26 physician coding auditor jobs found

Overview Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. Summary The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal stakeholders...

Physician Compliance Auditor Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal...

A healthcare organization based in Atlanta is seeking a Physician Compliance Auditor to conduct audits, report findings, and lead training sessions on coding and billing. The ideal candidate will possess at least five years of coding experience, with a strong organizational skill set and effective communication abilities. Preferred qualifications include a Certified Professional Coder certification and experience in auditing. Join a team committed to ensuring compliance and excellence in healthcare billing processes. #J-18808-Ljbffr

Coder Quality Auditor The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties. Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess coders'...

Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more Description Overview: Reporting to the Director, the Sr. Compliance Auditor, develops and executes audit, monitoring, and education for both facility and professional billing, coding and documentation programs that ensure compliance with regulatory standards across Physician Services. Continuously evaluates facility/professional billing compliance activities to assess...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what’s possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people’s lives. Job Summary Under the direction of the Coding Compliance Manager, conducts independent audits of professional fee coding. Assures appropriate and accurate coding assignments in accordance with federal coding regulations and guidelines. Prepares written reports of findings and leads meetings with providers to review the audit findings and recommend ways to improve when indicated. Also responsible for providing assistance with coding inquiries from providers, coding, staff, etc. This position requires knowledge of...

Coding Auditor Sr CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through homecare and community-based services. The CareBridge Coding Auditor Sr is responsible for auditing coders that diagnosis data collected from physician and hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements. Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from...

Overview Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs...and more! Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. Reviews discrepancies between the Clinical...

Medical Coding Auditor Become a part of our caring community and help us put health first. 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...

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.,...

Job Description Job Description Description: Southeast Primary Care Partners is seeking a dedicated and detail-oriented Certified Coder to join our dynamic team. The successful candidate will play a crucial role in accurately coding healthcare claims for reimbursements, ensuring compliance with federal regulations, and contributing to the efficiency and effectiveness of our healthcare services. Certified Coder reviews medical records to assure proper billing. Participates in audits to evaluate if all selected codes are accurate and develops methodologies to improve coding issues identified. Codes must meet QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Position Summary: Requirements: Key Responsibilities: Review patients' medical records to extract relevant information needed for billing and coding. Apply appropriate ICD-10, CPT, and HCPCS Level II code assignments to ensure accurate and timely billing. Work closely with healthcare...

Job Description Job Description Description: Seeking a detail-oriented and knowledgeable Provider/Coding Auditor Educator to support accurate and compliant coding practices across our provider network. This role will be responsible for performing audits of medical documentation and coding, educating providers on best practices, and ensuring adherence to industry guidelines and payer regulations. The ideal candidate is a certified coding professional with strong communication skills and a passion for education and compliance. This role requires flexibility to travel 50% of the time to various provider locations in the State of Georgia for onsite education and auditing support, as needed Requirements: Key Responsibilities Conduct prospective, concurrent, and retrospective coding audits for professional and/or facility services. Review medical documentation to ensure codes assigned (ICD-10-CM, CPT, HCPCS) are supported and meet regulatory and payer guidelines. Deliver coding...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This is a work from home position that requires the selected candidate to have a permanent address and live in New Mexico or be willing to relocate to New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217 Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical...

WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits and participate in provider education...

Job Description Job Description The Staff Pad has partnered with Blue Ridge Medical Center in Blue Ridge, Georgia. Blue Ridge Medical Center is seeking an experienced Health Information Management (HIM) Coder to join our team in a fully remote capacity. This individual will be responsible for reviewing, analyzing, and assigning diagnostic and procedural codes for inpatient, outpatient, and/or emergency department medical records using ICD-10-CM, CPT, and HCPCS coding systems in accordance with official coding guidelines and facility standards. Key Responsibilities: Review and abstract clinical documentation from patient records to assign accurate codes for diagnoses and procedures Ensure compliance with federal regulations and hospital policies related to coding and billing Maintain productivity and quality standards established by the HIM department Query physicians when appropriate to ensure accurate and complete documentation Assist in resolving...

Specialty Coder II - Anesthesia BayCare is currently in search of our newest team member 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. Position details: 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, Georgia, North Carolina, or South Carolina. Sign on bonuses available! 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...

