58 facility inpatient coding auditor jobs found

Become a part of our caring community Become a part of our caring community and help us put health first The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating...

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 credential....

Risk Adjustment Coder Porter is hiring a Risk Adjustment Coder to join our team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home health assessments. The ideal candidate will have a strong understanding of CMS...

Description The Sr Billing Compliance Auditor serves as the liaison responsible for monitoring and auditing NCPS coding and documentation functions for professional fee services. Conducts independent ongoing reviews of vendor and provider-coded professional fee services to ensure practices meet federal requirements. Works closely with NCPS to communicate monitoring / auditing results and provide feedback to support necessary actions taken accordingly. Functions as the subject matter expert for professional fee coding and documentation, and partners with NCPS administrators to ensure consistent, compliant, and accurate coding practices. Job Summary Conducts audits of NCPS professional fee encounters to validate accuracy of CPT, HCPCS, ICD-10-CM, and modifier assignment. Serves as the coding, documentation, and billing expert for NCPS, ensuring focused expertise on pediatric, Fl AHCA / Medicaid, and CMS regulatory requirements. Monitors professional fee vendor‑coding services to...

Job Description Job Description Medical Billing & Revenue Integrity Specialist Orange Park, Florida Position Overview Arthritis & Osteoporosis Treatment Center is seeking an experienced Medical Billing & Revenue Integrity Specialist to join our growing independent rheumatology practice. This is an advanced revenue cycle role for an experienced medical biller who enjoys identifying billing issues, improving processes, ensuring compliance, and strengthening the financial integrity of the practice. In addition to hands-on billing responsibilities, this individual will audit revenue cycle activity, monitor aging claims, investigate reimbursement discrepancies, reconcile financial activity, develop meaningful reports, and support operational improvements across the practice. This individual will serve as a key resource for billing quality, revenue integrity, compliance, reporting, and workflow improvement, transforming financial and operational data...

Job Description Job Description Description: Precision Healthcare Specialists is seeking an experienced and detail-oriented Certified Medical Coder to support our ENT & Allergy Specialists division. The Certified Medical Coder is responsible for accurately reviewing provider documentation and assigning appropriate diagnosis and procedure codes for otolaryngology, allergy, audiology, and related services. This role plays a critical part in ensuring coding accuracy, regulatory compliance, clean claim submission, and optimal reimbursement. The ideal candidate will possess strong knowledge of ICD-10, CPT, and HCPCS coding guidelines, have experience coding specialty physician services, and demonstrate exceptional attention to detail in a fast-paced healthcare environment. Essential Duties and Responsibilities Review and accurately code physician documentation, office visits, procedures, diagnostic testing, and surgical services. Assign ICD-10-CM, CPT, and HCPCS codes in...

Become a part of our caring community Become a part of our caring community and help us put health first The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating...

IPA Consultative Coding Professional The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS leaders and champions to identify STARS gaps and...

Overview North Florida Surgeons is a leading healthcare provider committed to delivering exceptional patient care and service. We have over 300 medical providers and physician extenders and are currently seeking a detail-oriented and motivated Medical Coding Specialist to support our revenue cycle department. This role is essential in ensuring accurate coding for services rendered, which directly impacts reimbursement and compliance. The Medical Coder is responsible for reviewing clinical documentation and assigning appropriate ICD-10, CPT, and HCPCS codes for billing and reimbursement. This position works closely with providers, billing staff, and insurance companies to ensure coding accuracy and compliance with federal regulations. Key Responsibilities Review medical records and documentation to assign accurate diagnosis and procedure codes Responsible for coding office visits and surgeries Collaborate between clinical, billing and patient services departments to ensure...

Position Summary Department : Patient Accounting- Physicians Status: Full Time Shift: Remote Location: Orlando, FL Title: Physician Coding Auditor Summary: The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding. Forbes has named Orlando Health as one of America's Best-In-State Employers. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. "Orlando Health Is Your Best Place to Work" is not...

Join Our Caring Community Become a part of our caring community and help us put health first. The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS...

Job Profile Medical Coding Professional 2 Job Level Professional 2 Become a part of our caring community Become a part of our caring community and help us put health first The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on...

Job Description Job Description The Medical Billing Specialist plays a crucial role in healthcare financial operations by managing patient billing processes and ensuring accurate and timely reimbursement from insurance companies and patients. This role requires expertise in medical billing systems, coding accuracy, and strong communication skills to interact with healthcare providers and payers effectively. Responsibilities Process and review medical claims for accuracy and compliance with insurance requirements Submit claims to insurance companies and follow up on unpaid or denied claims Verify patient insurance coverage and eligibility Maintain accurate patient billing records and documentation Follow up on unpaid or denied claims through effective collection strategies. Assist in resolving billing inquiries from patients and insurance companies promptly and professionally. Collaborate with healthcare providers to ensure correct coding and billing...

Outpatient Coder 3 The University of Miami/UHealth Department Health Information Management has an exciting opportunity for a full-time Outpatient Coder 3 to work in Miami, FL. Under the general direction of the Outpatient Coding Manager, the Outpatient Coder 3 reviews documentation in the electronic medical record (EMR) and assigns and sequences ICD-10-CM diagnosis codes and CPT procedure codes in accordance with national coding guidelines. The primary focus of this role is to capture all encounter specific diagnoses and procedure codes for accurate reimbursement, data collection, and research purposes. Core Job Functions Review, analyze, and interpret the entire electronic medical record (EMR) to identify all diagnoses and procedures documented during a patient's admission. Guidelines and knowledge of anatomy and physiology, medical terminology, and disease processes. Reviews documentation and reaches out to physicians for additional information when information for proper...

