44 profee coding auditor jobs found

Certified Coding Specialist HealthCare Support is actively seeking a Certified Coding Specialist to fill an opening in West Orange, California. Daily Responsibilities for Certified Coding Specialist: Presents at provider workshops and assists with provider training on regulations for appropriate coding of medical charts and documentation required to support proper claims submission. Assists other departments regarding evaluation of medical records, procedures or diagnosis code questions; identifies ambiguous or non-specific medical documentation regarding coding protocols related to provider disputes, appeals and coding audits on submitted claims. Assists the manager with identifying questionable billing practices based on coding protocol. Monday to Friday 8AM - 5PM Required Qualifications for Certified Coding Specialist: Bachelor's degree in public health, health services, or related field OR equivalent experience (so they'd need total of 7 years of...

Medical Billing Specialist III/IV - Behavioral Health Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5037514) Apply  Medical Billing Specialist III/IV - Behavioral Health Salary $54,060.11 - $76,162.64 Annually Location Ventura and may require travel throughout Ventura County, CA Job Type Full-Time Regular Job Number 0840HCA-25AA (NW) Department Health Care Agency Division Behavioral/Mental Health Opening Date 08/27/2025 Closing Date Continuous Description Benefits Questions Description THE POSITION Under general direction (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance reimbursement requirements. IDEAL CANDIDATE The ideal candidate has specialized expertise in mental health billing, including CPT, ICD-10, and HCPCS coding for Medicare and Medi-Cal....

Associate Medical Director Opportunity! $100K Hiring Incentive! Plus Monthly and Quarterly Bonus Incentives! Fresno County is the heart of California! Fresno offers outdoor adventures, family-friendly activities, and farm to table dining. The sun shines for more than 300 days of the year, creating the perfect environment to enjoy Concentra's work life Balance. We look forward to speaking with you! Through our evidenced based medicine approach, Concentra's goal is to provide quality patient care while treating everyone with friendliness, skill, and respect. We strive daily to promote a diverse environment of acceptance and compassion for our colleagues and cultivate a welcoming atmosphere where our patients can heal. As we've grown, we've expanded into urgent care, wellness services, administration, onsite health and wellness centers, and telemedicine. All these services together make achieving health easier and more accessible for our patients, clients, colleagues, and all...

We are looking for experienced HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities include the following: Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use of diagnosis and...

Job Description Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work. Job Summary: Reviews inpatient records to identify the diagnosis and procedure codes performed during the patients stay are valid and in accordance with coding conventions and guidelines. Records types including inpatient encounter types. Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work. Job Requirements: Education and Work Experience: High School Education/GED or...

Medical Biller Overview This temp to hire role requires strong technical accuracy, experience with insurance processes, and the ability to work efficiently in a high-volume environment. Responsibilities Retrieve, manage, and post charge batches from multiple EHR platforms Group and organize charge batches for processing Sequence ICD-10 and CPT codes based on client requirements Apply appropriate modifiers and add-on codes Audit coding for accuracy and resolve any discrepancies Perform A/R functions, including follow-up on aging reports Communicate with insurance representatives by phone regarding claims and EOBs Maintain productivity expectations (70-100 accounts daily) across multiple medical specialties, including radiology, pathology, dermatology, family practice, wound care, and urology Qualifications 1+ years of medical billing experience with ICD-10, CPT, and EHR systems Experience with...

Job Title Coder Job Description Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work. Job Summary Reviews inpatient records to identify the diagnosis and procedure codes performed during the patients stay are valid and in accordance with coding conventions and guidelines. Records types including inpatient encounter types. Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work. Job Requirements Education and Work Experience: High School Education/GED or...

Job Description Job Description Description: We are seeking a detail-oriented and knowledgeable Medical Biller to join our medical practice. The ideal candidate will be responsible for managing billing processes, ensuring accurate coding and submission of claims, and maintaining medical records. This role is crucial in facilitating the financial operations of our medical office while ensuring compliance with healthcare regulations. Requirements: Responsibilities Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues Follow up on claims using...

Become a part of our caring community and help us put health first The 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 Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy...

Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation’s leading health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team! Responsibilities The Outpatient Coder Auditor Trainee reviews and analyzes documentation present in the medical record for outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Outpatient Coder Auditor Trainee finalizes the coding and abstracting of the medical record upon ensuring the assignment of...

