38 drg coding auditor jobs found

Sign On Bonus: $1,500; paid in two installments: $500 at the time of hire and $1,000 after one year of service. DRG Coding Auditor - MS-DRG and APR-DRG Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development . Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of...

Baptist Health Care is seeking a Coding Auditor to review and audit patient records for correct ICD-10-CM/PCS codes, CPT codes, POA assignment and MS-DRG assignment. The role will issue quarterly report cards and provide coding training and education to coders. The ideal candidate has at least five years of inpatient and/or outpatient coding experience and holds CCS, CPC, and CCA certifications. Knowledge of Medicare and other third-party payer regulations is required. #J-18808-Ljbffr

Zelis Healthcare, LLC is seeking an RN or LVN with inpatient coding expertise to perform comprehensive DRG reviews for post-service and pre-payment claims. The role emphasizes accurate coding, documentation, and customer-facing rationale based on medical records, with a focus on readmission analysis and policy compliance. The successful candidate will have CCS/CIC certification within 4–6 months of hire, 1–3 years of ICD-10 CM/MS-DRG reviews, and strong organizational skills. #J-18808-Ljbffr

Experienced Associate, Healthcare ForensicsThe Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients.Job Duties:Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance mattersContributes to forensic engagements related to medical coding and...

Coding Auditor The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals. Responsibilities Reviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment Informs manager of any activities which do not meet federal or state coding and billing requirements Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and responds...

Job Description The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals. Responsibilities Reviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment. Informs manager of any activities which do not meet federal or state coding and billing requirements. Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and responds...

Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to medical coding and...

Miami, FL Full-Time Health Information Management Jackson Health System Full Time Summary The HIM Coding Compliance Auditor 1 analyzes abstracted/coded data for the purpose of ensuring accuracy and timeliness as it relates to DNFB management, quarterly AHCA data submissions and PFS communication. Responsibilities Reviews quality of coded and abstracted data assuring coding compliance within the Jackson Health System. Performs target and focused MS-DRG, APC, CPT, Case mix and Medical Necessity reviews. Identifies monitors and corrects rejected claims due to HIM coding. Works as a liaison with PFS and other internal departments to serve as a communicator/problem-solver for hindrances that prevent reimbursement. Based on new coding requirements, audit findings, RACs, MACs, etc. prioritizes and supports develops training/education protocols for UHS hospital coders in ICD-9-CM, CPT-4, APCs, Emergency Room Evaluation and Management Coding, Level II coding guidelines, modifier...

Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to medical coding and...

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...

Baptist Health Care is seeking a Coding Auditor to review patient records for accurate ICD-10-CM/PCS, CPT, POA and MS-DRG assignments across inpatient and outpatient settings. The role also issues quarterly report cards and provides coding training to staff. The ideal candidate has a technical coding credential and several years of inpatient/outpatient coding experience, with knowledge of Medicare/third-party payer guidelines, and the ability to work remotely from Pensacola, FL. #J-18808-Ljbffr

Experienced Associate, Healthcare ForensicsThe Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients.Job Duties:Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance mattersContributes to forensic engagements related to medical coding and...

Experienced Associate, Healthcare ForensicsThe Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients.Job Duties:Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance mattersContributes to forensic engagements related to medical coding and...

Coding AuditorThe Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals.ResponsibilitiesReviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment Informs manager of any activities which do not meet federal or state coding and billing requirements Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and responds within 5...

Health Information Management (HIM) Coding SpecialistLocation: Miramar, FloridaAt Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.SummaryReviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance.ResponsibilitiesEnhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical...

Job Description The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals. Responsibilities Reviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment Informs manager of any activities which do not meet federal or state coding and billing requirements Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and...

Job Description The Coder III reviews inpatient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines with a 97% accuracy rate, while maintaining coding standards for productivity. This position must preserve confidentiality of health information. This position must be able to use tact and diplomacy when communicating with employees, physicians, administration, and public, under complex or emotional situations. Responsibilities Responsibilities include: Reviews patient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines. Meets Productivity Standard for Inpatient Coding: 17 charts/day. Understands appropriate assignment of MS-DRG, POA, and discharge disposition. Assists with all levels of coding including inpatient, outpatient, and psych. Works as a team member to achieve goals for the department. Assists with data integrity audits, and corrects errors as needed (invalid codes,...

