39 medical coding auditor jobs found

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Become a part of our caring community Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Outpatient Behavioral Health Coding disputes and is part of the PPI Coding Disputes Team with Humana. The Outpatient Behavioral Health Coding Auditor on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient Behavioral Health coding disputes and expertise in CPT/HCPCS code...

Lakeshore Talent is seeking a Code Review Specialist – Medical Coding Methodology & Litigation Support in Greenwood Village, CO. This role combines medical coding review with methodology development and training support, with some Wednesdays remote. You will organize records, validate CPT/HCPCS codes, and review professional, facility, and anesthesia components, collaborating with attorneys and Case Managers to improve accuracy for litigation support. #J-18808-Ljbffr

Baylor Scott & White Health is seeking a DRC Coding Auditor to join the Denial Resource Center. You will review and appeal complex coding denials across Hospital and Professional Billing, ensuring documentation supports billed services and reported diagnoses. The role requires advanced coding knowledge, CMS/payer policy understanding, and collaboration with RNs, coders, and revenue cycle teams to improve coding accuracy and reduce denials. #J-18808-Ljbffr

This is a remote based position. Applicants can be located nationwide Outpatient Coding Auditor #2972 United States Remote/Nationwide Position Description About You You are a person who enjoys ensuring coding accuracy and solving documentation and compliance challenges. We need someone who demonstrates skills in organization, prioritization, professionalism, and coaching others. In the role of Outpatient Coding Auditor, you will be responsible for quality reviews and audits and coordinating with department managers to ensure standards are met in accordance with department and organization policies. Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM), Procedural Coding System (PCS), Current Procedural Terminology (CPT-4 and Healthcare Common Procedure Coding System...

Job Summary and Responsibilities As our Revenue Cycle Coder Lead-Inpatient Coding, you will be a cornerstone of our medical coding department, providing essential leadership and strategic direction for our inpatient coding team. You will be instrumental in driving coding accuracy, ensuring regulatory compliance, and optimizing revenue cycle performance for complex medical cases, making a direct impact on our healthcare data integrity and financial health. Every day you will provide expert technical guidance, conduct comprehensive quality oversight, and perform complex coding audits. You will actively collaborate with clinical and revenue cycle teams to enhance documentation and streamline processes. A significant part of your role involves mentoring, training, and fostering the professional growth of coding staff, ensuring adherence to the highest coding standards and best practices. To be successful in this role, you will possess advanced inpatient coding credentials...

Coding Auditor & EducatorInspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.The posted compensation range of $35.70 - $58.91 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.Job Summary and ResponsibilitiesAs our Coding Auditor & Educator, you will utilize advanced ICD-10-CM, ICD-10-PCS, and CPT-4 coding systems to support the...

Coding Auditor And Educator Professional FeeInspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.The posted compensation range of $34.00 - $56.10 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law. Job Summary and Responsibilities As our Coding Auditor and Educator Professional Fee, you will utilize ICD-10-CM, HCPCS, and CPT-4 classification...

Lakeshore Talent is in search of a Code Review Specialist – Medical Coding Methodology & Litigation SupportGreenwood Village, CO (Denver Tech Center)Schedule:Monday–Friday, with Wednesdays remote and the remaining days in the officeLakeshore Talent is in search of a detail-oriented Medical Coding Review Organize medical records and billing documentation into a clear, logical structure that supports efficient and thorough review. Compare captured billing information against medical records to validate CPT and HCPCS procedure codes and modifiers, making corrections when supported by the documentation. Evaluate procedures across applicable billing components, including professional services, facility charges, anesthesia, and other related services. Apply established coding review methodologies consistently and document the rationale behind decisions to ensure transparency and reproducibility. Manage multiple cases and review assignments while meeting established deadlines and...

