Drg validation coding auditor jobs

Ensemble Health Partners USA

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and...

WH

Quality Medical Auditor: DRG Validation & Coding Expert

WillHire Columbia, SC, USA

A leading health insurance company in South Carolina is seeking an Auditor for Quality Medical. This role involves validation reviews of Diagnosis Related Groups and will require strong coding knowledge. The position offers a pay rate of $30-$36/hour, with a work schedule from Monday to Friday. Candidates should have an Associate degree and at least 3 years of experience in medical record management. Benefits include medical, dental, and vision coverage along with a 401K plan. #J-18808-Ljbffr

Full Time

Clinical DRG Auditor – Remote

Gainwell Technologies Remote (USA)

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 a Clinical DRG Auditor who is responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to validate the conditions that were documented in the medical record, the ICD-10-CM/PCS code assignments and determine the accuracy of DRG assignment that is clinically supported as defined by review methodologies specific to the...

RU

Full Time

Healthcare Coding Compliance Auditor

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

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...

VS

Clinical Coding Auditor & Trainer

Veracity Solutions New York, NY, USA

Clinical Coding Auditor & Trainer Location: Remote (U.S.) Must be willing to travel to New York twice annually Position Type: Full Time The Clinical Coding Auditor & Trainer is responsible for conducting clinical documentation and coding audits to ensure compliance with federal regulations, payer requirements, and company policies. This position focuses on DRG validation, inpatient prospective payment system (IPPS) compliance, and ICD-10-CM/PCS coding accuracy.

Co

Healthcare Coding Compliance Auditor - RUHS

County of Riverside Riverside, CA, USA

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...

EH

Medical Coding Auditor

Exceptional Healthcare Inc. Dallas, TX, USA

Job Description Job Description 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...

CI

Coding Auditor (ICD-10)

Careers Integrated Resources Inc Newark, NJ, USA

Coding Auditor (ICD-10) A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description Position: Coding Auditor (ICD-10) Duration: Full-Time Location: Newark/Wall NJ Job Summary: This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various...

EH

Medical Coding Auditor

Exceptional Healthcare Dallas, TX, USA

Data Quality Auditor 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...

PH

Coder Auditor

Prime Healthcare Ontario, CA, USA

Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0 million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team! Responsibilities The Inpatient Coder Auditor reviews and analyzes documentation present in the medical record for Inpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the assignment of International...

SE

Inpatient Facility Medical Coder

Scout Exchange OR, USA

Title - Inpatient Facility Medical Coder (40h Day) Location - Clackamas, OR, US Job Type - Permanent | Remote Required: Minimum five (5) years experience in coding with four (4) years inpatient facility coding The candidate must have 1 from the following list: Registered Health Information Technician Certificate Certified Coding Specialist Registered Health Information Administrator Certificate Advanced knowledge of medical terminology, pharmacology and medial coding principles for ICD-10-CM, ICD-10-PCS, HCPCS/CPT and coding. Advance knowledge of disease processes, diagnostic and surgical procedures, ICD-10-CM, ICD-10-PCS, HCPCS/CPT classification systems, health information/medical record department responsibilities with knowledge of government regulations and areas of scrutiny for potential fraud and abuse issues. Job description Candidates must reside either in Washintgon or Oregon to be considered for this position. To independently and efficiently...

PH

Coder Auditor

Prime Healthcare Management Inc Ontario, CA, USA

Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team! Responsibilities The Inpatient Coder Auditor reviews and analyzes documentation present in the medical record for Inpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the assignment of International...

EM

Medical Biller

Experis/Manpower Group Maplewood, MN, USA

DRG auditor Location: Maplewood Mn Pay Rate: Negotiable Duration: 12 months potential for extension Summary: We are seeking two experienced inpatient DRG Auditors for an asneeded role offering flexible hours (8-40 hours per week). Candidates may already have fulltime jobs, and the position is open to applicants on either the East or West Coast. The role will likely include two interviews . Ideal candidates will have: 5-7+ years of inpatient hospital coding/auditing experience Experience working in acute care hospitals, large hospital systems, or academic medical centers Strong expertise with ICD10CM/PCS , MSDRG and APRDRG methodologies Understanding of Elixhauser scoring , HACs , PSIs , and clinical validation Prior exposure to Clinical Documentation Improvement (CDI) preferred Ability to independently perform DRG audits with high accuracy Strong analytical, communication, and documentation skills Role Responsibilities: Perform...

