33 documentation coding auditor jobs found

Position Summary The Coding Auditor conducts quality audits to ensure that medical diagnostic codes submitted to CMS (Centers for Medicare and Medicaid Services), New York State Department of Health (NYSDOH), and other entities are accurate based on the practitioners' medical record documentation of Healthfirst members' health conditions. Duties & Responsibilities Audits data, claim submissions, and member medical records for completeness, accuracy, and compliance with Healthfirst policy and documents findings per departmental procedure Identifies patterns of under-performance, noncompliance, and inconsistencies and recommends resolutions Evaluates the quality of medical coding and notifies management of discrepancies, as needed. Conducts internal audits of medical record reviews performed by colleagues Collaborates with other departments to improve compliance with coding conventions and clinical practice guidelines Supports continuous improvement and quality initiatives...

Gainwell Technologies is seeking an experienced Senior Associate Inpatient Coding Auditor to perform audits of inpatient medical records and other documentation to determine correct coding per contract-specific methodologies. The role requires extensive ICD-10 coding knowledge, MS-DRG/APR-DRG expertise, and AHIMA or AAPC credentials, with opportunities for training, advancement, and remote work within the U.S. #J-18808-Ljbffr

Select how often (in days) to receive an alert: Date: Aug 26, 2026 Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for an Inpatient Coding Auditor, Senior Associate who is responsible for performing coding reviews of inpatient medical records and/or other documentation to determine correct coding, as defined by review methodologies specific to the contract for which...

Select how often (in days) to receive an alert: Lead Coding Auditor, Itemized Bill Review and Appeals- Remote Date: Sep 9, 2026 Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for aLead Coding Auditor, Itemized Bill Review and Appeals who is responsible for performing itemized bill review, chart review, and coding validation to ensure that billed services were...

Date: Aug 21, 2026 Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for anOutpatient Coding Auditor, Senior Associatewho is responsible for performing coding reviews of medical records and/or other documentation to determine correct coding as defined by review methodologies specific to the contract for which review services are being provided. This involves accessing...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Responsible for providing accurate, reliable and effective education to physicians and extenders regarding outpatient procedural and diagnosis coding. This position performs individual and group documentation reviews, identifies opportunities for improvement, assists with implementation of physician lead CME documentation and coding courses and coordinates with physician...

Gainwell Technologies seeks a Lead Coding Auditor for Itemized Bill Review and Appeals. This 100% remote role requires expertise in inpatient hospital bill auditing, outpatient facility coding, and charge master review. You will train Coding Auditors, participate in hearings, and ensure billing is accurate and compliant with plan policies. As part of the mission, you will analyze documentation, maintain coding knowledge, and support management with production and quality goals while working #J-18808-Ljbffr

Covenant Health is seeking a Revenue Integrity Auditor to conduct audits related to compliance in billing, coding, and documentation. The ideal candidate will have 3-5 years of healthcare experience, strong knowledge of Medicare/Medicaid guidelines, and excellent analytical and problem-solving skills. Key responsibilities include auditing internal processes, communicating findings to management, and providing consultancy services. A clinical license in Tennessee or equivalent experience is preferred. This full-time position offers a focused day shift to enhance compliance and efficiency within the organization. #J-18808-Ljbffr

Gainwell Technologies is seeking an experienced Senior Associate Inpatient Coding Auditor to perform audits of inpatient medical records and other documentation to determine correct coding per contract-specific methodologies. The role requires extensive ICD-10 coding knowledge, MS-DRG/APR-DRG expertise, and AHIMA or AAPC credentials, with opportunities for training, advancement, and remote work within the U.S. #J-18808-Ljbffr

Select how often (in days) to receive an alert: Date: Aug 26, 2026 Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for an Inpatient Coding Auditor, Senior Associate who is responsible for performing coding reviews of inpatient medical records and/or other documentation to determine correct coding, as defined by review methodologies specific to the contract for...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Responsible for providing accurate, reliable and effective education to physicians and extenders regarding outpatient procedural and diagnosis coding. This position performs individual and group documentation reviews, identifies opportunities for improvement, assists with implementation of physician lead CME documentation and coding courses and coordinates with physician...

Select how often (in days) to receive an alert: Lead Coding Auditor, Itemized Bill Review and Appeals- Remote Date: Sep 9, 2026 Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for aLead Coding Auditor, Itemized Bill Review and Appeals who is responsible for performing itemized bill review, chart review, and coding validation to ensure that billed services were...

Gainwell Technologies seeks a Lead Coding Auditor for Itemized Bill Review and Appeals. This 100% remote role requires expertise in inpatient hospital bill auditing, outpatient facility coding, and charge master review. You will train Coding Auditors, participate in hearings, and ensure billing is accurate and compliant with plan policies. As part of the mission, you will analyze documentation, maintain coding knowledge, and support management with production and quality goals while working #J-18808-Ljbffr

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Date: Aug 21, 2026 Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for anOutpatient Coding Auditor, Senior Associatewho is responsible for performing coding reviews of medical records and/or other documentation to determine correct coding as defined by review methodologies specific to the contract for which review services are being provided. This involves...

