32 medical coding auditor jobs found

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...

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines Utilize encoders and various coding resources Perform CPT Procedure reviews...

About Optima Medical :Optima Medical is an Arizona-based medical group consisting of 30 locations and over 130medical providers, who care for more than 200,000 patients statewide.Our mission is to improve the quality of life throughout Arizona by helping communities Live Better, Live Longer through personalized healthcare, with a focus on preventing the nation's top leading causes of death.We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services.We aspire to aid the growth of our company by welcoming the most qualified and deserving candidates aboard.This position requires an initial 60-day training period at our corporate office in Scottsdale, Arizona.Upon successful completion of training, the position will transition to a fully remote role.Job Responsibilities :Audit Medical Records...

Quadris Team, LLC - A Revenue Cycle Management Group, is searching for a dynamic person to join us, working with our highly skilled Medical Coding Team to fill the role of Medical Coding Auditor & Educator.We are a 100% remote team supporting our clients across the United States! See us at.The ideal applicant will be a subject matter expert in both Facility and Profee medical coding auditing.Job Focus :The Senior Coding Auditor may be responsible for a variety of duties and obligations, depending on the client and assignment.These responsibilities may include inpatient / outpatient / professional fee facility auditing, denial management, coding, implementation specialist, job aid creation, training, and specialty coding.The position may also be responsible for management of the audit team and project management.All coding and auditing are performed within the scope of regulatory and compliance law expectations.Auditing Responsibilities :May include conducting inpatient,...

Job Description Job Description Overview The Coding Auditor & Provider Educator is a critical role responsible for ensuring the accuracy, completeness, and compliance of medical coding (CPT, HCPCS, ICD-10-CM) for professional services. This individual will conduct thorough coding audits, identify areas for improvement in documentation and coding practices, and develop and deliver targeted educational programs to physicians, advanced practice providers (APPs), and clinical staff. The primary goal is to optimize revenue integrity, mitigate compliance risks, and foster a culture of accurate and compliant documentation and coding. Responsibilities Coding Auditing & Compliance * Performs prospective and retrospective audits of professional fee coding (CPT, HCPCS, ICD-10-CM) across various medical and surgical specialties, including Evaluation and Management (E/M) services, procedures, and ancillary services. * Reviews medical record documentation to validate...

Physician Coding Auditor Ensemble Health Partners 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! The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW....

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

Certified Professional Coder Salary: $21.26 - $31.89 per hour, depending on qualifications Schedule: Monday through Friday, 8am to 5pm Job Purpose: The Certified Professional Coder coordinates and performs the implementation of concurrent coding and querying processes, as well as performing administrative and fiscal duties, tasks, and assignments in support of the Business Office Department and its varied operations. A Certified Professional Coder is responsible for the translation of healthcare providers' diagnostic and procedural phrases into coded form, as well as the review and interpretation of health record documentation to ensure accurate coding services are rendered and submitted. A Certified Professional Coder ensures that all technical aspects of the assignment of diagnostic and procedural coding are carried out in accordance with established standards and comply with CMS, NCQA, third-party payers, and other regulatory agencies. The incumbent will support and assist...

Medical Coding Specialist Responsible for reviewing patient medical records and assigning accurate CPT, ICD-10, and HCPCS codes for services provided. Supports billing, compliance, and quality teams under general supervision. Essential Functions Review and code medical records using standard coding systems. Audit provider documentation for accuracy and completeness. Communicate with providers to clarify documentation. Assist with billing processes and generate reports. Support training and implementation of new systems. Maintain confidentiality and adhere to safety protocols. Performs related duties as assigned. Minimum Qualifications Education: High school diploma or GED required; additional training in medical terminology or office administration preferred. Experience: Two (2) years of medical coding experience, preferably with Professional Coder Level I experience. Licensure or Certification: CPC Certification or CPC-A Certification required. Knowledge,...

Datavant is a leading data platform company dedicated to health data exchange, with a vision that every healthcare decision is powered by accurate data at the right time. Our network is one of the largest and most diverse in the U.S., ensuring that data remains secure and accessible to enhance health decisions. Our clients include prominent life sciences firms, government agencies, and healthcare providers. Joining Datavant means becoming part of a high-performing, values-driven team that is committed to solving the intricate challenges of healthcare through technological innovations. Our diverse team members bring a rich array of professional, educational, and personal experiences to support our ambitious vision for the future of healthcare. Your Role: We are seeking credentialed inpatient coders who possess meticulous attention to detail and a solid understanding of medical terminology to join our dynamic team. This position offers the flexibility of fully remote work,...

Inpatient Coder Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The...

Risk Adjustment Coder Specialist Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from...

Abstractor/Coder The University of Chicago Physicians Group (UCPG) team is responsible for the overall management of clinical revenue for physician billing. This includes frontend revenue capture, working of edits and conducting audits for physician education. Ensuring the workflow of charge capture through invoice creation. UCPG is seeking an Abstractor/Coder to work with providers and staff on professional billing and compliance activities. Strong knowledge of evaluation and management coding guidelines and requirements is strongly preferred. This position is eligible for a flexible work arrangement. Responsibilities: Obtain appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses, and physician visits. Analyze denial and rejection reports, and appeal wherever appropriate. Submit charges in a timely manner. Work in collaboration with the Clinical Revenue Supervisor and others, provide guidance to faculty and staff on...

