Drg coding auditor jobs | Healthcare Careers

Full Time

Riverside University Health System Medical Center Hybrid (Riverside, CA)

Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience in an acute care hospital...

HH

Coder III : Medical Coding

Hoag Health System Costa Mesa, CA

Job Description Primary Duties And Responsibilities The Coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM, ICD-10-PCS, and CPT codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Abides by the standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to all official coding guidelines. Verifies that all ICD-10-CM and CPT codes are correctly captured. Verify that physician is correctly abstracted. Keeps abreast of coding guideline changes by self-study, assigned education, coding meeting attendance or related in-services. Participates in internal and external quality review meetings. Performs other duties as assigned. Medical Coding - Hoag Hospital Resolves billing related errors and assists with workflow changes and process improvement projects....

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Inpatient Medical Coding Auditor

Humana Sacramento, CA

Become a part of our caring community The Inpatient 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 Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

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Healthcare Coding Compliance Auditor - RUHS

GovernmentJobs.com Riverside, CA

Coding Compliance Auditor Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive...

RC

Healthcare Coding Compliance Auditor - RUHS

Riverside County, CA Riverside, CA

Salary : $105,597.80 - $145,114.92 Annually Location : Riverside Job Type: Regular Job Number: 26-74191-01 AL Department: RUHS-Medical Center Opening Date: 03/03/2026 Closing Date: Continuous For questions regarding this position, please contact the Recruiter listed in the Supplemental Information section. ABOUT THE POSITION Riverside University Health System (RUHS)is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to...

IR

Inpatient Coder

INNOVA Revenue Group CA

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding...

IR

Inpatient Coder

INNOVA Revenue Group San Diego, CA

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding...

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Payment Integrity Nurse Coder RN III - $10,000 SIGN ON BONUS

IntelyCare Los Angeles, CA

Payment Integrity Nurse Coder RN III Salary Range: $102,183.00 (Min.) - $163,492.00 (Max.) L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Job Summary The Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management projects. The position serves as a subject matter expert (SME), performing medical records reviews to include quality audits as well as validation of accuracy and completeness of all coding elements. The position is also responsible for guidance related to Payment Integrity initiatives to...

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Medical Biller/Coder

RETINA ASSOCIATES OF ORANGE COUNTY Laguna Hills, CA

Job Description Job Description Description: We are seeking a detail-oriented and knowledgeable Medical Biller to join our medical practice. The ideal candidate will be responsible for managing billing processes, ensuring accurate coding and submission of claims, and maintaining medical records. This role is crucial in facilitating the financial operations of our medical office while ensuring compliance with healthcare regulations. Requirements: Responsibilities Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues Follow up on claims using...

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(Coder III (Healthcare) Hemet, CA / Menifee , CA area -Direct Hire

Suncap Technology Hemet, CA

Coder III Coder III is responsible conducting clinically based concurrent and retrospective reviews of inpatient medical records. This review is to evaluate that the clinical documentation is reflective of quality of care outcomes and reimbursement compliance for acute care services provided. The CDS will work closely with the medical staff to facilitate appropriate clinical documentation of patient care. The CDS/Coder III abstracts and codes the diagnostic and procedural information for Inpatient Services and Surgery medical records utilizing the current version of International Classifications of Diseases in accordance with regulatory agencies and hospital specific guidelines. The CDS/Coder III enters the coded data and other abstracted data from the medical record into the electronic information system. This position assumes primary responsibility for clarifying ambiguous documentation, DRG optimization with the primary role in assisting medical staff members with improving...

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Health Information Coder 3, Per Diem

University of California San Francisco, CA

Health Information Coder 3, Per Diem The Health Information Coder III is a senior-level inpatient coder with the knowledge and skill set to utilize the ICD-10-CM and ICD-10-PCS classification systems to code acute academic, teaching inpatient cases. The skill set extends to knowledge and comprehension of code sequences into Diagnoses-Related Groups on acute academic, teaching inpatient cases. Cases are coded to comply with the official guidelines for coding and reporting, practice standards and code of ethics for HIMS coder. Cases are abstracted according to UCSF Health policies and procedures. The focus of coding and abstracting is on a range of all primary hospital services. There is minimal review of coding for quality. Duties and Essential Job Functions Retrieve and analyze comprehensive medical records and information systems for appropriate documentation and follow-up as appropriate. Evaluate full episode of care of clinical data for inpatient cases and assign...

