9 physician coding auditor jobs found

Craft Health Technologies is seeking an experienced certified medical auditor to provide independent quality review of a sample of our production coding audits. You will compare clinical documentation with the audit’s coding conclusions, determine the correct result, and provide clear, evidence-based feedback. The purpose of the role is to provide external validation, monitor accuracy, and identify opportunities to improve the quality and consistency of our audits. This is a part-time, hourly independent-contractor engagement with flexible scheduling.    Responsibilities   Review a defined sample of completed coding reviews and the corresponding medical records. Independently determine the appropriate CPT, ICD-10-CM, E/M level, and modifiers, as applicable. Assess whether coding conclusions are supported by the clinical documentation and current guidelines. Identify overcoding, undercoding, unsupported conclusions, missed documentation,...

Thank you for considering Progyny! Progyny is seeking a Claims Audit Extern to join our team. This role will primarily support claims audits, quality assurance reviews, and other related audit activities. In this role, you’ll gain hands-on experience in healthcare claims auditing while working with provider clinics and cross-functional teams to support coding accuracy, compliance, and continuous improvement. What you'll do... Participate in claims audits and quality assurance reviews, including selecting and preparing patient claim samples, evaluating claims and provider documentation, validating CPT/HCPCS and ICD-10-CM coding, modifiers, billing accuracy, and adherence to applicable coding and documentation guidelines. Document audit findings and prepare audit reports, including workpapers, Executive Summaries/Management Response Forms, and other required audit documentation. Provide education to provider clinics and applicable stakeholders regarding audit...

REMOTE NATIONWIDE At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start  Caring. Connecting. Growing together. The key challenge of this role centers around your ability to work quickly, accurately, and independently. You'll be challenged with daily production goals as well as maintaining a high accuracy rate to achieve your quality goals. Extensive use of electronic medical records in an ICD-10 environment is also required. Hours : This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 5am - 5pm. We offer 2-3 weeks of paid training. The...

JOB SUMMARY: Support the Director of Health Information Management (HIM) by conducting comprehensive claim audits and reviewing hospital outpatient and professional fee (ProFee) claims for coding accuracy, revenue integrity, and billing compliance. Utilizing proprietary software, this role evaluates coding opportunities, identifies revenue cycle improvement recommendations, and assists clients in optimizing claim quality and reimbursement outcomes. The ideal candidate is an experienced outpatient facility coding professional with strong analytical skills, extensive knowledge of revenue cycle operations, and the ability to communicate complex coding concepts clearly to both clients and internal team members. This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES:  Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of...