Surgery Him Coder Wickenburg Community Hospital is a beautiful and sophisticated rural-access hospital located in Wickenburg, Arizona. WCH is a 8-bed Emergency Department, 19-bed Acute department and many ancillary services. We also have 3 Primary Care Clinics. Here at WCH, we strive to maintain the highest standards of professionalism and care. Join us today and let us be part of your success story. We offer: Full Benefits PTO/Sick Leave Wellness Benefits Wickenburg Community Hospital is a non-profit organization and qualifies for the Public Service Loan Forgiveness (PSLF) program. General Description We are seeking a highly detail-oriented and experienced Surgery HIM Coder to join our Health Information Management team. This position is responsible for reviewing, analyzing, and accurately assigning ICD-10-CM, CPT, and HCPCS codes for surgical procedures based on clinical documentation in the patient medical record. The Surgery Coder ensures coding compliance with...

Medix - 3003 North Central [Medical Records Clerk] As a Coder at Medix, you'll: Analyze medical records to assign appropriate codes for billing and insurance purposes; Ensure accuracy and compliance with coding guidelines and regulations; Collaborate with healthcare professionals to clarify diagnoses and procedures; Maintain confidentiality of patient information; Update coding knowledge through continuous education and training; Assist in audits and reviews to improve coding processes and accuracy...Hiring Immediately >>

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

Job Description Job Description Benefits/Perks Competitive Compensation Great Work Environment Career Advancement Opportunities Position Summary The Medical Biller is responsible for managing the full revenue cycle for a small, fastpaced family practice. This role ensures accurate claim submission, timely payment posting, denial management, and patient billing. The ideal candidate is detailoriented, reliable, and able to work independently while maintaining strict compliance with payer rules and practice policies. Key Responsibilities Claims & Billing Prepare, review, and submit clean claims to insurance carriers (electronic and paper). Verify coding accuracy and ensure all required documentation is present before submission. Correct and resubmit rejected or denied claims promptly. Maintain uptodate knowledge of CPT, ICD10, and payerspecific billing guidelines. Payment Posting & Reconciliation Post insurance and patient payments accurately into the practice...

Professional Coder I - TMCOne - Revenue Cycle Job Category Clerical Schedule Full time Shift 1 - Day Shift SUMMARY : Responsible for reviewing patient medical records and assigning accurate CPT, ICD-10, and HCPCS codes for services provided. Supports billing, compliance, and quality teams under general supervision. ESSENTIAL FUNCTIONS : Review and code medical records using standard coding systems. Audit provider documentation for accuracy and completeness. Communicate with providers to clarify documentation. Assist with billing processes and generate reports. Support training and implementation of new systems. Maintain confidentiality and adhere to safety protocols. Preforms related duties as assigned. MINIMUM QUALIFICATIONS EDUCATION: High school diploma or GED required; additional training in medical terminology or office administration preferred. EXPERIENCE : Two (2) years of medical coding experience, preferably with Professional Coder...

Medical Coder Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting. We are seeking an experienced Medical Coder to join our healthcare consulting practice. The role is fully remote within the US, with infrequent travel to client locations for onboarding and training. We are proud of our national presence, and excited to offer great career opportunities within the organization. What you'll do: Accurately assign ICD-10 CM, E/M, ICD-10 PCS, CPT, HCPCS, modifiers and units based on documentation. Adhere to systems and standards required in multi-specialty medical coding encounters, including Outpatient, Emergency Room, Surgery, Inpatient facilities, Inpatient Professional Rounds, and others. Process encounters within required SLA on contract with deficiencies identified escalated as necessary. Review and respond to each audit within...

Medical Coder Trajectory RCS joined the MedHQ family in 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing healthcare cash flow through integration of both business office processes and clinical documentation. MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and above all excellent...

Salary: $21.26 - $31.89 per hour, depending on qualifications Schedule: Monday through Friday, 8am to 5pm JOB PURPOSE : The Certified Professional Coder coordinates and performs the implementation of concurrent coding and querying processes, as well as performing administrative and fiscal duties, tasks, and assignments in support of the Business Office Department and its varied operations. A Certified Professional Coder is responsible for the translation of healthcare providers' diagnostic and procedural phrases into coded form, as well as the review and interpretation of health record documentation to ensure accurate coding services are rendered and submitted. A Certified Professional Coder ensures that all technical aspects of the assignment of diagnostic and procedural coding are carried out in accordance with established standards and comply with CMS, NCQA, third-party payers, and other regulatory agencies. The incumbent will support and assist in the training and...

Job Description: The HIM Hospital Inpatient & Same Day Surgery Coding Analyst deciphers and interprets provider documentation in the health record and assigns diagnostic information using ICD-10-CM/PCS and CPT codes for a complex range of acute care services for Intermountain Health. The caregiver provides specific coding expertise in the various fields of NCCI edits, Drugs and Biologicals, Revenue Codes, Current Procedural Terminology (CPT) codes, ICD-10 & CPT codes, DRGs, anatomy and physiology, pharmacology. The analyst also performs audits, provides feedback, and advanced training to clinical teams and physicians on ICD-10 and CPT coding best practices. Essential Functions Reviews and analyzes inpatient medical records for completeness, accuracy, and compliance for Same Day Surgery, Observation and Inpatient acute services at Intermountain Health. Performs coding at an advanced level of complexity for inpatient hospitals including governmental and/or...

Join Datavant, a leading data platform company revolutionizing health data exchange. Our mission ensures that every healthcare decision is guided by the right data at the right time and in the right format. As the world's foremost health data network, our platform enables secure, accessible, and actionable data, empowering healthcare stakeholders including life sciences firms, government agencies, and care providers. By becoming part of Datavant's high-performing, values-driven team, you'll contribute to innovative technology solutions that address some of healthcare's most challenging issues. Our diverse team brings various professional, educational, and life experiences together to achieve our ambitious goals for the healthcare sector. What You'll Be Doing: Conduct audits of coded medical charts according to the client's guidelines as assigned by the quality supervisor. Navigate multiple client guidelines with ease. Maintain a 95% quality average at the...