63 outpatient coding auditor jobs found

To ensure compliance with coding standards, the full-time Outpatient Coding Auditor will conduct quality reviews and audits, provide educational feedback to coding staff, and identify documentation issues impacting coding accuracy. Key responsibilities Perform audits and quality reviews of coding to ensure adherence to departmental standards and policies Create clear and accurate audit findings and deliver educational feedback to coders and management Identify and communicate documentation issues that affect coding accuracy and guide staff in resolving these issues Required qualifications Completion of a formal coding program with AHIMA or AAPC credentials (CCS, RHIT, CIC) preferred 5+ years of progressive experience in professional medical coding and reimbursement Strong knowledge of ICD-10-CM, ICD-10-PCS, medical terminology, and health record content Experience with coding guidelines and resources to support audit findings Proficiency in Microsoft Office applications and...

A healthcare integrity solutions provider is looking for an Outpatient Payment Integrity Coder Auditor in New York City. In this role, you will audit outpatient medical claims for coding accuracy and compliance with CMS guidelines. The ideal candidate must have advanced knowledge of outpatient coding and payment methodologies, along with at least 3 years of relevant experience. The position offers competitive salary options and comprehensive benefits including health insurance and a 401(k) plan. #J-18808-Ljbffr

A healthcare services provider is seeking an experienced coding auditor to perform quality audits and reviews on outpatient records. The role involves providing feedback to coding staff, extracting clinical information, and assisting in educational training. Candidates should have AHIMA or AAPC certification and 2–3 years of experience in facility outpatient audits. This position allows remote work on a PRN basis, offering full benefits and opportunities for professional growth. #J-18808-Ljbffr

Overview Join Our Award-Winning Team and Work with the Best! UASI has been recognized as a Top Workplace by the Cincinnati Enquirer in 2022, 2023, and 2024. With over 40 years of experience, we pride ourselves on stability and long-term success. Responsibilities Perform coding quality audits and reviews on a variety of facility outpatient records, including but not limited to Same Day Surgery, Observations, ED, and Infusions/Injections. Provide feedback and education to coding staff. Extract clinical information from a variety of medical records and assign appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. Assist in developing educational training content and materials for coding staff. Present educational seminars to clients and staff. Work remotely from a home office on a PRN basis. Qualifications AHIMA or AAPC certification. 2–3 years minimum experience performing facility outpatient audits. Experience in ICD-10-CM, CPT, HCC, and...

A leading health information management services company seeks a Medical Coding Consultant specializing in outpatient coding. The role involves auditing diagnostic and procedural codes to ensure compliance with coding guidelines. Candidates should possess relevant credentials and have at least three years of auditing experience. The position offers a competitive salary range of $76,000 - $90,000 and benefits. Ideal for detail-oriented individuals with strong analytical skills and a background in medical documentation. #J-18808-Ljbffr

A prominent academic health system is seeking a remote Outpatient Second Level Reviewer. This role involves auditing and reviewing compliant coding, training staff, and maintaining data integrity. Candidates should have a Bachelor’s degree or equivalent experience in auditing within a large hospital system, and possess strong interpersonal and communication skills. The position offers a competitive salary range of $79,200 to $143,400 annually, depending on experience and other factors. #J-18808-Ljbffr

Profee/Outpatient Medical Coding Auditor Remote Physician Based Outpatient Medical Coding Auditor Full Time Remote Virtual, USA Description At IKS Health, we are committed to revolutionizing healthcare through innovative technology that enhances patient communication and clinical efficiency. Our culture is rooted in collaboration, compassion, and innovation, empowering teams to make a tangible impact on the lives of patients and clinicians. The Auditor conducts clinical coding audits as defined by client contracts for audit service and internal quality assessment according to operational guidelines. The Audit staff will also contribute to the ongoing development and refinement of proprietary audit tools. The Auditor Position will serve as the primary mentor/trainer to internal coders as required by the deliverables of the contract and will be required to provide educational feedback and instruction to staff for coding guidelines as part of the internal quality review. Essential...

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...