Billing Coder IIIInform Diagnostics, a Fulgent Genetics Company, is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology, dermatopathology, urologic pathology, hematopathology, and breast pathology. Founded in 2011, our parent entity, Fulgent Genetics, has evolved into a premier, full-service genomic testing company built around a foundational technology platform. Through our diverse testing menu, Fulgent is focused on transforming patient care in oncology, anatomic pathology, infectious and rare diseases, and reproductive health. We believe that by providing a wide range of effective, flexible testing options in conjunction with best-in-class service and support, we can redefine the way medicine is managed for patients and clinicians alike. Since integrating with our therapeutic development business, Fulgent is also developing drug candidates for treating a broad range of cancers using a novel...

Position Overview Looking to be part of a team that provides extraordinary healthcare from the heart? You Belong Here. 100% Remote position with option to work onsite. Wisconsin or Illinois residency required. Title Medical Coding Specialist – Outpatient Position Specs FTE: 1.0 (40 hours per week) Schedule: Monday to Friday, five (5) 8-hour shifts between hours of 6am and 5pm Holiday Rotation: None Weekend Rotation: None On Call Requirements: None Position Summary Reviews medical reports and physician documentation for clinic and hospital outpatient services in order to apply diagnostic and procedural codes to individual patient health information for claims processing, data retrieval and analysis. This role will primarily focus on Emergency Department and Urgent Care coding but will also assist in other areas. Technical Responsibilities Assigns codes for ambulatory outpatient services using International Classification of Diseases (ICD) and Current Procedural Terminology (CPT)...

Major Responsibilities This role will have all responsibilities of coder I, II and III in addition to: reviews complex inpatient documentation at a highly skilled and proficient level to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software. Adhere to organizational and internal department policies and procedures to ensure efficient work processes. Responsible for coding high dollar and long length of stay cases for all patient types. Expertise in query guidelines, and coding standards. Follow up and obtain clarification of inaccurate documentation as appropriate. Serves as a subject matter expert to Coding department leaders and peers. Recommends modifications to current policies and procedures as needed to coincide with government regulations. Maintain continuing...

Driscoll Children’s Hospital seeks a skilled Medical Coder to review medical records and assign ICD and CPT codes for outpatient services, ensuring accurate billing and compliant documentation. The role requires 3–5 years of physician coding experience, preferably in pediatric multi-specialty coding. You will work with the coding manager and billing staff to resolve denials and support audits. #J-18808-Ljbffr

* This is a hybrid position to be located in WI with travel required. * JOB SUMMARY The Coding and Billing Compliance Analyst plays a critical role in safeguarding the accuracy, integrity, and regulatory compliance of coding and billing operations across all service lines.  This position supports the organization’s revenue cycle and compliance initiatives by conducting detailed coding and billing reviews, identifying areas of risk, and contributing to the development of corrective action plans and educational programs.  The analyst ensures adherence to federal and state billing regulations, including Medicaid/Medicare guidelines, HRSA program requirements, and Office of Inspector General (OIG) guidance specific to Federally Qualified Health Centers (FQHCs).  The Analyst collaborates with providers, billing teams, compliance officers, and revenue cycle leadership, to improve clinical documentation, optimize reimbursement, and maintain full compliance with all applicable...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Job Details Level: Experienced Job Location: Hudson, WI - Hudson, WI 54016 Position Type: Full Time Travel Percentage: None Job Shift: Any Job Summary The primary purpose of the position is to review both procedural and diagnostic (ICD-10) coding to ensure appropriate billing and insurance regulations are met. This position will be staffed during clinic hours and is largely remote. Occasionally in-person meetings with providers will be required. Must live within reasonable traveling distance from Hudson, WI. Core Duties and Responsibilities Have in-depth understanding of coding and compliance rules and regulations. Responsible for reviewing provider documentation, coding and posting charges for healthcare services; including Primary Care, Lab/Pathology, Podiatry and more. Provide coding education and engage with assigned providers. Research and communicate governmental and payer-specific rules and regulations to ensure coding compliance. Identify and communicate best practices...

MUST RESIDE IN TEXAS AND HAVE CODING AND AUDITING EXPERIENCE. Counter Affidavit as well as Testimony experience is preferred. We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong Texas based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. Counter Affidavit experience is preferred. Responsibilities Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS) Conduct utilization reviews to determine medical necessity and documentation compliance Review and prepare demand packages and audit response materials Analyze records for payer disputes and recoupments Prepare written audit findings and defensible reports Provide expert support for depositions and testimony as needed Review...