37 medical coding auditor jobs found

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a 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 works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Compliance Auditor & Billing Analyst Oncology McKesson is an impact?driven, Fortune 10 company that touches virtually every aspect of healthcare. We focus on the health, happiness, and well?being of you and those we serve we care. Title: Compliance Auditor & Billing Analyst Oncology Hub Locations : Atlanta, GA; Columbus, OH; Dallas, TX (Preferred) Onsite/Remote/Hybrid: REMOTE position Certification : Active CPC/COC/or ROCC certification (REQUIRED) Industry Experience : Healthcare background (REQUIRED) Experience : 4+ years healthcare coding experience using CPT, ICD?10?CM, HCPCS, and E/M (REQUIRED) Position Description Under minimal supervision, the Health Care Coding & Billing Analyst performs data?driven coding and billing reviews, validates reimbursement accuracy, and assesses compliance with federal and state regulatory requirements. The analyst supports Network practices through audit activities, data interpretation, coding...

Sr. Compliance Auditor Be inspired. Be rewarded. Belong. At Emory Healthcare, we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more Reporting to the Director, the Sr. Compliance Auditor develops and executes audit, monitoring, and education for both facility and professional billing, coding and documentation programs that ensure compliance with regulatory standards across Physician Services. Continuously evaluates facility/professional billing compliance activities to assess compliance with the Compliance Audit and Analysis Program Work...

Program Integrity Coder- FWA Auditor Evolent partners with health plans and providers to achieve better outcomes for people with 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 the...

Professional Coding Auditor/Consultant PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA's Revenue Integrity team in a professional coding auditor role. Responsibilities: Responsible for the accurate review of PYA clients' professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education (generally, conducted remotely). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength in E/M and surgical coding, preferably including...

Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programsand more! We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. Reviews discrepancies between the Clinical Documentation Specialist (CDS) DRG and...

Compliance Auditor & Billing Data Analyst - Oncologyhub McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. Title: Compliance Auditor & Billing Data Analyst - Oncologyhub Locations: Atlanta, GA; Columbus, OH; Dallas, TX (Preferred) Onsite/Remote/Hybrid: Remote Position Position Description: Under minimal supervision, the Health Care Coding & Billing Data Analyst is responsible for performing data-driven coding and...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more Work Location: Atlanta, GA Description The Senior Compliance Auditor - Healthcare Provider provides expert leadership in evaluating and strengthening the organization's compliance program across clinical, billing, privacy, and operational domains. This role leads complex, risk-based compliance audits to ensure adherence to federal and state healthcare...

Job Type Full-time Description Seeking a detail-oriented and knowledgeable Provider/Coding Auditor Educator to support accurate and compliant coding practices across our provider network. This role will be responsible for performing audits of medical documentation and coding, educating providers on best practices, and ensuring adherence to industry guidelines and payer regulations. The ideal candidate is a certified coding professional with strong communication skills and a passion for education and compliance. This role requires flexibility to travel 50% of the time to various provider locations in the State of Georgia for onsite education and auditing support, as needed Requirements Key Responsibilities Conduct prospective, concurrent, and retrospective coding audits for professional and/or facility services. Review medical documentation to ensure codes assigned (ICD-10-CM, CPT, HCPCS) are supported and meet regulatory and payer guidelines. Deliver coding and...

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...

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. Title: Compliance Auditor& Billing Analyst - Oncology Hub Locations : Atlanta, GA; Columbus, OH; Dallas, TX (Preferred) Onsite/Remote/Hybrid: REMOTE position Certification : Active CPC/COC/or ROCC certification (REQUIRED) Industry Experience : Healthcare background (REQUIRED) Experience : 4+ years healthcare coding experience using CPT, ICD10CM,...

Description WHAT IT'S LIKE AT SGMC HEALTH Purpose . No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place. Excellence . We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service. Team Spirit. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. Award Winning Performance. We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides. WHY YOU WILL LOVE SGMC HEALTH SGMC has great benefit options, depending on the role that you are going into- including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities...

Lead Medical Coder - FT - Days - HPG Administration Hybrid HAMILTON PHYSICIAN GROUP - DALTON, GA 30722 Description Hours: 8AM - 5PM, Weekdays Job Summary Works under direct supervision of the Coding and Documentation Manager and follows written policies and procedures to perform the job duties. The coding lead will remain an active coder for the department when needed. The associate will complete required daily activity reporting as needed. The individual will maintain positive business relationships internally and externally to ensure effective and efficient coordination of services to promote individual and departmental goals. The associate ensures the accuracy and timeliness of all encounters coded, and provides support to team members on a regular basis. The individual resolves and advises medical coders on answers to routine questions and problems and refers more complex issues to higher levels. The associate assists the Coding and Documentation Manager in routine...

For over 29 years, Surgical Information Systems (SIS) has empowered surgical providers to Operate Smart™ by delivering innovative software and services that drive clinical, financial, and operational success. For ambulatory surgery centers (ASCs), SIS provides comprehensive software and services, including ASC management, electronic health records (EHRs), patient engagement capabilities, compliance technology, and revenue cycle management and transcription services, all built specifically for ASCs. For hospital perioperative teams, SIS offers an easy-to-use anesthesia information management system (AIMS). Serving over 2,700 surgical facilities, SIS is committed to delivering solutions that enable surgical providers to focus on what matters most: delivering exceptional patient care and outcomes. Recognized as the No. 1 ASC EHR vendor by Black Book for 10 consecutive years and honored with the Best in KLAS Award for ASC Solutions in 2025, 2023, and 2022, SIS remains the trusted...