Medical Coder A Medical Coder for WellStreet Urgent Care is responsible for supporting all aspects of the Revenue Cycle for our Urgent Care Centers. Responsibilities Coding for our Urgent Care Centers using our internal software Knowledge of ICD-10 Coding and compliance Experience using an encoder Setting up insurance plans within our software Working with the Revenue Cycle Management to identify & resolve issues related to coding and the process flow Interfacing with clinic staff on billing & coding issues. Comply with all legal requirements regarding coding procedures and practices Conduct audits and coding reviews to ensure all documentation is accurate and precise Assign and sequence all codes for services rendered Collaborate with billing department to ensure all bills are satisfied in a timely manner Communicate with insurance companies about coding errors and disputes Contact physicians and other health care professionals with questions about...

Inpatient Facility Coder My client is hiring for an experienced Inpatient Facility Coder to support hospital-based coding operations within a Trauma Level I teaching facility. This is a fully remote opportunity offering flexible daytime hours, with the expectation that candidates are available to work full-time (40 hours per week). Key Responsibilities: Assign accurate ICD-10-CM and ICD-10-PCS codes for inpatient facility encounters Review clinical documentation to ensure compliant and complete coding Apply inpatient coding guidelines in accordance with CMS, UHDDS, and facility standards Support DRG assignment and coding quality initiatives Collaborate with CDI, physicians, and revenue cycle teams as needed Meet established productivity and accuracy benchmarks Required Qualifications: CCS, RHIT, or RHIA certification (required) 23 years of inpatient facility coding experience Experience coding in a Trauma Level I teaching hospital Strong knowledge of inpatient...

Welbehealth Pace Coding Auditor And Educator WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews...

Datavant is a leading data platform company dedicated to health data exchange, with a vision that every healthcare decision is powered by accurate data at the right time. Our network is one of the largest and most diverse in the U.S., ensuring that data remains secure and accessible to enhance health decisions. Our clients include prominent life sciences firms, government agencies, and healthcare providers. Joining Datavant means becoming part of a high-performing, values-driven team that is committed to solving the intricate challenges of healthcare through technological innovations. Our diverse team members bring a rich array of professional, educational, and personal experiences to support our ambitious vision for the future of healthcare. Your Role: We are seeking credentialed inpatient coders who possess meticulous attention to detail and a solid understanding of medical terminology to join our dynamic team. This position offers the flexibility of fully remote work,...

Location: Fully Remote Schedule: Flexible Daytime Hours (Must Work Full-Time) Pay Rate: $35-40/hour Benefits: LaSalle Network contractors have the opportunity to enroll in benefits including medical, dental, and vision insurance. Job Description: My client is hiring for an experienced Inpatient Facility Coder to support hospital-based coding operations within a Trauma Level I teaching facility. This is a fully remote opportunity offering flexible daytime hours, with the expectation that candidates are available to work full-time (40 hours per week). Key Responsibilities: Assign accurate ICD-10-CM and ICD-10-PCS codes for inpatient facility encounters Review clinical documentation to ensure compliant and complete coding Apply inpatient coding guidelines in accordance with CMS, UHDDS, and facility standards Support DRG assignment and coding quality initiatives Collaborate with CDI, physicians, and revenue cycle teams as needed Meet...

Job Description Job Description The Medical Coder / Coder PAR at Apex Spine and Neurosurgery is responsible for reviewing clinical documentation and assigning accurate CPT, ICD-10, and HCPCS codes for spine, neurosurgical, and interventional pain management services. This role ensures compliant, complete, and timely coding to support revenue integrity, authorization accuracy, and efficient claims processing in accordance with CMS and payer guidelines. Key Responsibilities Review operative reports, clinic notes, imaging, and diagnostic studies to accurately assign CPT, ICD-10, and HCPCS codes for spine and neurosurgical procedures. Code surgical and procedural services including (but not limited to): spine surgeries, decompressions, fusions, discectomies, laminectomies, injections, nerve blocks, ablations, and other interventional pain procedures. Ensure compliance with CMS guidelines, NCCI edits, payer-specific policies, and internal coding standards. Communicate directly...

You will be able to work from your home location within the United States PURPOSE AND SCOPE: Conducts data quality audits of outpatient encounters to validate coding assignment is in compliance with the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. Provides feedback and education to coders. Escalates compliance, risk-related issues to expedite mitigation. PRINCIPAL DUTIES AND RESPONSIBILITIES: Consults facility leaders and staff on best practices, methodology, and tools for accurately coding. Chart Analysis, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA/AAPC). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to...