33 drg coding auditor jobs found

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...

Compliance Auditor, Billing and Coding Compliance The Compliance Auditor, Billing and Coding Compliance is responsible for the oversight and management of auditing and monitoring billing and coding compliance activities, assist with internal compliance policies and procedures, completing compliance risk assessments, and developing risk-based educational materials to ensure compliance with federal/state laws and regulations, and UT Health San Antonio policies. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Responsibilities Provide oversight on billing compliance auditing, monitoring, and educational activities within the compliance department. Performs audits of electronic and manual documentation, coding, and billing systems. Conducts close-out meetings with senior management of audited departments. Maintain current knowledge of changes in federal and state coding and...

Coding Compliance Auditor Conducts coding compliance audits of inpatient and outpatient encounters to validate code assignment. Follows the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. Job Requirements Minimum Education Associates degree in relevant field preferred or combination of equivalent of education and experience Minimum Work Experience Five (5) years coding experience including; but not limited to; hospital inpatient and outpatient encounters Required Licenses/Certifications AHIMA and/or AAPC Coding Credential; CCS preferred Required Skills; Knowledge; and Abilities Ability to consistently and accurately audit coding of inpatient and outpatient encounters Ability to create clear and concise audit reports and maintain productivity standards Must successfully pass pre-hire coding assessment Knowledge of medical...

Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: • Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to...

Job Description Job Description Specialty Senior Medical Coder – General Surgery Location: Irving, TX COMPENSATION & SCHEDULE • $35.75/hr (Non-CGSC Certified) | $42.00/hr (CGSC Certified – General Surgery) • Monday–Friday | 8:00 AM–5:00 PM • W2 | Temp to Perm • Start Date: 03/16/2026 ROLE IMPACT: The Specialty Coder Senior – General Surgery ensures accurate, compliant coding for high-dollar inpatient and outpatient professional services. This role drives revenue integrity by reducing denials, supporting clean claims, and maintaining a minimum 95% coding accuracy rate. Success is defined by precise code assignment, strong documentation review, and consistent productivity in a remote environment. Key Responsibilities • Assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes in accordance with Official Coding Guidelines and AMA CPT standards • Code inpatient and outpatient Evaluation & Management (E/M) and surgical/operative procedures, generating accurate...

Job Description Job Description Senior Medical Coder – Urology/Nephrology Location Irving, TX | Onsite Compensation & Schedule • $35.75/hour – Non-Urology Certified Coder | $42.00/hour – Certified Urology Coder (CUC) • Full Time |8:00 AM - 5:00 PM • Temp to Perm (W2) • Start Date: March 16, 2026 Role Impact: The Senior Medical Coder ensures accurate, compliant coding for high-dollar and specialty professional fee accounts within Urology and Nephrology. This role directly supports clean claims, optimized reimbursement, and reduced denials by maintaining a minimum 95% coding accuracy rate. Success is defined by precision in ICD-10-CM, ICD-10-PCS, and CPT code assignment, strong collaboration with HIM (Health Information Management) and CDI (Clinical Documentation Improvement) teams, and consistent productivity performance. Key Responsibilities • Assign diagnosis and procedure codes in accordance with ICD-10-CM/PCS Official Guidelines and AMA CPT guidelines...

Job Family: PFS Billing Travel Required: None Clearance Required: None What You Will Do The Healthcare - Medical Biller is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers. Has an extensive knowledge of billing requirements mandated by payers and / or governmental regulations. This position will perform any and all related job duties as assigned. Individuals must be able to work an eight hour shift between the hours of 8:30 AM CT - 5:30 PM CT, with no remote work initially but with opportunity for some hybrid (in office/remote) after training. We will consider individuals open to...

Medical Coder Revenue Cycle Management is looking for a Medical Coder to join our team. Remote opportunity after in-person training. The Medical Coder is responsible for reviewing medical documentation and accurately assigning CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS codes depending on the encounter type. The position ensures accurate billing, compliance, and optimized reimbursement across outpatient and/or facility (inpatient) settings. Essential Functions: Assign accurate diagnosis and procedure codes based on medical record documentation using CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS. Review provider documentation to ensure coding is supported and complete for billing submission. Apply proper modifiers, sequencing, and coding conventions appropriate to the setting (inpatient or outpatient). Ensure compliance with coding regulations, organizational policies, and HIPAA standards. Meet coding productivity and quality benchmarks. Collaborate with clinical, billing,...

Job Description Insight Global is seeking a highly skilled Inpatient DRG Coding Specialist to provide the advanced skills necessary for proper coding of all pertinent diagnoses and procedures and to provide optimal DRG assignment after thorough review of medical record and analysis of DRG options. ESSENTIAL JOB FUNCTIONS · Selects records from EPIC WQ according to priority. · Reviews all federally insured and other patient discharge encounters for accurate coding and sequencing of diagnoses and procedures. · Correctly assigns ICD-10 -CM diagnoses and ICD-10-PCSprocedure codes and enters appropriate codes into EPIC Encoder. · Identifies responsible staff and resident physicians for each procedure coded. · Always protects confidentiality of patient information. · Participates in section meeting and office in-services. · Attends and participates in coding education sessions. · Keeps coding knowledge and skills current through attending continuing education...