Lakeshore Talent is in search of a Code Review Specialist – Medical Coding Methodology & Litigation Support Location: Greenwood Village, CO (Denver Tech Center) Position Type: Direct Hire Salary: $75,000–$85,000 annually Schedule: Monday–Friday, with Wednesdays remote and the remaining days in the office Start Time: 7:00 AM or 8:00 AM Position Overview Lakeshore Talent is in search of a detail-oriented Code Review Specialist to join a growing team specializing in medical coding methodology, billing review, and litigation support. This role is ideal for an experienced medical coding professional who enjoys analytical work, takes pride in accuracy, and is interested in improving processes rather than simply following established procedures. Beyond day-to-day code review, you will play an important role in refining coding methodologies, improving workflows, developing training resources, and establishing clear guidelines that help the team work more efficiently. You will also...

Job Summary and Responsibilities As our Coding Auditor and Educator Professional Fee, you will utilize ICD-10-CM, HCPCS, and CPT-4 classification systems to support the professional fee coding team. You will serve as a key resource for coding and billing inquiries while facilitating the standardization of coding practices across the organization. Every day, you will perform internal audits and provide necessary follow-up education to ensure accuracy and compliance. You will also monitor evolving regulatory changes, effectively communicating these updates to ensure timely and precise implementation within the PB coding teams. In this role, you will be responsible for the onboarding and training of new staff, as well as the development and deployment of ongoing educational programs. Working in conjunction with leadership, you will participate in both short-term and long-term strategic planning to maintain excellence in compliant coding and regulatory billing practices....

Lakeshore Talent is in search of a Code Review Specialist – Medical Coding Methodology & Litigation Support Greenwood Village, CO (Denver Tech Center) Schedule: Monday–Friday, with Wednesdays remote and the remaining days in the office Lakeshore Talent is in search of a detail-oriented Code Review Specialist to join a growing team specializing in medical coding methodology, billing review, and litigation support. This role is ideal for an experienced medical coding professional who enjoys analytical work, takes pride in accuracy, and is interested in improving processes rather than simply following established procedures. In this position, you will review medical records and billing documentation, validate CPT and HCPCS procedure codes and modifiers, and ensure that coding decisions are accurate, consistent, and well-documented. Your work will support the development of transparent, defensible medical damage valuations used in litigation-related cases. Beyond day-to-day code...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level. Job...

Coding Auditor & EducatorThe Coding Auditor-Educator is an advanced level position utilizing ICD-10-CM, ICD-10 PCS, and CPT-4 Coding Classification systems who supports the facility and Coding Service Center. Responsible for answering coding and billing questions, onboarding and training new staff, performing coding audits, and development and deployment of coding education. Works in conjunction with the Coding Service Center leadership team in planning and performing coding education and training across the system. Responsible for performing internal audits and follow up education. Facilitates and promotes standardization of coding practices, monitors and communicates regulatory coding and billing changes for timely and accurate implementation. Participates in short-term and long-term strategic planning with regard to compliant coding and regulatory billing practices.Along with CO, KS and NM, this position is open to remote/out of state candidates residing in only these...

Clinical Risk Adjustment Coder Alpine Physician Partners partners with independent physician groups to deliver coordinated, value-based care that improves outcomes and lowers the total cost of care. Our clinical and coding teams support providers with the accurate, compliant documentation and coding practices that make value-based care possible. The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding guidelines. Review medical records, encounter notes, and provider documentation to identify and validate diagnosis codes relevant to HCC and other risk adjustment models. Conduct in-home or virtual health assessments with patients, evaluating and...

Clinical Risk Adjustment Coder Alpine Physician Partners partners with independent physician groups to deliver coordinated, value-based care that improves outcomes and lowers the total cost of care. Our clinical and coding teams support providers with the accurate, compliant documentation and coding practices that make value-based care possible. The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding guidelines. Review medical records, encounter notes, and provider documentation to identify and validate diagnosis codes relevant to HCC and other risk adjustment models. Conduct in-home or virtual health assessments with patients, evaluating...

