33 outpatient coding auditor jobs found

Job Description Job Description Description: Sage Clinical RCM, LLC is seeking an experienced Outpatient Coding Auditor with a strong background in surgical coding. This role is responsible for auditing outpatient surgical encounters to ensure accurate code assignment, compliance with regulatory guidelines, and adherence to payer and client requirements. The ideal candidate has hands-on experience auditing complex outpatient surgical cases and providing clear, constructive feedback to coding staff. Key Responsibilities Perform audits of outpatient surgical encounters, including operative reports and related documentation Validate accurate assignment of CPT, ICD-10-CM, modifiers, and applicable APCs Ensure compliance with CMS, payer, and official coding guidelines Identify trends, risks, and educational opportunities based on audit findings Provide written audit feedback and coding education to support quality improvement Collaborate with coding leadership and...

Overview Baptist Health is the region’s largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 25 years, we’ve been named one of Fortune’s 100 Best Companies to Work For, and in the 2024-2025 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 45 high-performing honors. What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families...

Coding Auditor The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals. Responsibilities Reviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment Informs manager of any activities which do not meet federal or state coding and billing requirements Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and responds...

Medical Record Audit / Coding Auditor Miami, Florida, United States About the Job Our client is a contracting and data management services organization dedicated to primary care physicians throughout Florida. In this role you are responsible to assist in the development, undertaking and maintenance of a long term comprehensive, clinical coding audit program for inpatient and outpatient activity. To develop and implement policies to support the clinical coding audit function Receive, review and communicate findings on patient billing coding related complaints. Identify training needs through the audit program of work and liaise with the clinical coding training manager and audit manager to provide the necessary training identified Conduct routine, risk based, proactive or reactive compliance reviews of procedural and diagnosis coding/billing and medical record documentation performed by clinical service providers Prepare reports as required relative to these...

Medical Records Technician (Coder) Auditor The Medical Records Technician (Coder) Auditor is responsible for abstracting medical record data and assigning codes using current clinical classification systems appropriate for the type of care provided. Auditors serve as experts of current coding conventions and regulations related to professional and facility coding; perform audits of encounters to identify areas of non-compliance in coding; provide recommendations on appropriate coding; and are responsible for maintaining current knowledge of the various regulatory guidelines and requirements. Auditors work with staff to ensure that regulations are met or areas of weakness are identified and reported to appropriate supervisor for corrective action; perform prospective coding audits and utilize results to identify processing inadequacies and re-educate coding staff where necessary; and coordinate retrospective reviews to ensure adequate auditing of coding activities. Auditors act...

Coding Specialist Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts pertinent data points for billing and quality reviews. Communicates with various departments as needed to ensure accuracy of patient data. Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing). May assign and sequence basic CPT...

Physician Practice E&M Auditor Educator Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 26 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2025-2026 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 63 high-performing honors. What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful...

Medical Coding SpecialistAt Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.Location:Miramar, FloridaSummary:Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance.Responsibilities:Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category),...

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As an Inpatient Coding Auditor with Parallon you can be a part of an organization that is devoted to giving back! Job Summary and Qualifications As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. What you will do in this role: Leads,...

Job Description The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals. Responsibilities Reviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment Informs manager of any activities which do not meet federal or state coding and billing requirements Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and...

Abstracts clinical information from a variety of medical records, charts and documents and assigns appropriate ICD-10 and/or CPT-4 codes to patient records according to established procedures. Works with coding databases and confirms DRG assignments. Responsibilities: Codes data from patient records utilizing coding systems to ensure optimal reimbursement of the office visits and hospital surgery for all surgeons and mid-levels of the practice. Translates diagnostic and procedural information using the International Classification of Diseases codes and sequences these codes in a manner which legitimately optimizes office and hospital reimbursement through the use of proper coding and modifiers. Skilled in accurate assignment and auditing of ICD-10-CM, CPT, HCPCS, and E/M services for inpatient, outpatient and office-based encounters. Abstracts data from patients’ medical records in order to compile accurate and timely statistical data. Reviews and analyzes all patient types to...

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

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

A leading healthcare system based in souther Florida is now seeking an experienced Remote Medical Coding Auditor to join their award-winning healthcare organization!Regarded as a leading healthcare provider in the vibrant region of South Florida, this renowned hospital system encompasses a network of expansive facilities known for delivering outstanding medical services and excellent patient care.The organization boasts a comprehensive range of healthcare services, including state-of-the-art emergency care, advanced surgical procedures, and specialized medical practices across various fields.Recognized for its commitment to excellence, the network has achieved numerous awards for quality, safety, and patient satisfaction, reflecting its dedication to healthcare innovation and community wellness.The Remote Medical Coding Auditor is responsible for leading the continuous improvement of the inpatient coding staff.Responsibilities include leading complex coding audits, assess coding...

