, DRG, POA assignments, APC assignment...

Job Summary: The Coder manages the day to day responsibilities of chart abstraction, vendor auditing and reporting in accordance with state and federal regulations. The coder will abstract from in-patient and out-patient medical records and record findings via electronic data base and or excel spread sheets. The coder ensures that all claims accurately reflect the appropriate diagnosis information as outlined in the member’s medial record Our Investment in You: Full-time remote work Competitive salaries Excellent benefits Responsibilities Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation. Ability to code government and state models. This includes code everything projects. Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations. Ability to maintain a 95% accuracy rate on all coding projects. Coders assist...

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. A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021). Duties Total Compensation Package Check out IHS's outstanding total compensation package for this job: Medical Records Technician Total Compensation | Pay (ihs.gov) 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...

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...

Koniag Advisory Business Solutions LLC, a Koniag Government Services company , is seeking a Medical Records Technician Coder III to support KABS and our government customer in Oklahoma, OKC. This position requires the candidate to be able to obtain a Public Trust. This position is covered under the Service Contract Act. We offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, paid holidays, paid Vacation, paid sick leave and more. Join Our Team Where Precision, Integrity, and Expertise Matter. Koniag Advisory Business Solutions (KABS) is seeking detail-oriented, highly capable, and motivated Medical Records Coder III professionals to support a large-scale healthcare mission serving hospitals and clinics. This is an opportunity to contribute to a team responsible for coding and billing more than 300,000 patient visits, where accuracy, compliance, accountability, and sound judgment are...