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868 internal coding auditor jobs found

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El Camino Health
Full Time
 
HIM Professional Billing Coding Manager (Hybrid)
El Camino Health Hybrid (Mountain View, CA)
Lead Coding. Drive Revenue Integrity. Shape Provider Performance.  El Camino Health is seeking a highly experienced HIM Professional Billing Coding Manager to lead coding operations across its medical network. This is a critical leadership role directly tied to revenue cycle performance, compliance, and provider documentation excellence. If you bring deep expertise in professional billing (PB) coding, auditing, and provider education , this is your opportunity to make a meaningful impact within a respected, nonprofit health system. About El Camino Health El Camino Health is an integrated, nonprofit health system known for delivering high-quality, patient-centered care across its communities. With a strong commitment to innovation, compliance, and clinical excellence, the organization plays a vital role in driving healthcare outcomes and access across the region. This position is onsite in Mountain View, CA 2 days a week, with 3 days available for remote work....

May 19, 2026
C2Q Health Solutions
Full Time
 
Medical Coding and Billing Analyst
C2Q Health Solutions Hybrid (NY)
JOB PURPOSE: Responsible for supervising, evaluating, and consistently improving the day-to-day operations of Medical Practice. This role is responsible for accurate and timely billing of insurance claims and patient statements across multiple sites, implements accurate medical coding policies, and enhances operational processes. It involves acting as a liaison between coding operations and clinical staff, training and coaching medical personnel on coding guidelines, and ensuring the accuracy and timeliness of clinical documentation. Additionally, the role includes analyzing and optimizing diagnosis data submission processes, presenting performance results to leadership, and supporting HCC/RAF optimization strategies. The role will also oversee the training of Medical Practice Assistants, Physician and IDT disciplines in ICD-9/ICD-10 guidelines. JOB RESPONSIBILITIES: Responsible to deliver accurate and timely billing of insurance claims and patient statements for all...

Apr 15, 2026
MedKoder
Full Time
 
Physician Coding Auditor
MedKoder Remote
About Us MedKoder, LLC is a full-service medical coding management services provider based in Mandeville, Louisiana, specializing in expert medical coding for health systems, providers, and payers. MedKoder delivers accurate, efficient, and ethical coding, aiming to ensure accurate payment and financial peace for clients. With a team of certified coders throughout the United States, MedKoder emphasizes coding excellence, remote-work flexibility, and a positive workplace culture, earning high employee satisfaction ratings and awards with Best Places to Work in Modern Healthcare and City Business Best Places to Work.   Position Location: 100% Remote This is a full-time, remote position that offers a flexible schedule.  Description: Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable...

Mar 27, 2026
Gainwell Technologies
Full Time
 
Clinical DRG Auditor – Remote
Gainwell Technologies Remote (United States)
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...

Mar 10, 2026
TJ
Compliance Auditor - Billing
Thomas Jefferson University PA
Position Overview Compliance Auditor – monitors and improves the quality of clinical and financial documentation related to the provision of patient services. Under general supervision, the Compliance Auditor compares clinical and financial records to ensure documentation supports patient charges, codifies findings, and assists in reporting, monitoring, and education. Responsibilities Performs audits of clinical documentation of physician, technical or specialty (e.g., Home Health, Hospice, Inpatient Rehab) billing and payment records and applicable industry standard billing codes by analyzing medical records, coding records and health system bills, validating clinical documentation in conjunction with the bill; assessing the level and accuracy of coding; determining that governmental and third‑party payer regulations are being complied with; and evaluating appropriateness of billing and coding procedures. Evaluates accuracy of coding and billing performance by individuals,...

Jun 03, 2026
MU
Compliance Auditor
Medical University of South Carolina Lima, NY
Job Summary The Compliance Auditor reports to the Internal Audit Coordinator and performs audits to evaluate adherence to laws, regulations and policies by reviewing records, analyzing data, and interviewing staff and stakeholders. These audits include high‑risk services identified via the annual risk assessment, OIG‑CMS‑PGBA workplan areas, ad hoc audit requests, and “for cause” coding and billing concerns. The audit scope covers regulatory and industry research for audit planning, pre‑and post‑audit meetings with stakeholders, a cohesive audit report communicating results with a corrective action plan if warranted, and education and training to stakeholders as needed. Education & Qualifications Bachelor’s degree in a related field and a minimum of 2 years of medical billing, coding, or audit experience; or a high school diploma or equivalent (GED) and 4 years of medical billing, coding, or audit experience. A college degree is preferred. The applicant must be credentialed...

Jun 03, 2026
EH
DRG Validation Coding Auditor
Ensemble Health Partners Blue Ash, OH
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 experimentation.Striving for...

Jun 03, 2026
HI
Medical Coding Auditor Evaluation & Management
Humana Inc United States
Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry‑standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana’s internal standards. WORK STYLE Remote / Work at home WORK HOURS Associates will work on EST, regardless of where the associate resides. All associates must start between 6 AM‑9 AM EST, Monday‑Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Responsibilities Conduct comprehensive...

Jun 03, 2026
HI
Inpatient Medical Coding Auditor
Humana Inc United States
Become a part of our caring community and help us put health first 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. 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...

Jun 03, 2026
HI
Medical Coding Auditor Evaluation & Management
Humana Inc Concord, NH
Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry‑standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana’s internal standards. WORK STYLE Remote / Work at home WORK HOURS Associates will work on EST, regardless of where the associate resides. All associates must start between 6 AM‑9 AM EST, Monday‑Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Responsibilities Conduct comprehensive...