Specialty Coder II - Anesthesia BayCare is currently in search of our newest team member who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area. Position details: Location: Remote (must reside in the state of Florida, Georgia, North Carolina, or South Carolina) Status: Full time (non-exempt) Shift: 8:00am - 4:30pm Days: Monday through Friday This Specialty Coder II opportunity is a full-time remote position. This team member must reside in the state of Florida, Georgia, North Carolina, or South Carolina. Sign on bonuses available! Responsibilities: The Specialty Coder II is a Certified Professional Coder who assigns diagnosis and procedural codes using ICD-10 CM and CPT-4 coding systems. The Specialty Coder audits physician documentation to assign appropriate CPT codes, diagnosis codes, and modifiers related to anesthesia...

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 for...

Coder For over 29 years, Surgical Information Systems (SIS) has empowered surgical providers to Operate Smart by delivering innovative software and services that drive clinical, financial, and operational success. For ambulatory surgery centers (ASCs), SIS provides comprehensive software and services, including ASC management, electronic health records (EHRs), patient engagement capabilities, compliance technology, and revenue cycle management and transcription services, all built specifically for ASCs. For hospital perioperative teams, SIS offers an easy-to-use anesthesia information management system (AIMS). Serving over 2,700 surgical facilities, SIS is committed to delivering solutions that enable surgical providers to focus on what matters most: delivering exceptional patient care and outcomes. Recognized as the No. 1 ASC EHR vendor by Black Book for 10 consecutive years and honored with the Best in KLAS Award for ASC Solutions in 2025, 2023, and 2022, SIS remains the...

Health Information Management (HIM) Coder The Staff Pad has partnered with Blue Ridge Medical Center in Blue Ridge, Georgia. Blue Ridge Medical Center is seeking an experienced Health Information Management (HIM) Coder to join our team in a fully remote capacity. This individual will be responsible for reviewing, analyzing, and assigning diagnostic and procedural codes for inpatient, outpatient, and/or emergency department medical records using ICD-10-CM, CPT, and HCPCS coding systems in accordance with official coding guidelines and facility standards. Key Responsibilities: Review and abstract clinical documentation from patient records to assign accurate codes for diagnoses and procedures Ensure compliance with federal regulations and hospital policies related to coding and billing Maintain productivity and quality standards established by the HIM department Query physicians when appropriate to ensure accurate and complete documentation Assist in resolving coding-related...

Job Description Job Description Description: The Certified Professional Coder (CPC) – Primary Care (with Risk Code Review) is responsible for accurate and compliant coding of professional services, verification of demographic and insurance information, and timely resolution of front-end claim edits prior to submission. This role also includes reviewing encounters for accuracy of risk-related diagnosis codes to ensure proper documentation support in compliance with payer and CMS guidelines. The coder supports Southeast Medical Group’s goals for revenue integrity, compliance, and operational efficiency through close collaboration with providers, front-end staff, and billing teams. Requirements: Essential Duties and Responsibilities Coding and Charge Review Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes for all primary care encounters, including preventive, chronic, and acute visits. Ensure all codes are supported by clinical documentation and...

Job Description Job Description Experienced Medical Biller (RCM2) – Full-Time Revenue Cycle Management Department Locations: Carrollton, Newnan, or Peachtree City, GA Work Setting: In-Office) About Our Practice West Georgia Dermatology, Newnan Dermatology, and Peachtree City Dermatology are physician-led, fast-growing dermatology practices serving communities across West Georgia. We provide comprehensive medical, surgical, and cosmetic dermatology services, including in-house Mohs surgery and dermatopathology. Our Revenue Cycle Management (RCM) team plays a vital role in the financial health of the practice and in supporting high-quality patient care. We value accountability, efficiency, teamwork, and continuous improvement. We are seeking an experienced Medical Biller who is confident working independently and ready to take ownership of assigned revenue cycle responsibilities. Position Overview The Experienced Medical Biller (RCM2) is responsible for managing assigned...

JOB SUMMARY: Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and compliance with the Official Coding Guidelines for Coding and Reporting, payer regulations, and hospital policy. Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure compliant coding and billing practices. Educates and trains coders to ensure both a working knowledge of coding and reimbursement guidelines and successful career ladder completion, including the development of training materials and reference documents. Researches audit results, error reports, and denials and resolves by successful appeal, staff education, and correction of discrepancies. GENERAL REQUIREMENTS: Adheres to the hospital and departmental attendance and punctuality guidelines Performs all...

Job Description Job Description Position Summary The Certified Medical Coder and Biller is responsible for accurate medical coding, charge capture, and timely billing of services provided within a Federally Qualified Health Center (FQHC). This role ensures compliance with federal, state, and payer-specific regulations, including HRSA, CMS, Medicare, Medicaid, and managed care requirements. The position plays a key role in maintaining revenue integrity while supporting the organization’s mission to provide high-quality, affordable care to underserved populations. Responsibilities and Duties Coding Responsibilities Assign accurate CPT, HCPCS, and ICD-10-CM codes in accordance with official coding guidelines and FQHC requirements Review clinical documentation to ensure coding accuracy, completeness, and medical necessity Apply appropriate modifiers, revenue codes, and PPS/encounter billing methodologies (e.g., T1015 where applicable) Identify documentation...