Join Care Synergy and be part of a mission-driven organization dedicated to elevating care, advancing wellness, and strengthening the communities we serve. Our collaborative, supportive team works across hospice, palliative care, PACE, CAPABLE, and community-based wellness services to advance excellence for patients, participants, families, and those who care for them—all while offering excellent benefits and meaningful opportunities to grow and make an impact. Care Synergy is looking for a Senior Medical Coding Specialist . LOCATION: Denver, CO STATUS: Full-time SCHEDULE: Monday-Friday; 8am-5pm PAY RANGE: $71,489 - $83,990 SUPPLEMENTAL PAY: Based on position, schedule and/or availability: Paid Mileage/Shift Differentials/Stipends/Overtime CULTURE, BENEFITS AND PERKS: We value engagement, community, and outreach initiatives and know it matters for our team members and our patients. We provide welcoming and supportive care to our patients and a...

Clinical Risk Adjustment Coder Alpine Physician Partners partners with independent physician groups to deliver coordinated, value-based care that improves outcomes and lowers the total cost of care. Our clinical and coding teams support providers with the accurate, compliant documentation and coding practices that make value-based care possible. The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding guidelines. Review medical records, encounter notes, and provider documentation to identify and validate diagnosis codes relevant to HCC and other risk adjustment models. Conduct in-home or virtual health assessments with patients, evaluating...

Job Description Job Description Description: At AMPLIFII, we support Federally Qualified Health Centers who provide comprehensive services—including primary care, dental, pharmacy, behavioral health, health education, and outreach. General Purpose: This position is responsible for understanding the billing requirements for all payors and programs. Essential Duties and Responsibilities: Responsible for understanding the billing requirements for all payers Enters and approves data into the Management Information system according to appropriate guidelines to ensure that the accounts receivable is accurate. Analyzes provider documentation to assure the appropriate Evaluation & Management coding levels are assigned the correct CPT or CDT code Provides expertise to the billing staff in addressing appeals for denials for incorrect diagnoses for services performed. Completes audits of provider encounters to ensure compliance and maximize reimbursement. Serves as coding...

Clinical Risk Adjustment Coder Alpine Physician Partners partners with independent physician groups to deliver coordinated, value-based care that improves outcomes and lowers the total cost of care. Our clinical and coding teams support providers with the accurate, compliant documentation and coding practices that make value-based care possible. The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding guidelines. Review medical records, encounter notes, and provider documentation to identify and validate diagnosis codes relevant to HCC and other risk adjustment models. Conduct in-home or virtual health assessments with patients, evaluating and...

Overview Apex Service Partners - We are not just another HVAC service provider - we're a team of passionate professionals dedicated to delivering exceptional service to our valued customers. We're passionate about people, collaborative in our approach, and believe in staying scrappy while having fun. Here, you'll find a work environment that feels like family, where every team member is valued and empowered to succeed. We are seeking a motivated and detail-oriented Accounts Payable Coder to join our growing Accounting/Finance team. This individual will play a key role in supporting the Accounts Payable Manager while contributing to the continued development of a scalable, efficient, and best-in-class finance organization. This position offers an exciting opportunity to make a meaningful impact by driving process improvements, strengthening financial operations, and supporting the company's continued growth. The ideal candidate will demonstrate exceptional organizational and...

Job Summary and Responsibilities As our Outpatient Coder Lead, you will code and abstract outpatient records for data retrieval, analysis, reimbursement, and research, ensuring complete charge capture, and providing expert guidance to coding and hospital staff. Every day you will direct Outpatient Coding Service Center operations including personnel management, training, education, productivity, work assignments, and quality reviews. You will assist with coding education, audits, denials, claim edits, and CHA data submissions, promoting standardization and managing DNB and coding compliance to achieve financial goals and improve the accuracy and integrity of patient data. To be successful in this role, you will possess expert-level outpatient coding proficiency, strong leadership and management skills, a deep understanding of coding regulations and reimbursement methodologies, and the ability to drive accuracy, quality, and standardization across coding operations, while...

Care Synergy is seeking a Senior Medical Coding Specialist to translate clinical documentation into precise ICD-10-CM codes across Hospice, Palliative Care, and PACE services. You will work with physicians, HIM, and Revenue Cycle teams to improve accuracy and reimbursement. The role emphasizes CMS/payer compliance, documentation quality improvements, and participation in audits, within a Colorado Front Range nonprofit setting committed to high-quality care. #J-18808-Ljbffr