8 outpatient coding auditor jobs found

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g., ICD‑10‑CM, CPT, HCPCS). The role requires interpretation and independent determination of the appropriate courses of action, contributing to overall cost reduction by increasing the accuracy of provider contract payments in our payer systems and ensuring correct claims payment for appropriate CPT/HCPCS code assignments. The Auditor analyzes, enters and manipulates database data, responds to or clarifies internal requests for medical information, understands departmental, segment and organizational strategy and operating objectives, and follows established guidelines and procedures while making decisions in ambiguous situations. Where you come in The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g.,...

A leading healthcare company is seeking a Medical Coding Auditor to ensure coding accuracy and compliance for medical claims. You will verify procedure codes, review documentation, and perform peer reviews in a remote setting. The ideal candidate has at least 3 years of post-certification experience and a strong understanding of CPT/HCPCS coding guidelines and outpatient procedures. Join us in making a positive impact in health care while enjoying a flexible work environment. #J-18808-Ljbffr

Coding Specialist Assigns ICD diagnosis and CPT procedure codes to assigned Outpatient work types. Employment Type: Full Time Weekly Scheduled Hours: Mon-Fri 7am-3:30pm Wage Range: $21.14-$31.70 Requirements: - High school diploma/GED, or higher education - Registered Health Info Tech (R-RHIT) required Preferred Requirements: - Registered Health Info Admin (R-RHIA) - Certified Coding Specialist (C-CCS) Coding: Based on clinical documentation, computerized encoding, accepted coding classification principals, and reference material, efficiently and accurately assigns appropriate ICD diagnosis codes CPT procedure codes and modifiers on assigned chart types. Verifies accuracy of completed fields. Maintains credentials and ongoing education in order to apply current policies and principals for accurate coding. Assigns appropriate ICD codes. Assigns appropriate CPT codes. Assigns appropriate Modifiers on APC accounts. Searches chart documentation for appropriate code...

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 set...

Job ID: 52414 Positions Location: Lansing, MI Job Description General Purpose of Job: Ensure Description: Positions Location: Lansing, MI Job Description General Purpose of Job : Ensure Revenue Cycle Coding and Billing are compliant with State and Federal regulations. Respond to and Investigate compliance issues within Revenue Cycle. Lead and/or coordinate audit activity with governmental audits. Essential Duties : This job description is intended to cover the minimum essential duties assigned on a regular basis. Team members may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position. Ensures conformance with applicable laws, regulations and Medicare/Medicaid reimbursement rules to ensure UMHS is in compliance with federal, state and/or local regulations. Monitors, analyzes and reports on laws, regulations, audits and industry standards that impact the organization....

Title: Medical Coder - Long Term Acute Care Hospital Reports to: Director of Operations Effective Date: 12.2025 Revise Date: Summary The Medical Coder - Long Term Acute Care Hospital is responsible for accurate and compliant coding of diagnoses, procedures, and services for inpatient, outpatient, and skilled nursing encounters. This role supports appropriate reimbursement under Medicare, Medicaid, and commercial payers while ensuring compliance with CMS, DRG, and hospital coding regulations. Core Responsibilities: Assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes for inpatient encounters Ensure accurate DRG/APR-DRG assignment and appropriate sequencing of diagnoses and procedures Review operative reports, discharge summaries, progress notes, and ancillary documentation Collaborate with CDI staff to clarify diagnoses and ensure complete, compliant documentation General Responsibilities: Ensure compliance with CMS, Medicare, Medicaid, and payer-specific...

Professional Coder A professional coder provides timely and accurate clinical and administrative data to ensure optimal reimbursement for services performed at acute care, inpatient, outpatient, urgent care, or physician offices. The role requires ICD10CM diagnosis, CPT‑4 coding, and charge entry, working closely with billing staff, practice managers and office personnel while maintaining high coding quality standards. Responsibilities Contribute to organizational success targets for patient satisfaction. Develop and maintain effective working relationships with HIM department staff, physicians, external customers, patients, and other staff. Adhere to coding rules for multiple specialties (neurosurgery, pediatric surgery, rehab, orthopedic, cardiology, etc.) ensuring high-quality coding based on documentation. Follow policies, procedures, and guidelines, while using analytical skills to review charts, interpret documentation, and apply codes. Ensure coding is completed on...

Job Summary Perform coding quality audits on outpatient records to assure appropriateness, accuracy, and compliance for CPT/HCPCs, ICD-10-CM code assignments, and modifier assignment in accordance with Center of Medicare and Medicaid Service (CMS) Guidelines, AMA and AHA Official ICD-10-CM Coding Guidelines. Provide ongoing feedback to managers and coders. Develop and implement educational programs regarding elements of the coding compliance program and act as a subject matter expert for the outpatient coding department. Mission Statement Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society....