8 documentation coding auditor jobs found

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

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. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines Utilize encoders and various coding resources Perform CPT Procedure reviews Maintain strict patient and physician...

A leading healthcare company is seeking a Medical Coding Auditor to review and ensure that medical claims meet coding guidelines. This remote position requires at least 3 years of experience in outpatient specialty surgeries and relevant certifications. You will analyze medical documentation and ensure accurate CPT coding assignments while maintaining confidentiality. The role offers a competitive salary ranging from $59,300 to $80,900 per year along with various benefits. #J-18808-Ljbffr

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Job Description Job Description Warm Valley Health Care is looking to add to the Billing/Coding department. Job Summary: The Medical Biller/Coder is responsible for translating healthcare services rendered into standardized codes for insurance billing, ensuring accurate reimbursement. This role ensures the efficient processing of patient data, medical records, and insurance claims in compliance with healthcare regulations. Key Responsibilities: Accurately assign appropriate ICD-10, CPT, and HCPCS codes to diagnoses and procedures based on medical documentation. Review patient records for completeness, accuracy, and compliance with regulations. Prepare and submit clean claims to insurance companies electronically or via paper submission. Follow up on unpaid claims within standard billing cycle timeframe. Resolve billing issues with insurance companies, patients, and healthcare providers. Correct rejected or denied claims and resubmit for payment. Post payments and...

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...

Certified Medical Coding Specialist Sublette County Health Discover Your Next Adventure in Pinedale, Wyoming! Nestled in the heart of the breathtaking Wind River Range, Sublette County offers the rugged beauty of the West alongside a once-in-a-lifetime career opportunity. Sublette County Health proudly operates two urgent care clinics with Level 5 Trauma receiving Emergency Rooms, as well as two EMS stations. On August 4, 2025, we opened Sublette County’s first hospital – a historic milestone for our community. As part of our growth, Heritage Home – our Skilled Nursing facility – is expanding to its new home with a 40‑bed Skilled Nursing Unit and a brand‑new 10‑bed Memory Care Unit, designed to provide compassionate, resident‑centered care. Overview The Certified Medical Coding Specialist translates clinical and/or ambulance work into code and enters billing codes into the practice management system for reimbursement. The role also performs chart compliance audits and provides...