Job Description Job Description Description:  At Sage Clinical RCM, you'll code high-acuity inpatient encounters across a national portfolio of health systems, from academic medical centers to community hospitals. No two client environments are identical, and that's the point. You'll sharpen your skills across specialties, payers, and documentation styles instead of coding the same census for years.    What You'll Do   Review inpatient encounters and assign accurate ICD-10-CM/PCS codes and DRGs that hold up to audit.  Read documentation critically. When it doesn't support the coded services, flag it and escalate the gap.  Code in full compliance with CMS requirements, payer-specific rules, and official coding guidelines.  Move confidently between client workflows, systems, and audit expectations.  Hold the line on quality (95% accuracy or better) while meeting realistic productivity standards.  Requirements:   What You Bring   Active RHIA, RHIT, and/or CCS...

Job Description Job Description Senior Clinical Coder (Inpatient Facility Coding) – Remote $80,000–$90,000 | Contract-to-Hire | 100% Remote Are you an experienced Inpatient Facility Clinical Coder with strong DRG validation expertise? We're seeking a Senior Clinical Coder to join a collaborative clinical operations team supporting complex medical claims reviews and coding accuracy. This is a fully remote opportunity with long-term potential for permanent employment. Position Details Contract-to-Hire (average conversion: 6–9 months) 100% Remote Salary: $80,000–$90,000 annually (based on approved work state and geographic location) Full-time What You'll Do Perform retrospective reviews of inpatient and outpatient medical claims Validate DRGs and ensure accurate reimbursement Apply ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding guidelines Review claims for coding accuracy, compliance, and payment integrity Prepare coding determinations and...

Overview FTE: 1.0 Hours: Monday - Friday, 8:00 AM - 5:00 PM Location: Remote (eligible only within FL, GA, MO, PA, SC, TN, and TX) Position Summary This role is responsible for reviewing, analyzing, and assigning final diagnoses and procedures as documented by the practicing provider, following all compliance policies and guidelines. The position ensures accurate coding of office and hospital procedures to guarantee proper reimbursement. Key Responsibilities Providing physician education to ensure proper completion of Electronic Health Records (EHR). Ensuring correct assignment of ICD-10-CM, HCPCS, and CPT codes. Delivering education verbally, in writing, and through hands‑on training as needed. Responsibilities Review clinical documentation and code to the highest level of specificity for accurate charge capture. Interact with providers to provide feedback and education using verbal, written, and hands‑on communication methods. Assign and sequence appropriate codes and...

Job Description Job Description Description:   Role Summary  Responsible for reviewing inpatient coding to validate accuracy, compliance, and documentation support. This role identifies risks, ensures consistency in DRG assignment, and provides actionable feedback to improve coding quality.  Core Responsibilities   Perform retrospective and/or concurrent audits of inpatient coding.  Validate ICD-10-CM/PCS code assignment and MS-DRG/APR-DRG accuracy.  Follow and adhere to AHIMA’s Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policies.   Identify trends, risks, and opportunities for coding improvement.  Provide clear, actionable audit feedback and education to client & internal coding staff.  Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards.  Requirements:   Minimum Qualifications   Credentials: CCS, RHIA, or RHIT (active).  Experience: Minimum 3+ years of...

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As an Inpatient Coding Auditor with Parallon you can be a part of an organization that is devoted to giving back! Job Summary and Qualifications As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. What you will do in this role: Leads,...

The Coder III reviews inpatient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines with a 97% accuracy rate, while maintaining coding standards for productivity. This position must preserve confidentiality of health information. This position must be able to use tact and diplomacy when communicating with employees, physicians, administration, and public, under complex or emotional situations. Responsibilities Reviews patient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines. Meets Productivity Standard for Inpatient Coding: 17 charts/day. Understands appropriate assignment of MS-DRG, POA, and discharge disposition. Assists with all levels of coding including inpatient, outpatient, and psych. Works as a team member to achieve goals for the department. Assists with data integrity audits, and corrects errors as needed (invalid codes, discharge codes, etc.). Monitors backlog of un-coded...

Requisition No: 883023 Agency: Department of Health Working Title: MEDICAL CODER Pay Plan: Career Service Position Number: 64035562 Salary: $36,004.80 - $38,001.60 Posting Closing Date: 09/23/2026 Total Compensation Estimator Tool HEALTH INFORMATION SPECIALIST Open Competitive Your Specific Responsibilities: Are you a whiz with a knack for navigating the intricate world of healthcare? Look no further! We're on the hunt for a dynamic individual to join our squad! As Medical Coding Specialist, you'll be the unsung hero behind the scenes, turning complex medical information into a symphony of perfectly coded data. DOH Sarasota requires a Medical Coder/Referral specialist to ensure accurate, timely coding for clinical services such as family planning, Obstetric care, STI care, and HIV/AIDs and Hepatitis C treatment. The coder will also be responsible for referral tracking. Proper coding is essential for compliant reporting, reimbursement, and data...