65 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:...

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

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:...

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...

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law. Description Medical Coder and Auditor - Family Care Practice Full-Time Monday - Friday Flexible Schedule $25.00 - $39.00 per hour (depending on experience) Medical Coder and Auditor Benefits: Annual performance review, performance-based merit increase Health, dental and vision benefits available with coverage effective the first of the month following date of hire Full complement of voluntary benefits $1,000 annual employer HSA contribution for employees enrolled in CNYFC high deductible health plan Free office visits with NP or PA employees who are patients of the practice and enrolled in CNYFC high deductible health plan Waiver program for health benefits ($3,000...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

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...

Benefits include: Monday - Friday (No weekends and no holidays) Health, dental, and vision full coverage for individual Short term/long term disability options Vacation (annual) + PTO (accrued weekly) 16 paid holidays in the calendar year 401K - 5% matching Parental, medical, education, bereavement leaves and so much more! BASIC FUNCTION: Incumbent reviews, analyzes, and codes diagnostic and procedural information that determines Medicare, Medicaid, and private insurance payments. Ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. GENERAL RESPONSIBILITIES: Abstracts all necessary information and sequences and assigns codes (ICD-10, CPT, and HCPCS), which most accurately describe each documented diagnosis, surgical procedure and special therapy/procedure according to established guidelines, and to identify secondary complications and co-morbid conditions. Determines the final diagnoses and...

Facility: Administrative Regional Training Cntr Shift: Shift 1 Status: Full Time FTE: 1.0 Bargaining Unit: ACE Associates Exempt from Overtime: Yes Work Schedule: Days Hours: 7-4, 8-4 flexible Job Summary Under the direction of the Manager/Director of Revenue Integrity, including oversight from System revenue cycle leadership, the Revenue Integrity Coder of Infusion Services will be responsible for optimization of charge capture, charge review, appropriate documentation and work queue edits for all infusion services, specifically Oncology and Chemotherapy. This position serves as the primary contact/resource for Patient Financial Services, Revenue Integrity and Infusion Clinical Staff. The position requires advanced knowledge of Oncology, Chemotherapy, and Infusion drug requirements of various insurance providers as well as federal billing rules, Medicare and Medicaid. The incumbent actively participates as needed in both external third‑party audits and internal audits and...

RIS - OUTPATIENT CODER II Corporate - Oneida, NY 13421 Overview Salary Range $22.00 - $28.00 Hourly Position Type Full Time Job Shift Days Description Outpatient Coder Level II Oneida Health is actively searching for a skilled Revenue Integrity Outpatient Coder Level II to join our dynamic team. The successful candidate will play a crucial role in ensuring accurate and compliant coding of outpatient services, optimizing revenue capture, and maintaining regulatory compliance. Key Responsibilities: Review outpatient services (primarily surgical, emergency, oncology, and wound care) medical records to assign appropriate CPT, HCPCS, and ICD-10 codes. Ensure accuracy and completeness of coded information for billing and reimbursement purposes. Stay updated on coding guidelines, regulations, and compliance requirements related to outpatient services. Collaborate with physicians, nurses, and other healthcare professionals to resolve coding discrepancies and obtain...

Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $64,972.00 - $97,458.00 The Senior Hospital Coder is responsible for performing detailed inpatient coding quality audits, scheduled and random, on staff and providing thorough education and feedback, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI. Responsible for monitoring and tracking trends of staff, bringing forward concerns to leadership regarding coding quality and productivity, completes duties as assigned by the Quality Manager. Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. Senior Hospital Coder may be asked to assist with denials work, including researching and writing appeal letters. These individuals are highly skilled and considered experts in medical coding. This is a remote...