Jun 03, 2026
HI
Medical Coding Auditor Evaluation & Management
Humana Inc Helena, MT
Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry‑standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana’s internal standards. WORK STYLE Remote / Work at home WORK HOURS Associates will work on EST, regardless of where the associate resides. All associates must start between 6 AM‑9 AM EST, Monday‑Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Responsibilities Conduct comprehensive...

Jun 03, 2026
CU
Compliance Auditor Prof Svcs - Remote
Cooper University Health Care. NJ
About UsAt Cooper University Health Care , our commitment to providing extraordinary health care begins with our team.Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols.We have a commitment to our employees to provide competitive rates and compensation programs.Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement.We also provide attractive working conditions and opportunities for career growth through professional development.Discover why Cooper University Health Care is the employer of choice in South Jersey.Short DescriptionThe auditor reviews professional fee billing, coding and documentation.Reviews to be performed are identified based on the then-current OIG Workplan and compliance risk analyses.Customers include employed providers, senior leadership,...

Jun 03, 2026
HI
Remote E/M Coding Auditor — Elevate Compliance & Revenue
Humana Inc Montgomery, AL
Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry‑standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana’s internal standards. WORK STYLE Remote / Work at home WORK HOURS Associates will work on EST, regardless of where the associate resides. All associates must start between 6 AM‑9 AM EST, Monday‑Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Responsibilities Conduct comprehensive...

Jun 03, 2026
HI
Medical Coding Auditor Evaluation & Management
Humana Inc Jackson, MS
Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry‑standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana’s internal standards. WORK STYLE Remote / Work at home WORK HOURS Associates will work on EST, regardless of where the associate resides. All associates must start between 6 AM‑9 AM EST, Monday‑Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Responsibilities Conduct comprehensive...

Jun 03, 2026
HI
Medical Coding Auditor Evaluation & Management
Humana Inc Dover, DE
Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry‑standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana’s internal standards. WORK STYLE Remote / Work at home WORK HOURS Associates will work on EST, regardless of where the associate resides. All associates must start between 6 AM‑9 AM EST, Monday‑Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Responsibilities Conduct comprehensive...

Jun 03, 2026
HI
Medical Coding Auditor Evaluation & Management
Humana Inc Charleston, WV
Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry‑standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana’s internal standards. WORK STYLE Remote / Work at home WORK HOURS Associates will work on EST, regardless of where the associate resides. All associates must start between 6 AM‑9 AM EST, Monday‑Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Responsibilities Conduct comprehensive...

Jun 03, 2026
TM
Professional Coding Auditor and Educator - Remote
Tufts Medicine PA
Professional Coding Auditor And Educator - Remote This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing.In addition, this role focuses on performing the following Health Information Management duties:Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information.An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a hands on environment.The majority of time is spent in the delivery of support services or activities, typically under supervision.An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education.Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation or...

Jun 03, 2026
HI
Medical Coding Auditor Evaluation & Management
Humana Inc Lansing, MI
Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry‑standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana’s internal standards. WORK STYLE Remote / Work at home WORK HOURS Associates will work on EST, regardless of where the associate resides. All associates must start between 6 AM‑9 AM EST, Monday‑Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Responsibilities Conduct comprehensive...

Jun 03, 2026
HI
Medical Coding Auditor Evaluation & Management
Humana Inc Topeka, KS
Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry‑standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana’s internal standards. WORK STYLE Remote / Work at home WORK HOURS Associates will work on EST, regardless of where the associate resides. All associates must start between 6 AM‑9 AM EST, Monday‑Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Responsibilities Conduct comprehensive...

Jun 03, 2026
SH
Remote Compliance Coding Auditor - CPC/CCS, Multi-Specialty
Sentara Healthcare Inc Norfolk, VA
Compliance Coding Auditor Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year. All queries arising from the audit process are...

Jun 03, 2026
1S
Billing Compliance Auditor (CPC)
10 Sarah Bush Lincoln Health Center Springfield, IL
10 Sarah Bush Lincoln Health Center is seeking an Internal Auditor to oversee auditing coding and billing accuracy. This role involves coordinating with clinical and administrative staff to enhance documentation practices and mitigate denials. Key qualifications include a High School Diploma and Certified Professional Coder (CPC) certification. The position offers a dynamic environment and a compensation range of $26.35 - $40.84 per hour, commensurate with experience. #J-18808-Ljbffr

Jun 03, 2026
SH
Remote Compliance Coding Auditor & Education
Sentara Health Plans Norfolk, VA
Compliance Coding Auditor page is loaded## Compliance Coding Auditorremote type: Remotelocations: Norfolk, VAtime type: Full timeposted on: Posted 2 Days Agojob requisition id: JR-99531**City/State**Norfolk, VA**Work Shift**First (Days)**Overview:**# Compliance Coding AuditorPerforms a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines.Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology,...

Jun 03, 2026
HI
Remote E/M Coding Auditor — Elevate Compliance & Revenue
Humana Inc Springfield, IL
Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry‑standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana’s internal standards. WORK STYLE Remote / Work at home WORK HOURS Associates will work on EST, regardless of where the associate resides. All associates must start between 6 AM‑9 AM EST, Monday‑Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Responsibilities Conduct comprehensive...

Jun 03, 2026
HI
Medical Coding Auditor Evaluation & Management
Humana Inc Olympia, WA
Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry‑standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana’s internal standards. WORK STYLE Remote / Work at home WORK HOURS Associates will work on EST, regardless of where the associate resides. All associates must start between 6 AM‑9 AM EST, Monday‑Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Responsibilities Conduct comprehensive...

Jun 03, 2026
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