Coding Specialist Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. For physician billing, collaborates with billing department to ensure all bills are satisfied. For hospital, routes to billing charge...

Outpatient Surgery Coder The outpatient surgery coder reviews and codes a high volume of surgical charts each day, including procedures such as laser treatments and skin grafting, ensuring accurate CPT and ICD-10 assignment using the Solventum (3M) encoder. They maintain a steady productivity pace of around 7 charts per hour while prioritizing accuracy and compliance with coding guidelines. Throughout the day, they validate documentation, resolve any discrepancies, and collaborate with billing or audit teams as needed. A strong focus is placed on quality, consistently achieving a 95% or higher QA score.

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

Job Description The outpatient surgery coder reviews and codes a high volume of surgical charts each day, including procedures such as laser treatments and skin grafting, ensuring accurate CPT and ICD-10 assignment using the Solventum (3M) encoder. They maintain a steady productivity pace of around 7 charts per hour while prioritizing accuracy and compliance with coding guidelines. Throughout the day, they validate documentation, resolve any discrepancies, and collaborate with billing or audit teams as needed. A strong focus is placed on quality, consistently achieving a 95% or higher QA score. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual...

Tampa | Business and Administrative | Full Time Description BayCare is currently in search of our newestTeamMember 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. 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, George, North Carolina, or South Carolina. 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 coding and billing as well as...

At Houston Methodist, the Lead Outpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to outpatient encounters based upon documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. FLSA STATUS Non-exempt...

Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here (https://www.myworkday.com/umiami/d/task/1422$7248.htmld) to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER_eRecruiting_ApplyforaJob.pdf) . The University of Miami/UHealth Department Health Information Management has an exciting opportunity for a full-time Outpatient Coder 3 to work in Miami, FL. Under the general direction of the Outpatient Coding Manager, the Outpatient Coder 3 reviews documentation in the electronic medical record (EMR) and assigns and sequences ICD-10-CM diagnosis codes and CPT procedure codes in accordance with national coding guidelines. The primary focus of this role is to capture all encounter specific diagnoses and procedure codes for accurate reimbursement, data collection, and research...

Summary/Objective Under limited supervision the Coder Physician reviews medical records and performs coding on all diagnoses, procedures, DRG/APC, and charge codes. The Coder Physician uses the most accurate codes for reimbursement purposes, research, epidemiology, statistical analysis outcomes, financial and strategic planning, evaluation of quality of care, and communication to support the patient’s treatment. The Coder Physician will be charged with maintaining the confidentiality of patient records and procedures. Essential Job Functions Responsible for abstracting, coding, sequencing and interpreting the clinical information from inpatient, outpatient, emergency department, pro fee, and clinical medical records. Responsible for the assignment of correct principal diagnoses, secondary diagnoses and principal procedure and secondary procedure codes with attention to accurate sequencing. Utilizes technical coding principals and DRG/APC reimbursement expertise to assign...

Job Description Job Description Description: Role Summary Responsible for reviewing medical records and assigning accurate CPT, HCPCS, ICD-10-CM, and appropriate modifiers for outpatient services. This role supports compliant coding and consistent performance across a variety of outpatient encounter types. Requirements: Core Responsibilities Review medical records and assign accurate CPT/HCPCS, ICD-10-CM, and modifiers. Ensure documentation supports coded services and identify/escalate discrepancies or gaps. Ensure compliance with CMS, payer-specific rules, and official coding guidelines (including NCCI edits). Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards. Minimum Qualifications Credentials: CPC, CCS, RHIA, or RHIT (active). Experience: Minimum 3+ years outpatient coding experience across multiple outpatient service types. Skills & Knowledge: Strong knowledge of?CPT, HCPCS, ICD-10-CM, modifiers, and...

Job Description Job Description Description: Role Summary Responsible for reviewing medical records and assigning accurate CPT, HCPCS, ICD-10-CM, and appropriate modifiers for outpatient services. This role supports compliant coding and consistent performance across a variety of outpatient encounter types. Core Responsibilities Review medical records and assign accurate CPT/HCPCS, ICD-10-CM, and modifiers. Ensure documentation supports coded services and identify/escalate discrepancies or gaps. Ensure compliance with CMS, payer-specific rules, and official coding guidelines (including NCCI edits). Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards. Requirements: Minimum Qualifications Credentials: CPC, CCS, RHIA, or RHIT (active). Experience: Minimum 3+ years outpatient coding experience across multiple outpatient service types. Skills & Knowledge: Strong knowledge of CPT, HCPCS, ICD-10-CM,...