Working remotely from a home office, the part-time Certified Coding Auditor will conduct coding audits of outpatient facility services and professional E&M documentation to ensure accuracy and compliance while providing feedback and education to coding staff. Key responsibilities Conduct coding audits of outpatient facility services and professional E/M documentation to ensure coding accuracy and regulatory compliance Perform comprehensive reviews of clinical documentation and assigned codes to validate code assignment and reimbursement accuracy Provide ongoing feedback and coaching to coding staff to improve coding quality and adherence to guidelines Required qualifications AHIMA or AAPC certification 2-3 years of hospital outpatient and professional E&M auditing experience Experience in ICD-10-CM, CPT, HCC, and procedural/surgical coding Ability to participate in client-facing discussions regarding audit findings Excellent communication skills, both verbal and written

To ensure the accuracy and compliance of diagnosis coding in risk adjustment programs, the contract-to-hire Certified Risk Coder Auditor will conduct medical record audits, validate diagnosis codes, and provide coding guidance while working remotely. Key Responsibilities Perform prospective and retrospective medical record reviews and audits Validate diagnosis code accuracy, completeness, specificity, and appropriateness based on provider documentation Identify coding and documentation deficiencies and provide written and verbal feedback Required Qualifications 7+ years of relevant professional experience 5+ years of HCC/Risk Adjustment coding experience utilizing inpatient and outpatient coding guidelines 5+ years of Risk Adjustment auditing experience CRC (Certified Risk Coder) certification in good standing Strong knowledge of Medicare, ACA Commercial, and Medicaid risk adjustment models

Location Miramar, Florida 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. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments. For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding. Submits daily productivity report to HIM manager by defined deadline....

Overview At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions. The Outpatient Payment Integrity Coder Auditor is responsible for reviewing outpatient medical claims to ensure coding accuracy, compliance, and appropriate payment in accordance with CMS and payer-specific guidelines. This role supports the development and implementation of payment integrity initiatives by identifying coding and billing inaccuracies, trends, and potential cost savings opportunities across outpatient facility claims. The ideal candidate has advanced knowledge of outpatient coding, APC and EAPG payment methodologies, and clinical documentation requirements, with strong analytical and auditing skills. Salary Range: $100,000 - $102,500 Responsibilities Perform detailed coding audits on outpatient facility claims to validate appropriate CPT/HCPCS, revenue codes, modifiers, and ICD-10 coding...

Inpatient Coding Auditor We are seeking an experienced Inpatient Coding Auditor to perform pre-bill and retrospective audits across multiple facilities. This role focuses on ensuring coding accuracy, compliance, and quality across complex inpatient cases in a large academic hospital setting. The ideal candidate will have strong inpatient auditing experience, knowledge of coding guidelines, and the ability to collaborate effectively with coding teams. Perform pre-bill reviews (100% audit of new inpatient coder charts) Conduct retrospective audits across inpatient cases Review PSI's, HAC's, diagnoses, DRGs, MCCs, and malnutrition documentation Ensure coders capture all appropriate diagnoses and procedures accurately Audit cases across multiple facilities within the system Provide feedback and support to coding teams to improve accuracy and compliance Track productivity and quality metrics using internal tools A minimum 5 years of Inpatient coding experience required A minimum of...

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for a Certified Coding Auditor to work in its New York office or remotely. Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers....

Seeking a full-time Coding Compliance Auditor to work remotely, this position involves performing comprehensive audits of medical records, ensuring compliance with regulatory requirements, and providing education to improve coding quality across healthcare environments. Key responsibilities Conduct thorough audits of inpatient and outpatient medical records for accurate coding assignments Identify compliance risks and opportunities for improvement through detailed analysis of documentation trends Develop and deliver educational materials and reports to enhance coding practices and documentation quality Required qualifications 4+ years of acute care inpatient and outpatient coding experience, including compliance auditing Active credentials such as CCS, RHIA, RHIT, CPC, or CIC Strong knowledge of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding systems Understanding of Medicare reimbursement methodologies and federal coding guidelines Proficiency with EHR Epic

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 relationships with patients and their families that...

Lead Him Hospital Coder/Auditor (In-Patient - Observation) Remote The Health Information Management (HIM) Inpatient/Observation Hospital Coder Auditor/Lead responsibilities include reviewing all diagnosis and procedural coding in ICD-10-CM/PCS for accurate DRG assignment. This position will have daily interactions with internal and external customers to include physicians, hospital support services and ancillary departments. The HIM Inpatient/Observation Hospital Coder Auditor/Lead will perform inpatient/outpatient coding compliance audits and provide coder education. This position will assist in the preparation and finalization of auditing reports. Responsibilities and Essential Job Functions Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department. Note: These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may...