Medical Coding Professional 2 The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS leaders and champions to identify STARS gaps and deficiencies....

MRA Coder The MRA Coder will be responsible for coordinating/supporting retrospective and concurrent chart reviews using knowledge of Hierarchical Condition Categories (HCC) coding to translate, input, extract and validate medical record data. Review patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries in order to verify whether the diagnosis codes are supported by the documentation to ensure they are within Guidelines for Coding and Reporting Schedule chart reviews with Physician practices Assist in obtaining medical records from Physicians to support audits requested by Health Plans Ensure compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment. Educate Physicians regarding proper billing and documentation policies, procedures, and conflicting/ambiguous or...

Job Description Job Description Benefits: 401(k) matching Competitive salary Dental insurance Health insurance Paid time off About Us We are a fast-growing, innovative medical billing company committed to transforming the healthcare revenue cycle through technology, transparency, and top-tier customer service. Our team is passionate about simplifying the complexities of medical billing so healthcare providers can focus on what matters most—patient care. We're seeking a highly motivated and experienced Charge Posting (Coder) Supervisor to join our leadership team and help us continue delivering exceptional results to our clients across the country. Job Overview As the Medical Coder Supervisor, you will lead group of certified coders to accurately review and approval encounters using industry coding guidelines, optimize workflow efficiency, and oversee a high-performing medical coding team. You'll be responsible for the training, on-going development, quality...

Become a part of our caring community Become a part of our caring community and help us put health first The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while...

Medical Coding Professional 2 The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS leaders and champions to identify STARS gaps and deficiencies....

Job Description Job Description Description: POSITION SUMMARY: Reporting to the VP of Compliance, the Compliance Auditor is responsible for ongoing analysis and review of coding accuracy, medical necessity documentation, and regulatory compliance in patient records. ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES: Conduct compliance focused monitoring and audits related to coding accuracy, medical necessity, supporting documentation and other operational functions. Conducts ad hoc reviews and audits based on high risk, problem prone, or otherwise specified areas. Maintains tools, reports, data, metrics, benchmarking, tracking, and trending patient and compliance data. Participates in various committees to address risks and opportunities for improvement, to report on compliance data, and collaborate in process improvement initiatives. Provide reports to management on compliance metrics and audit findings as requested. Requirements: EDUCATION AND QUALIFICATIONS: RN or...

PRIMARY FUNCTION The Professional Fee Coding Auditor is responsible for conducting comprehensive coding audits (prospective and retrospective), ensuring documentation and coding compliance, identifying revenue integrity opportunities, and providing feedback to providers and clinical staff. This role serves as a key partner to physicians, advanced practice providers, operational leaders, and revenue cycle teams to promote accurate coding, documentation integrity, regulatory compliance, and reimbursement optimization. This role ensures compliance with applicable coding guidelines and/or payer requirements as well as regulatory standards while supporting revenue cycle integrity through education and process improvement. In addition to audit and education responsibilities, this position maintains coding proficiency by performing production coding activities as needed to support business operations, staffing coverage, backlogs, special projects, and organizational priorities....

Medical Coder Educator - USFTGP Revenue Cycle Operations Serves as the coding reviewer and documentation educator for USFTGP Revenue Cycle Operations. Collaborate extensively with compliance; utilizing approved coding industry tools and approved internal documentation. This position is responsible for providing coding literacy and awareness using adult methodologies to revenue cycle, coding professionals, department managers, medical staff and others, ensuring proficiency is accurate and within compliant coding practices for billing. Analyze and report review findings indicating documentation gaps reimbursement and data internation, inpatient, outpatient and professional service coded. Report to compliance focused areas of improvements, recommendations and actions taken to improve medical staff knowledge and coding accuracy. Conduct individual and group coding and documentation support instructions as assigned and acts as an internal coding expert resource. Qualifications...

Miami, FL | Full-Time Health Information Management Department: Health Information Management Address: 1611 NW 12 Ave, Miami, FL 33136 Shift Details: Monday to Friday, 7.30 AM to 4 PM [Remote but open to applicants who reside in the state of Florida] Summary HIM Outpatient Coder 1 is responsible for coding and abstracting outpatient medical records, including Emergency Room visits, Clinic visits and Recurrent visits. The Coder 1 is responsible for reviewing the clinical documentation contained in the patient health record to accurately assign and sequence ICD-9 and CPT codes for use in reimbursement and data collection. Able to transition to ICD-10-CM. Responsibilities Codes outpatient diagnostics/outpatient clinics/recurring visits/emergency room visits using ICD-9 or CPT codes as appropriate. Maintains a yearly average accuracy rate of 94% during internal and/or external Coding audits. Verifies patient information to identify any discrepancies...

Risk Adjustment Coder It's rewarding to be on a team of people that truly believe in making an impact! We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us. Job Summary The Risk Adjustment coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations. Duties & Responsibilities Review medical record information to identify all appropriate coding based on CMS HCC categories Prepare the medical charts and track patient information via Excel spreadsheets. Complete appropriate...