EH

Medical Coding Auditor

Exceptional Health Care Dallas, TX, USA

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...

PH

Coding Compliance Auditor 2, Health Information Management, Full Time, Days

Public Health Trust of Dade Co USA

Department: Health Information Management Address: 1611 NW 12 Ave, Miami, FL 33163 Shift Details: Monday to Friday, Days. This is a remote position and is only open to candidates in Florida. Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of medical excellence and community care for more than a century. Throughout its rich and storied history, Jackson Memorial - located in the heart of the City of Miami - has been ground zero for some of the world's greatest medical breakthroughs and important moments in South Florida. We've grown into one of the nation's largest public hospitals, and one of the few that is also a world-class academic medical center with a proud mission and proven success. Jackson Memorial is an accredited, tertiary teaching hospital with 1,500 licensed beds, where nearly every medical specialty is provided by some of the world's most skilled and highly regarded multidisciplinary team of healthcare...

AI

Inpatient Facility Medical Coder

American IT Staff USA

Company Description Job Description To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional...

SE

Coding Auditor, Facility

Scout Exchange OR, USA

Title - Coding Auditor Location - Clackamas, OR Job Type - Permanent Job Summary: To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP),...

HS

Permanent - Outpatient Facility Medical Coder

Healthcare Staffing Plus OR, USA

JOB DESCRIPTION To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional coding...

Ve

Coding Auditor, Facility

Veracity OR, USA

Coding Auditor, Facility Onsite Clackamas, OR To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Healthcare...

PF

Inpatient Coding Auditor

Patient Financial Concepts Paterson, NJ, USA

Required: 5+ years of experience in inpatient coding auditing or compliance Location: Remote Job Summary: The Inpatient Coding Auditor is responsible for auditing inpatient coding and DRG assignment to ensure accurate ICD-10-CM/PCS coding, documentation support, and compliance with official guidelines and payer requirements. This role tracks audit outcomes, supports corrective actions, and provides education to improve coding quality and reduce audit risk. Responsibilities include, but are not limited to: Review entire medical record to confirm correct assignment of ICD-10-CM/PCS coding, sequencing and POA to ensure proper assignment of MS-DRG/APR-DRG. Review clinical documentation for guideline compliance, clinical support, and accurate capture of CC/MCC and key secondary diagnoses and procedures. Identify trends, root causes, and compliance risks; recommend corrective actions and process improvements in collaboration with coding leadership and CDI. Work...

RC

Healthcare Coding Compliance Auditor - RUHS

Riverside County, CA Riverside, CA, USA

Salary : $101,536.34 - $139,533.58 Annually Location : Riverside Job Type: Regular Job Number: 26-74191-01 AL Department: RUHS-Medical Center Opening Date: 03/03/2026 Closing Date: Continuous 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 ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through...

Ve

Inpatient Facility Medical Coder (40h Day)

Veracity USA

Inpatient Facility Medical Coder (40h Day) Remote Clackamas, OR Candidates must reside either in Washington or Oregon to be considered for this position. To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding...

PH

Health Information Management Inpatient Coding Auditor Sr. FT, Days, - Remote

Prisma Health Columbia, SC, USA

Join to apply for the Health Information Management Inpatient Coding Auditor Sr. FT, Days, - Remote role at Prisma Health . Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for leading coding teams, coder training, work queue management, performing prebill and second-level coding reviews utilizing auditing software and documents findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. Reviews and responds to inpatient denials as needed. Performs Inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment. Essential Functions All team members are expected to be...

Ta

Remote Medical Coding Auditor

Talently TN, USA

Location :RemoteSalary :$85,000depending on experienceSkills :Auditing, Inpatient Coding, DRG Validation, Quality ReviewAbout the Company / Opportunity :Are you passionate about upholding quality standards in health information management and coding practices? Our client, an industry leader in the hospitals and health care sector, provides nationwide revenue cycle services to a vast network of hospitals and physician practices.This remote opportunity allows you to leverage your expertise in coding quality review, ensuring compliance with national guidelines and maintaining data integrity.Join a mission-driven organization focused on supporting patient outcomes and enhancing health care delivery through excellence in coding quality.Responsibilities :Lead, coordinate, and perform all functions of quality review for inpatient and outpatient coding across multiple facilities.Conduct routine, pre-bill, policy-driven, and incentive plan-driven coding quality audits to ensure compliance...

57 drg validation coding auditor jobs found