Hours Per Week: 40 Job Type: Full-time, Non-Exempt  Summary/Objectives of Position The Certified Biller & Coder Specialist's responsibility is to ensure the smooth facilitation of communication with funding sources, program partners, and insurance companies. This position will spend most of the time interpreting patient files and using established systems that make it easy for insurers to recognize the type of treatment covered under a patient’s plan. The day-to-day work of the Certified Biller & Coder Specialist includes proper coding of services, procedures, diagnoses, and treatments. Preparing and sending invoices or claims for payment. It is the responsibility of the position to gather documentation to validate the coding choices and argue against any wrongfully denied claims. They analyze all parts of a patient’s visit, including diagnostic tests, consultations, in-office procedures, and prescribed medication. Essential Duties, Functions &...

A bit about us: We are a long-standing nonprofit treatment provider with over five decades of service in the recovery community. For over 40 years, we've helped more than 50,000 individuals overcome health challenges through compassionate, evidence-based care. With 300+ residential beds and a dedicated team of 150+ staff, interns, and volunteers, we offer comprehensive services that promote long-term sobriety and personal growth. Why join us? Medical Dental Vision 401K Growth Options Job Details The billing specialist ensures accurate and timely billing for services provided. This role is responsible for preparing, reviewing, and submitting claims, resolving denied or unpaid claims, and maintaining compliance with local, state, and federal billing regulations. The ideal candidate is detail-oriented, tech-savvy, and experienced in medical billing systems and procedures. Key Responsibilities Daily Billing Operations Reconcile billing records for accuracy,...

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:...

Job Description Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL‑certified campus—a rejuvenating place for associates systemwide to collaborate, innovate and connect. Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well‑being and inspire your best work. Job Summary Reviews patient records to identify the diagnosis and procedure codes performed during the patient’s stay are valid and in accordance with coding conventions and guidelines. Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work. Job Requirements Education and Work Experience: High School Education/GED or equivalent: Preferred Associate's/Technical Degree or equivalent combination of education/related...

Position Purpose: The Certified Medical Coder plays a crucial role in the Billing Department by ensuring precise and compliant coding of medical services. Under the guidance of the Billing Department Supervisor, the Coder will assign appropriate diagnosis and procedural codes for services provided by JWCH physicians, adhering to industry standards and legal requirements. This position involves validating and auditing coding practices to guarantee accuracy in billing, supporting optimal reimbursement, and maintaining adherence to regulatory guidelines. Duties and Responsibilities: Serve as the primary liaison between providers and the Billing Department, effectively communicating to clarify diagnoses, procedures, coding, and documentation requirements. Recommend appropriate ICD-10-CM, CDT diagnosis codes, CPT codes, and HCPCS codes. Regularly review diagnosis and procedure coding within NextGen to ensure optimal billing accuracy. Collaborate with clinicians on the...

Job DescriptionJob DescriptionSUMMARYThe Certified Risk Adjustment Coder is responsible for accurately abstracting provider services into ICD-10 codes from medical documentation.This role adheres to the coding ethics of organizations such as the American Academy of Procedural Coders (AAPC), American Health Information Management Association (AHIMA), and the National Alliance of Medical Auditing Specialists (NAMAS), as well as payer guidelines.The coder conducts concurrent, prospective, and retrospective reviews of medical record documentation to ensure the accurate and complete capture of the clinical picture, severity of illness, and complexity of patients.Additional duties include provider communication and education to support the closure of both risk adjustment and quality care gaps, as well as providing ongoing feedback to physicians regarding coding guidelines and requirements.ESSENTIAL JOB FUNCTIONSPerform coding quality audits of medical records to ensure ICD-10 codes are...

Job Title: Certified Medical Coder / Certified Professional Coder (CPC) Duration: 3 months Location: Orange, CA 92868 Shift: Monday through Friday, 8:00 a.m. - 5:00 p.m. Mode: Onsite Pay Rate: $27.98-$43.37/hr Role & Responsibilities: Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department. Supports the manager in ensuring current coding methodology and modifier rules are applied to appropriate reimbursement and ensures the organization is following Medicare and Medi-Cal protocol for payment of claims. Maintains and monitors code listing updates for International Classification of Diseases (ICD)-10-Clinical Modification (CM)/Procedure Coding System (PCS), Current Procedural Terminology (CPT) and...

Job Description Codes and abstracts inpatient and outpatient conditions, diseases, reason for encounters, social determinants of health and PCS/CPT procedures to report accurate administrative and clinical data, utilizing approved coding guidelines as set forth in Official Coding Guidelines, ICD Book, Coding Clinic for ICD-CM/PCS, AHA Coding Clinic for HCPCS and CPT Book. Assigns appropriate DRG/APC prospective payment systems and classifications, to reflect the appropriate severity and illness for inpatient and specialty cardiac, neurology, and vascular outpatient encounters. Collaborates closely with clinicians and CDI staff, not excluding inpatient rehab coordinators to obtain appropriate documentation, as needed. Assists with internal coding audit and training activities Responsibilities This is not an exhaustive statement of duties, responsibilities, or requirements. Employees will be required to perform any job, with related instruction given by their supervisor,...

