11 policy coding auditor jobs found

Become a part of our caring community The 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 Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

Job Description Job Description Description: A Certified Professional Medical Auditor is responsible for reviewing and auditing medical documentation, including patient records, charts, and clinical notes, to ensure accuracy, compliance with regulations, and adherence to industry standards. This role is crucial in maintaining the integrity of medical records, billing processes, and healthcare facilities' compliance with applicable laws and regulations. Requirements: Key Responsibilities: Medical Documentation Review: Conduct thorough audits of patient medical records, including physician notes, progress notes, discharge summaries, and other relevant documentation. Examine medical records to verify their completeness and conformity with established standards, ensuring they accurately reflect the patient's condition, diagnosis, treatment, and other pertinent information. Verify that documentation adheres to established coding guidelines, such as ICD-10 and CPT, and...

Medical Billing Specialist Administration - Flint, MI 48502 Overview Position Type Full Time Education Level High School Category Health Care Description This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third-party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities. General responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks. Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days. Accurately post all insurance payments by line item. Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely* Collects on outstanding claims...

Back-End Medical Biller Full-Time, Temp to Hire Opportunity - Onsite Hours: 8 am to 4:30 pm M-F (30-minute lunch) $19-$20 per hour DOE Professional Summary This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities General Responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days Accurately post all insurance payments by line item Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely* Collects outstanding claims from...

Job Description Job Description The Ambulatory Coding and Reimbursement Specialist is responsible for reviewing, analyzing, and accurately coding ambulatory and/or hospital-based encounters. This role performs initial charge review for E/M visits, diagnostic tests, and procedures across multiple specialty departments to determine the appropriate assignment of CPT, ICD-10, HCPCS codes, and modifiers for reporting physician services to third-party payers. The Specialist ensures all coding aligns with established coding standards, regulatory requirements, and reimbursement policies. Essential Duties and Responsibilities: Analyzes provider documentation to assure the appropriate Evaluation & Management levels are assigned using the correct CPT and current Evaluation and Management Guidelines Interprets outpatient office visit notes and charge documents to determine services provided and accurately assign CPT , Modifiers, and ICD-10 coding to these services. Performs...

Medical Billing Specialist Administration - Flint, MI 48502 Overview Position Type Full Time Education Level High School Category Health Care Description This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third-party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities. General responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks. Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days. Accurately post all insurance payments by line item. Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely* Collects...

Job Description Job Description Description: About KODE We're coding rebels with a cause. KODE is a health-tech company developed by medical coders for medical coders looking to change the way things are done in the industry. Our company may be young but we're growing rapidly. That also means we're not buried in outdated policies and bureaucracies. Coders play a critical role in healthcare, but have you ever felt like you're just a cog in the machine? At KODE there are no cogs, there are people. We aren't looking for a coder to fill an open position simply. We're looking for a new teammate passionate about professional coding who wants to join our collective mission to be awesome.We're serious about two things: coding and treating you like the professional you are. If this intrigues you, please keep reading. About this Role The Hospital Emergency Department Coder reviews emergency department medical record documentation. The Coder works independently and is responsible...

Job Description Job Description Description: CPC-As are not being considered at this time. We're coding rebels with a cause. KODE is a health-tech company developed by medical coders for medical coders looking to change the way things are done in the industry. Our company may be young but we're growing rapidly. That also means we're not buried in outdated policies and bureaucracies.Coders play a critical role in healthcare, but have you ever felt like you're just a cog in the machine? At KODE there are no cogs, there are people. We aren't looking for a coder to fill an open position simply. We're looking for a new teammate passionate about professional coding who wants to join our collective mission to be awesome.We're serious about two things: coding and treating you like the professional you are. If this intrigues you, please keep reading. About this Role We're looking for a Facility Inpatient Coder to join our company! Responsibilities: Review medical records...

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...

Back-End Medical Biller Full-Time, Temp to Hire Opportunity - Onsite Hours: 8 am to 4:30 pm M-F (30-minute lunch) $19-$20 per hour DOE Professional Summary This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities General Responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days Accurately post all insurance payments by line item Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely* Collects...

Metro Vein Centers is a rapidly growing healthcare practice specializing in state‑of‑the‑art vein treatments. Our board‑certified physicians and expert staff are on a mission to improve people’s quality of life by relieving the painful, yet highly treatable symptoms of vein disease—such as varicose veins and heavy, aching legs. With over 60 clinics across 7 states , and still growing,we’re building the future of vein care—delivering compassionate, results‑driven care in a modern, patient‑first environment. We proudly maintain a Net Promoter Score (NPS) of 93 , the highest patient satisfaction in the industry. In this position, you’ll serve as a key resource for the coding team. You’ll help guide coders by answering questions, offering coaching, and mentoring where needed. You’ll also perform regular audits to make sure coding is accurate and compliant, and provide support with claims processing when issues come up. In addition, this position will work closely with the Coding...