Requisition number: 2360324 Job category: Medical & Clinical Operations Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Senior Medical Coder performs concurrent review of FFS coding rules, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. This position will support coding functions within charge review, claim edits, and denials and play a critical role in maintaining...

At Houston Methodist, the Lead Outpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to outpatient encounters based upon documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. FLSA STATUS Non-exempt...

At Houston Methodist, the Lead Outpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to outpatient encounters based upon documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. FLSA STATUS Non-exempt...

HIM/Medical Records Coding Specialist Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility is fully accredited and included a 16-bed residential treatment center for adult chemical dependency. We offer a broad range of behavioral health programs for children, adolescents and adults. Treatment is offered at multiple levels of care including inpatient, partial hospitalization and intensive outpatient. We are available 24 hours a day, seven days a week to assist you and answer your questions about treatment options and insurance coverage. The hospital is easily accessible off the Southwest Freeway near the Galleria. West Oaks Hospital is seeking a dynamic and talented HIM/Medical Records Coding Specialist to join our team of compassionate, dedicated professionals. The HIM/Medical Records Coding Specialist will be responsible for assigning diagnostic and procedures codes...

Inpatient Coder (Remote) Full-time Work From Home Must have CCS, RHIA, or RHIT certification Job Summary As a Coding Integrity Specialist III WORK FROM HOME, you will review and evaluate hospital inpatient medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM and ICD-10-PCS codes. A CIS III performs coding and/or code/DRG validation across multiple entities by applying all appropriate coding guidelines and criteria for code selections. Job Qualifications Assign, sequence, validate, and/or edit codes/DRGs and abstracted data (e.g., physician, discharge disposition, query tracking) for inpatient records for multiple facilities using ICD-10-CM and ICD-10-PCS Maintain or exceed established accuracy standards Maintain or exceed established productivity standards Utilize the complete patient medical record documentation in code/DRG assignment, validation, and/or editing of codes/DRGs Undergraduate (Associate's or Bachelor's)...

Your future role at a glance Location: REMOTE Department/Specialty: Coding - Behavioral Health & Dermatology Schedule: Full-time / Day Salary Range: $24.87 - $33.64 Life at Ascension: Where purpose meets opportunity Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 99,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you'll find an inclusive and supportive environment where your contributions truly matter. Benefits that help you thrive Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options Financial security & retirement: employer-matched 403(b), planning and hardship resources, disability and life insurance Time to...

Location: Medical Center - Fort Worth Department: HIM-Coding Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: The HIM Coder Analyst III requires superior knowledge of and skill in applying International Classification of Diseases and Procedures (ICD), and Current Procedural Terminology (CPT) code sets and associated Medicare/Medicaid rules and guidelines. Reviews and interprets patient medical record documentation to identify pertinent diagnoses and procedures and assigns ICD-9-CM, ICD-10-CM/PCS and CPT 4 codes accurately and timely to the highest level of specificity based upon physician documentation for inpatient, observation and outpatient ambulatory procedures/treatment room records. Validates the coded data to one or more Diagnosis Related Groupers (DRG) validates the Present on Admission (POA) indicators for accuracy. Primarily codes more complex and difficult inpatient medical records. Identifies and abstracts specified...

Description Summary: Responsible for maintaining current and high-quality ICD-10-CM/PCS coding for all Inpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding and Reporting. Inpatient coding is applicable towards all regional Inpatient encounters. Coder will work collaboratively with various CHRISTUS Health HIM and Clinical Documentation Specialists to ensure accurate and complete physician documentation to support accurate billing and reduce denials. Coder will also assist in other areas of the department, as requested by leadership. Coder will report directly to their Regional Coding Manager, with additional...

HIM/Medical Records Coding Specialist Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility is fully accredited and includes a 16-bed residential treatment center for adult chemical dependency. We offer a broad range of behavioral health programs for children, adolescents, and adults. Treatment is offered at multiple levels of care including inpatient, partial hospitalization, and intensive outpatient. We are available 24 hours a day, seven days a week to assist you and answer your questions about treatment options and insurance coverage. The hospital is easily accessible off the Southwest Freeway near the Galleria. West Oaks Hospital is seeking a dynamic and talented HIM/Medical Records Coding Specialist to join our team of compassionate, dedicated professionals. The HIM/Medical Records Coding Specialist will be responsible for assigning diagnostic and procedures codes...

