18 outpatient coding auditor jobs found

A healthcare provider in Ridgewood, NJ is seeking an Outpatient Coding Auditor to ensure compliance with coding guidelines through detailed audits of outpatient medical records. The ideal candidate will have at least 5 years of relevant experience and certifications in coding. This position offers comprehensive benefits including medical, dental, and a retirement plan, with a competitive hourly pay range of $33.16 - $41.45. #J-18808-Ljbffr

Position Summary The Outpatient Coding Auditor is responsible for auditing coded outpatient medical records to ensure compliance with official coding guidelines, regulatory agencies, and internal policies. This role supports coding accuracy, education, and process improvement through detailed review of encounters, identification of trends and variances, and communication with coding staff and leadership. This position also collaborates with external vendors to monitor performance and incorporate industry best practices into audit feedback and education. Education High school diploma or equivalent required. Experience Minimum of 5 years of experience in hospital auditing or education experience ICD-10-CM and Outpatient CPT-4, HCPCs coding experience required. Knowledge of Medical Necessity APC,OCE, LCD, and NCD edits required . 3M Encoder experience, Meditech, EPIC, or CERNER preferred. Skills CCS or COC, CPC, RHIT, RHIA required. Knowledge of ICD-10-CM, CPT-4 and HCPCs...

Overview Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Physician Billing (PB) Coding Auditor and Educator is responsible for auditing and educating healthcare providers on related applicable clinical documentation. This work supports coding and billing regulations that ensure appropriate reimbursement, public reporting, and various initiatives as directed by the Hackensack Meridian Health (HMH) Network. Responsibilities A day in the life of a Physician Billing (PB) Coding Auditor and Educator...

The Position We seek to fill a Compliance Auditor role in the Cherry Hill, NJ area. The candidate will be responsible for supporting the corporate compliance program. The position includes a generous salary of up to $67K and benefits. (This is not a remote position). Compliance Auditor responsibilities include: Conducting audits of inpatient and outpatient hospital regulatory requirements, including billing, coding, and documentation, and related processes to determine the organizational integrity of billing facility and technical hospital fees, including detection and correction of documentation, coding, and billing errors. Preparatory work for reviews/audits including developing a scope of work. Reviewing available documentation. Assisting in the development of policies and procedures that establish standards for compliance, as well as preparation of other guidance documents and tools to assist providers and staff in appropriate billing, coding, and documentation....

About UsAt Cooper University Health Care , our commitment to providing extraordinary health care begins with our team.Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols.We have a commitment to our employees to provide competitive rates and compensation programs.Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement.We also provide attractive working conditions and opportunities for career growth through professional development.Discover why Cooper University Health Care is the employer of choice in South Jersey.Short DescriptionThe auditor reviews professional fee billing, coding and documentation.Reviews to be performed are identified based on the then-current OIG Workplan and compliance risk analyses.Customers include employed providers, senior leadership,...

About Us At Cooper University Health Care , our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs.  Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development. Discover why Cooper University Health Care is the employer of choice in South Jersey. Short Description The auditor reviews professional fee billing, coding and documentation.  Reviews to be performed are identified based on the then-current OIG Workplan and compliance risk analyses.  Customers include employed providers,...

DRG Coding Auditor Principal _Virtual: _ _ ​_ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group...

Auditor The auditor reviews professional fee billing, coding and documentation. Reviews to be performed are identified based on the then-current OIG Workplan and compliance risk analyses. Customers include employed providers, senior leadership, clinical and non-clinical staff of Cooper University Health Care. Under the supervision of the Chief Compliance Officer, auditors are responsible for supporting the corporate compliance program, responsibilities include: Performance of timely and effective compliance and operational reviews to assess coding, documentation and billing accuracy, identify compliance related risks, internal control weaknesses, revenue capture opportunities and assist in determining the root cause of any identified non-compliance with government rules and regulations, state laws and Cooper policies and procedures Preparatory work for reviews/audits including developing a scope of work. Reviewing available documentation. Analyze/review audit data and...

Coding Auditor/ Educator, Physician Billing HMH PHYSICIAN SERVICES, INC. Edison, New Jersey Requisition # 2025-173031 Shift Day Status Full Time with Benefits Overview Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Physician Billing (PB) Coding Auditor and Educator is responsible for auditing and educating healthcare providers on related applicable clinical documentation. This work supports coding and billing regulations that ensure appropriate reimbursement, public reporting, and various initiatives as...

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...

Insight Global Hiring For Cpc, Certified Professional Coders Day to day insight global is hiring several CPC, certified professional coders to join a large healthcare client in southern NJ. This role focuses on multi-specialty professional fee coding in a high-volume, production-driven environment. Candidates will work remotely but must reside in approved states and be available for occasional onsite visits. Responsibilities: Abstract billing for outpatient evaluation and management (E/M) codes, minor surgical procedures, and HCPCS codes (including supplies and pharmaceuticals) from provider documentation. Assign CPT-4 and ICD-10-CM codes with appropriate modifiers. Investigate coding and billing questions to determine the best approach. Analyze medical records to verify coding accuracy and detect potential misuse. Collaborate with coding, charge, and audit analysts to resolve discrepancies. Work across multiple epic work queues for different specialties. Meet...

