15 policy coding auditor jobs found

Anticipated End Date: 2026-08-31 Position Title: DRG Coding Auditor - MS-DRG and APR-DRG Job Description: DRG Coding Auditor - MS-DRG and APR-DRG 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 if candidates reside within a commuting distance from an office 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. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also...

*Description* Risk Adjustment Coding Auditor The Impact you will have The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. Your Responsibilities Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy,...

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2814 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

DRG Coding Auditor - MS-DRG and APR-DRG 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 if candidates reside within a commuting distance from an office 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. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation to...

Become a part of our caring community The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate DRG and ICD-10-CM/ PCS coding assignments for accuracy within the coding disputes team from a variety of medical records. The Disputes Auditor - MSDRG Inpatient Coding on the Disputes Team consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality. Will be an experienced medical coding auditor with in-depth experience in inpatient coding audits (MSDRG/APDRG) Ensures overall accuracy and compliance of coding disputes reviews by adhering to all appropriate coding guidelines and communicates disputes outcomes to providers in a professional and concise manner. Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices Manages multiple...

Medical Coder Location: Greater Baltimore Area Type/Duration: Contract, 13 weeks possible extensions Pay: $15-40/hour We are currently staffing for Medical Coders across several Hospital locations and units. This is a Generic Post for Personnel, who would be working in a Hospital setting in the greater Baltimore area. Specifics on Pay, Location, Unit, and Hours would be provided during your interview. JOB SUMMARY: Following established conventions and guidelines, codes and abstracts the medical records of the diverse population of records within the facility. Meets departmental accuracy and production standards. Reviews medical records to determine the providers diagnosis/procedures for unit and assigns ICD-10-CM codes, CPT, and facility E&M levels to those diagnoses/procedures. Reviews the entire record for codable information. Uses resources (Coding references and guidelines, Coding Clinics, Auditors, CDI staff, Co-workers, internet, etc.) for guidance on coding as...

Technical Coder Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, third party payors, other regulatory agencies and Kaiser Permanente policy. Functions includes, but are not limited to working charge review work queues for reimbursable accounts for all internal and external surgical services. Serves as a technical coder for all specialties. Assists supervisor in responding to coding questions from other levels of coders and in responding to providers. Conducts special projects and focused reviews of encounters as requested. Essential Responsibilities: Required to research and assign HCPCS Level II codes for ambulatory surgical services and/or professional services performed. Ability to research, analyze and/or review detailed and high complexity code edits and transactions within the Kaiser Permanente system. Provides additional support to the coding...

Job Summary: Position is remote within the local area. Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, third party payors, other regulatory agencies and Kaiser Permanente policy. Functions includes, but are not limited to working charge review work queues for reimbursable accounts for all internal and external surgical services. Serves as a technical coder for all specialties. Assists supervisor in responding to coding questions from other levels of coders and in responding to providers. Conducts special projects and focused reviews of encounters as requested. Essential Responsibilities: Required to research and assign. HCPCS Level II codes for ambulatory surgical services and/or professional services performed. Ability to research, analyze and/or review detailed and high complexity code edits and transactions within the Kaiser Permanente...

Technical CoderEnsures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, third party payors, other regulatory agencies and Kaiser Permanente policy. Functions includes, but are not limited to working charge review work queues for reimbursable accounts for all internal and external surgical services. Serves as a technical coder for all specialties. Assists supervisor in responding to coding questions from other levels of coders and in responding to providers. Conducts special projects and focused reviews of encounters as requested.Essential Responsibilities:Required to research and assign HCPCS Level II codes for ambulatory surgical services and/or professional services performed. Ability to research, analyze and/or review detailed and high complexity code edits and transactions within the Kaiser Permanente system.Provides additional support to the coding staff by...

Job Summary: Position is remote within the local area. Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, third party payors, other regulatory agencies and Kaiser Permanente policy. Functions includes, but are not limited to working charge review work queues for reimbursable accounts for all internal and external surgical services. Serves as a technical coder for all specialties. Assists supervisor in responding to coding questions from other levels of coders and in responding to providers. Conducts special projects and focused reviews of encounters as requested. Essential Responsibilities: Required to research and assign. HCPCS Level II codes for ambulatory surgical services and/or professional services performed. Ability to research, analyze and/or review detailed and high complexity code edits and transactions within the Kaiser Permanente...

Job Title : Medical Coder Location : Greater Baltimore Area Type/Duration : Contract, 13 weeks - possible extensions Pay : $15-40/hour We are currently staffing for Medical Coders across several Hospital locations and units. This is a Generic Post for Personnel, who would be working in a Hospital setting in the greater Baltimore area. Specifics on Pay, Location, Unit, and Hours would be provided during your interview. JOB SUMMARY : Following established conventions and guidelines, codes and abstracts the medical records of the diverse population of records within the facility. Meets departmental accuracy and production standards. Reviews medical records to determine the providers diagnosis/procedures for unit and assigns ICD-10-CM codes, CPT, and facility E&M levels to those diagnoses/procedures. Reviews the entire record for codable information. Uses resources (Coding references and guidelines, Coding Clinics, Auditors, CDI staff, Co-workers, internet, etc.)...

About J29 J29, Inc. (J29) has been supporting commercial, State, and Federal health and human service programs since companyinceptionin 2017 as an employee-centered healthcare management consulting company. Our team of 260 employees focuses on providing processing,review, and analysis of medical claims, records, data, and audits between areas of compliance, policy, and clinicalexpertise. Our team is experienced in program, payment, provider, and patient integrity as we continue to support advanced programs of policy, clinical requirements, and compliance measures at the commercial, State, and Federal levels. J29 was founded to be an employee-centric company that prioritizes the well-being and value of its employees. Our mission is to empower our employees to dogreat thingsfor the benefit of those that need it most. The J29 mission supports not only our health and human service programs, but also the philanthropy efforts of our team. We are proud to continue our support to...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...