Certified Coder Oakland, CA Information Systems Health Information Servcies Full Time - Day $29.59 - $49.31/ hour Req #:41093-30377 FTE:1 Posted:February 13, 2026 Summary SUMMARY: Reads and interprets medical record documentation to assign diagnosis codes, assigns CPT codes, and applies knowledge of payer reimbursement guidelines to ensure proper reimbursement. Performs related duties as required. DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE:The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification. Adheres to the ICD-9-CM (International Classification of Diseases, 10th revision, Clinical Modification) coding conventions, official coding guidelines approved by the cooperating parties, the CPT (Current Procedural Terminology) rules...

Job Summary The Health Information Coder III is a senior-level inpatient coder with the knowledge and skill set to utilize the ICD-10-CM and ICD-10-PCS classification systems to code acute academic, teaching inpatient cases. The skill set extends to knowledge and comprehension of code sequences into Diagnoses-Related Groups on acute academic, teaching inpatient cases. Cases are coded to comply with the official guidelines for coding and reporting, practice standards and code of ethics for HIMS coder. Cases are abstracted according to UCSF Health policies and procedures. The focus of coding and abstracting is on a range of all primary hospital services. There is minimal review of coding for quality. DUTIES AND ESSENTIAL JOB FUNCTIONS Retrieve and analyze comprehensive medical records and information systems for appropriate documentation and follow-up as appropriate. Evaluate full episode of care of clinical data for inpatient cases and assign appropriate codes using...

Step Into a High-Impact Revenue Role With Room to Grow This Jobot Job is hosted by: Kevin Shilney Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume. Salary: $70,000 - $100,000 per year A bit about us: Our client is an established, fast-growing organization operating within the healthcare and technology space. The company provides innovative, data-driven solutions that support healthcare delivery, operations, and patient engagement. With a strong focus on quality, compliance, and scalability, the organization partners with healthcare stakeholders to improve efficiency, outcomes, and long-term sustainability. This is a stable environment with continued investment in systems, processes, and talent, offering employees the opportunity to make a meaningful impact while working in a collaborative, cross-functional setting. Why join us? Onsite role in Sunnyvale, CA, working closely with cross-functional teams Competitive salary range of...

Benefits: Employee discounts Training & development Wellness resources Role Overview Own the end-to-end medical billing lifecycle for a multi-specialty healthcare clinic. Drive clean claims, fast reimbursements, and zero leakage. This is an execution-heavy, accountability-driven role—not a passive billing position. Core Responsibilities Manage full-cycle billing: charge entry, claim submission, payment posting, and follow-up. Bill and reconcile across multiple payor types: Commercial insurance Medicare Personal injury (PI) Workers’ compensation Cash-based services Ensure accurate CPT, ICD-10, and modifier usage across: Medical Chiropractic Physical therapy Acupuncture Massage therapy Aggressively work A/R: Identify denials, underpayments, and delays. Execute timely appeals and corrections. Maintain compliance with: Medicare rules State and federal billing regulations Payor-specific policies Communicate clearly with:...

Job Family : PFS Billing Travel Required : None Clearance Required : None What You Will Do : The Medical Biller is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers. Has an extensive knowledge of billing requirements mandated by payers and / or governmental regulations. This position will perform any and all related job duties as assigned. This position is a hybrid schedule working two days in the El Segundo office and three days from home. Essential Job Functions Hospital Billing Emphasis Correcting and billing electronic and hardcopy claims...

Billing Specialist - Leading TX Center for over 40 years This Jobot Job is hosted by: Jamal Elkhateib Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $23 - $28 per hour A bit about us: We are a long-standing nonprofit treatment provider with over five decades of service in the recovery community. For over 40 years, we've helped more than 50,000 individuals overcome health challenges through compassionate, evidence-based care. With 300+ residential beds and a dedicated team of 150+ staff, interns, and volunteers, we offer comprehensive services that promote long-term sobriety and personal growth. Why join us? Medical Dental Vision 401K Growth Options Job Details The billing specialist ensures accurate and timely billing for services provided. This role is responsible for preparing, reviewing, and submitting claims, resolving denied or unpaid claims, and maintaining compliance with local, state, and federal...