The OpportunityDescriptionLooking for Candidates under CST or ESTReview and analyze inpatient medical records to assign accurate ICD-10-CM and PCS codes.Ensure compliance with coding guidelines, payer requirements, and hospital standards.Work with clinical staff or coding auditors when clarification is needed.Code high-acuity cases, including trauma, surgical, and complex inpatient encounters.Meet productivity and accuracy standards set by the companyWeekly Schedule :5 days a week on flex schedule.May have to work a weekend day here and there - Ideally, are able to work 2 weekends a week.Work Schedule :8 :00 am to 4 :00 pmExperience Required for Your SuccessExperience :Min.of 3 years of inpatient coding in a hospital setting.Trauma Exposure :Must have experience coding Level 1 Trauma cases.Specialization :Strictly inpatient coding (no ER / outpatient-only experience).EMR System :EpicCertification :RHIA, CCS, or RHIT ( at least one required ).Work Setting :Prior experience working...

Job Description Day to Day Insight Global is hiring several CPC, Certified Professional Coders to join a large healthcare client in Southern NJ. This role focuses on multi-specialty professional fee coding in a high-volume, production-driven environment. Candidates will work remotely but must reside in approved states and be available for occasional onsite visits. Responsibilities  • Abstract billing for outpatient evaluation and management (E/M) codes, minor surgical procedures, and HCPCS codes (including supplies and pharmaceuticals) from provider documentation.  • Assign CPT-4 and ICD-10-CM codes with appropriate modifiers.  • Investigate coding and billing questions to determine the best approach.  • Analyze medical records to verify coding accuracy and detect potential misuse.  • Collaborate with Coding, Charge, and Audit Analysts to resolve discrepancies.  • Work across multiple Epic work queues for different specialties.  • Meet productivity expectations...

POSITION SUMMARY: Position Summary The Inpatient Senior Coder is responsible for accurate, compliant, and timely coding and abstracting of inpatient medical records, including the assignment of ICD-10-CM/PCS codes and validation of MS-DRG and APR-DRG groupings. This position ensures proper reimbursement, adherence to regulatory and coding guidelines, and supports overall clinical documentation accuracy for inpatient services. This is a remote position with onsite availability required as needed. EDUCATION: High school diploma or equivalent. CCS (Certified Coding Specialist) Required . EXPERIENCE: * Three to five years of inpatient hospital coding experience * Proficient in ICD-10-CM and ICD-10-PCS coding * In-depth knowledge of MS-DRG and APR-DRG reimbursement systems * Familiarity with coding audits and clinical documentation review * Experience with Observation or complex outpatient cases is a plus * Prior mentoring or training experience preferred...

Local candidates preferred - requires ability to be onsite as needed. Job Summary : Responsible for leading professional fee (pro-fee) coding quality audits, education, and training, etc. for CPT, ICD-10-CM, and HCPCS codes for Virtua Medical Group clinicians and coding department. This includes leading the workflow of the audit team performing internal audits and providing education and training to the pro-fee coders and clinicians. Responsible for leading all activities related to the large scale external audit, including creating and maintaining audit documentation, ensuring audit schedule and reporting meet required timelines, and coordinating post-audit activities (including provider education and re-audit). Works with Director to implement and execute on the compliance plan for VMG coding. Position Responsibilities: Leads and coordinates all phases of external clinical professional fee coding audit: Selects audit sample and applies national bell curve in...

Job Summary: Responsible for professional fee (pro-fee) coding quality and audits, education and training, etc. for CPT, ICD-10-CM, and HCPCS codes for Virtua Medical Group clinicians and coding department. This includes performing internal audits, overseeing external audits, and providing education and training to the pro-fee coders. Responsible for working with VMG practices to resolve all coding issues that prevent accounts from being processed appropriately. Responsible for developing, implementing and maintaining compliance plan for pro-fee coding and abstracting. Position Responsibilities: Training and Education: Providing training and education for newly hired coders that includes utilizing the medical record in conjunction with rules and regulations to properly code VMG encounters. Audits new coders once they approved to submit charges in the work queues and provides appropriate feedback. Developing coding and training resources for the entire coding team...

Please note all candidates must complete & pass onsite testing in Marlton, NJ prior to an interview. Position Responsibilities: Responsible for abstracting clinical information and assigning CPT-4 and ICD-10 codes from medical records and documents to support physicians professional fees, including but not limited to outpatient evaluation and management (E/M) services and procedures in accordance guidelines. Job Description Job Description Position Responsibilities: • Abstract billing for outpatient evaluation and management codes, minor surgical procedure(s) and HCPCS (supplies and pharmaceuticals) codes from provider documentation to include; assignment of CPT-4, ICD-10-CM codes and modifiers. • Research simple coding/billing issues for the physicians to identify and recommend the most appropriate method of coding/billing. Research may involve interaction with such organizations as American Medical Association, specialty societies, or other coding...

Coder - Physician Practice - CPC Required Virtua Health Responsibilities: Abstract billing for outpatient evaluation and management codes, minor surgical procedure(s) and HCPCS (supplies and pharmaceuticals) codes from provider documentation to include; assignment of CPT-4, ICD-10-CM codes and modifiers. Research simple coding/billing issues for the physicians to identify and recommend the most appropriate method of coding/billing. Research may involve interaction with such organizations as American Medical Association, specialty societies, or other coding consultants. Analyze the medical record to determine the appropriateness of coding and potential patterns of abuse, working with the Coding/Charge/Audit Analyst(s) to resolve the issue(s). Qualifications: Minimum of two years records coding experience and/or equivalent education (completion of AAPC course or completion of coding program at trade school). Ability to perform functions in a Microsoft Windows environment....