Revenue Cycle Management is looking for a Medical Coder to join our team! Remote opportunity after in-person training SUMMARY: The Medical Coder is responsible for reviewing medical documentation and accurately assigning CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS codes depending on the encounter type. The position ensures accurate billing, compliance, and optimized reimbursement across outpatient and/or facility (inpatient) settings. ESSENTIAL FUNCTIONS: Assign accurate diagnosis and procedure codes based on medical record documentation using CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS. Review provider documentation to ensure coding is supported and complete for billing submission. Apply proper modifiers, sequencing, and coding conventions appropriate to the setting (inpatient or outpatient). Ensure compliance with coding regulations, organizational policies, and HIPAA standards. Meet coding productivity and quality benchmarks. Collaborate with clinical,...

Inpatient Coder (Remote) - 12-Week Contract | Irving, TX (75038) Inpatient Coder (Remote) - 12-week contract in Irving, TX (75038) supporting a leading Dallas-Fort Worth hospital system. Competitive weekly pay and a collaborative Health Information Management (HIM) team focused on coding accuracy, clinical documentation improvement (CDI), and professional growth. Job Details Location: Remote (based in Irving, TX 75038) - Dallas-Fort Worth (DFW) area Job Title: Inpatient Coder / Hospital Coder Weekly Estimated Pay: $1,126 - $1,251 Contract Duration: 12 weeks Shifts per Week: 5 Shift Duration: 8-hour days Start Date: March 23, 2026 Hours per Week: 40 Job Requirements Minimum 1 year of inpatient coding experience in a hospital or acute care setting (inpatient coding / ICD-10 coding) High school diploma required; additional coding certification or training preferred Strong knowledge of ICD-10-CM and ICD-10-PCS...

Outpatient Coder (Remote) - Arlington, TX / Dallas-Fort Worth Remote Outpatient Coder - Arlington, TX (76011). Seeking an experienced medical coder with hospital outpatient surgical coding expertise in CVIR and GI for a 13-week remote assignment. Join a dynamic healthcare team as a Remote Outpatient Coder (medical coder) supporting accurate coding and billing for CVIR (cardiovascular interventional radiology) and GI procedures. This remote coding job is ideal for certified coders experienced in hospital-based outpatient surgical coding who want the flexibility of work-from-home while supporting a hospital in the Arlington, TX / Dallas-Fort Worth area. Job Details Location: Remote (based in Arlington, TX 76011) - remote / work-from-home / telecommute Assignment Duration: 13 weeks with potential to renew Start Date: June 1, 2026 Shifts per Week: 5 (Monday-Friday) Shift Duration: 8-hour days (8:00 AM-4:30 PM) Estimated Weekly Pay:...

Job Description Insight Global is seeking a highly skilled Inpatient DRG Coding Specialist to provide the advanced skills necessary for proper coding of all pertinent diagnoses and procedures and to provide optimal DRG assignment after thorough review of medical record and analysis of DRG options. ESSENTIAL JOB FUNCTIONS Selects records from EPIC WQ according to priority. Reviews all federally insured and other patient discharge encounters for accurate coding and sequencing of diagnoses and procedures. Correctly assigns ICD-10-CM diagnoses and ICD-10-PCS procedure codes and enters appropriate codes into EPIC Encoder. Identifies responsible staff and resident physicians for each procedure coded. Always protects confidentiality of patient information. Participates in section meeting and office in-services. Attends and participates in coding education sessions. Keeps coding knowledge and skills current through attending continuing education activities and reviewing pertinent...

Hours of Work : 8 am - 4:30pm Days Of Week : M-F Work Shift : Job Description : Your Job: In this highly technical and fast-paced position, you will collaborate with multidisciplinary team members to provide the very best care for our patients. The Coder 3 performs pre-bill (secondary) audits on inpatient, ambulatory care and observation records to ensure accurate ICD10-CM, ICD10 PCS and/or CPT codes for optimal reimbursement and provide data and clinical information to management, medical STAFFnd various hospital departments. The reviewer also codes and abstracts inpatient, ambulatory and observation records for diagnosis and procedures to determine optimal reimbursement. Your Job Requirements: • Associate's degree in Health Information Management or Certification as a Coding Specialist; Bachelor's degree in Health Information Management preferred • RHIA, RHIT, or CCS preferred • Minimum of 3 years of DRG-based coding experience in an acute care hospital...

DHR Health - US:TX:McAllen - Days Summary: POSITION SUMMARY: The Inpatient coder reviews and analyzes documentation in the medical record for inpatient visits to ensure accuracy of diagnosis and procedure codes. Coder finalizes the coding and abstracting of the medical record according to ICD-10-CM/PCS, CPT, and HCPCS coding conventions and guidelines supported by the clinical documentation in the medical record. Coder analyzes diagnosis and procedure codes concurrently assigned by Clinical Documentation Specialists. The Inpatient Coder assumes primary responsibility for DRG validation/accuracy, primary role in assisting CDS and medical staff members with improving quality of clinical documentation. Sequence the diagnoses and procedures using official coding guidelines. Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges. Resolve Inpatient billing edits. Abide by the Standards of Ethical Coding as set...