To ensure compliance with coding guidelines, the remote California Licensed Coding Auditor will perform quality reviews and audits, coordinate with department leadership, and contribute to process improvements in a full-time capacity. Key responsibilities Conduct regular quality reviews and audits for hospital inpatient and outpatient coding, facilitating the coder audit appeal process Prepare detailed audit reports that outline findings, recommendations, and necessary corrective actions Maintain up-to-date knowledge of coding guidelines and regulations, identifying educational opportunities for staff Required qualifications High School Education/GED required; Associate's/Technical Degree preferred Five years of acute care inpatient and/or outpatient coding experience required Three years of coding auditing/monitoring experience preferred Certified Coding Specialist credential through AHIMA required Certified Coding Specialist (CCS) certification required

Job TypePart-timeDescriptionRequired :3-5 years of experience in acute care facility (hospital) medical coding auditing or complianceLocation :RemoteJob Summary :The Medical Coding Auditor is responsible for reviewing medical records to ensure accurate coding and compliance with regulatory requirements.This role ensures continuous quality improvement in coding practices while maintaining compliance with healthcare laws and organizational policies.Occasional travel may be required for audits or meetings.Key Responsibilities :Conduct reviews and audits of medical records for coding accuracy (ICD-10-CM, CPT, HCPCS) and documentation compliance.Ensure compliance with federal, state, and payer-specific regulations, including CMS guidelines.Identify and address coding discrepancies and recommend corrective actions.Prepare detailed audit reports with findings and provide feedback on documentation and coding practices.Collaborate with relevant departments to resolve audit findings and...

Select how often (in days) to receive an alert: *As required under NYC Human Rights Law Int 1208-2018 - Salary range for this role when Hired for NYC Offices Position Summary Under supervision, assists in the development and evolution of the overall strategy for the departments coding operations This role is also responsible for reviewing medical records for compliance with coding and documentation requirements Job Responsibilities Composes and maintains billing and/or billing compliance associated correspondence. Determines proper account resolution and/or adjustment as needed. Performs charge entry and/or payment posting within the practice management billing system as needed. Tracks and resolves issues on denied claims. Resubmits or appeals claims as required. Escalates more complex claim issues when necessary. Attends workshops, seminars and/or conferences to keep abreast of standards and best practices within the field. Disseminates information to colleagues and/or staff as...

## Insurance/Billing Rep - Interventional - HPW - Full-time - DayApplylocations: Pennington, NJtime type: Full timeposted on: Posted Todayjob requisition id: JR110438Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.The...

Brellium is hiring a certified medical coder to code and audit outpatient encounters, focusing on CPT, E/M levels, and ICD-10-CM diagnoses. You will validate coding decisions with documentation and collaborate with Customer Success, Product, and Engineering to improve automated coding at scale. You will work with senior coders and clinicians to ensure accuracy, defensibility, and payer alignment, contributing to QA, training, and evolving coding playbooks within a modern, technology-driven team. #J-18808-Ljbffr

Specialised Part-Time Consulting Opportunity for Certified Medical Coders We are sharing a specialised part-time consulting opportunity for certified medical coders with strong expertise in CPT, ICD-10, clinical documentation review, and US healthcare coding standards. This high-volume project focuses on accurately coding medical records and clinical documentation while maintaining strong quality, compliance, and productivity standards. Selected professionals will assign appropriate codes, review documentation for completeness, identify discrepancies, and collaborate with quality teams to support consistent coding outcomes. Key Responsibilities Medical Record Coding Assign accurate CPT and ICD-10 codes to medical records and clinical documentation Apply appropriate coding conventions across varied healthcare encounters Review clinical information carefully before determining final code assignments Maintain accuracy across high-volume coding workflows Documentation &...

Brellium Mission Brellium's mission is to improve the standard of care across the US healthcare system. We've built AI-powered technology that helps healthcare providers deliver safer, higher-quality care - starting with the first real-time medical review platform built to fix clinical and compliance risks before they impact patients. Each year, 1 in 20 people in the U.S. experiences a medical diagnostic or compliance-related mistake. Most providers lack the time, staffing, and tools to mitigate these issues - so they go unnoticed, impacting care quality and increasing clinical and financial risk. Brellium is building the AI-powered platform that helps providers deliver safer, more consistent care by mitigating risk early and aligning patient visits with clinical best practices. Our goal is to give every provider in the U.S. the tools to deliver clinically excellent, data-driven care - at scale. Brellium was founded in 2021. Since then, we've grown to serve over 250,000 providers...