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Inpatient Coder

INNOVA Revenue Group Bakersfield, CA

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding credential required...

IR

Inpatient Coder

INNOVA Revenue Group Long Beach, CA

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding credential required...

IR

Inpatient Coder

INNOVA Revenue Group Oakland, CA

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding credential required...

IR

Inpatient Coder

INNOVA Revenue Group Fresno, CA

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding credential required...

IR

Inpatient Coder

INNOVA Revenue Group San Jose, CA

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding credential required...

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Medical Coding Specialist (Inpatient)

Insight Global Palo Alto, CA

JOB DESCRIPTION Insight Global is seeking a fully remote Medical Coding Specialist (Inpatient) to support a Healthcare AI client. This is a part-time, fully remote opportunity where candidates will leverage their inpatient coding expertise to evaluate and improve AI-driven coding recommendations. This role is highly analytical and requires a deep understanding of diagnosis/procedure coding, DRG assignment logic, and clinical reasoning within acute care settings. Laptop and equipment will be provided. Responsibilities: • Review inpatient encounters and evaluate AI-generated coding recommendations across diagnosis and procedure coding • Assess the accuracy and reasoning behind ICD-10-CM/PCS code assignments, sequencing, and DRG selection (MS-DRG/APR-DRG) • Identify discrepancies where AI-generated outputs diverge from correct inpatient coding practices and explain the rationale • Provide insight into complex coding decisions, including cases requiring clinical interpretation...

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Inpatient Coder

INNOVA Revenue Group San Francisco, CA

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding credential required...

IR

Inpatient Coder

INNOVA Revenue Group San Diego, CA

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding credential required...

IR

Inpatient Coder

INNOVA Revenue Group Anaheim, CA

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding credential required...

IR

Inpatient Coder

INNOVA Revenue Group Sacramento, CA

Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an experienced and detail-oriented Inpatient Medical Coder to join our growing team. This role focuses on accurate inpatient coding support across multiple healthcare client projects. We are looking for someone who is dependable, collaborative, highly accurate, and comfortable working in a fast-paced healthcare revenue cycle environment. Responsibilities Perform Inpatient coding services Assign accurate ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance, and PSI-related indicators Work across multiple client projects as assigned Collaborate with INNOVA leadership and team members regarding coding workflows and questions Participate in coding quality reviews and audits Complete additional coding-related projects and tasks as assigned Qualifications Current coding credential required...

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Coding Auditor

Trinity Health Modesto, CA

Details Client Name WelbeHealth - Modesto Job Type Local Offering Non-Clinical Profession Professional Specialty IT Job ID 13826730 Job Title Coding Auditor Weekly Pay $1040.0 Shift Details Shift Days 5x8 Scheduled Hours 40 Job Order Details Start Date 11/27/2023 End Date 02/26/2024 Duration 13 Week(s) Job Description Duties and Responsibilities: -Assist with retrospective and concurrent coding for PACE (Programs of All-Inclusive Care for the Elderly) Dual participants. -Conducts pre-visit chart preparations and post visit chart reviews. -Conducts audits and participates in provider education programs to ensure compliance with CMS risk adjustment diagnosis coding guideline. -Works closely with direct manager in identifying opportunities for HCC coding education. -Complete all required documentation in a timely and accurate manner. -Protect privacy and maintain confidentiality of all company procedures and...

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Medical Coder

LAKE COUNTY TRIBAL HEALTH CONSORTIU Lakeport, CA

Job description TITLE: MEDICAL CODER DEPARTMENT: H.I.M SUPERVISOR: H.I.M. DIRECTOR CLASSIFICATION:FULL TIME NON-EXEMPT POSITION SUMMARY: This incumbent performs highly technical and specialized functions. The employee reviews, analyzes, and codes diagnostic and procedural information to ensure compliance with established coding guidelines, third party reimbursement policies and regulations. The coding function is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. ESSENTIAL FUNCTIONS: • Responsible for reviewing patient charts and entering pertinent patient data into RPMS database. • Compiles, sorts and verifies accuracy of data entered into the Electronic Health Record. • Assigns and sequences ICD-9-CM/CPT/HCPCS codes to diagnoses and procedures for documented information. • Assures the final diagnoses and operative procedures as stated...

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Inpatient Medical Coder - FT - Up to $5,000 Sign on Bonus

Datavant Sacramento, CA

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...

25 drg coding auditor jobs found