36 profee coding auditor jobs found

Job Description Job Description   PYA is seeking an experienced Inpatient/Outpatient Facility Coding Auditor to join our nationally recognized  Revenue and Compliance Advisory team. As a trusted advisor to leading healthcare organizations, you will apply your expertise in coding, reimbursement, compliance, and documentation to help clients improve revenue integrity and reduce risk. WHAT YOU'LL DO Perform inpatient and outpatient facility coding audits and reimbursement reviews, including:  ICD-10-CM/PCS, CPT, and HCPCS coding validation MS-DRG and APC validation Charge capture and revenue integrity reviews Clinical documentation improvement (CDI) assessments Third-party payer compliance evaluations Deliver high-quality client reports, recommendations, and presentations  Manage multiple engagements while maintaining exceptional quality and compliance standards  Collaborate with PYA's consulting, compliance, and executive teams to deliver comprehensive...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Schedule: Monday-Friday, 8-hour shifts between the hours of 7am-5pm PST. Training schedule will be 8:30am-5pm PST. Schedule to be determined by supervisor upon hire. Location: 2716 North Tenaya Way, Las Vegas, NV 89128. Travel will be required up to 50% of the time for chart retrievals. The Medical Coder supports IPA (Independent Provider Association) Providers with ongoing ICD-10 CM Coding Education...

All inclusive preventive care in Miami, FL, is seeking a Senior Medical Coding Auditor (CPC) to join our multi-specialty practice focusing on Primary Care and Gynecology. The role reviews provider notes before submission to ensure accurate coding, proper E/M levels, and compliance while supporting optimal reimbursement. You will work with providers and the billing team to reduce denials, improve documentation quality, and maintain regulatory compliance. #J-18808-Ljbffr

Job Description The Coder III reviews inpatient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines with a 97% accuracy rate, while maintaining coding standards for productivity. This position must preserve confidentiality of health information. This position must be able to use tact and diplomacy when communicating with employees, physicians, administration, and public, under complex or emotional situations. Responsibilities Responsibilities include: Reviews patient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines. Meets Productivity Standard for Inpatient Coding: 17 charts/day. Understands appropriate assignment of MS-DRG, POA, and discharge disposition. Assists with all levels of coding including inpatient, outpatient, and psych. Works as a team member to achieve goals for the department. Assists with data integrity audits, and corrects errors as needed (invalid codes,...

Job Description Job Description Description: The Professional Fee (ProFee) Coder is responsible for reviewing provider documentation and assigning accurate CPT, HCPCS, and ICD-10-CM codes for physician services. This role supports compliant coding, accurate charge capture, and overall revenue integrity across a variety of specialties and client environments.   Coders may support single-specialty or multi-specialty engagements depending on client needs and experience. Requirements:   Core Responsibilities (Sage Standards)   Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes   Ensure documentation supports coded services and identify discrepancies  Apply appropriate modifiers, NCCI edits, and payer-specific coding rules   Ensure compliance with CMS, AMA, and payer guidelines   Maintain =95% coding accuracy and meet established productivity standards  Identify documentation gaps and escalate for clarification when needed   Participate in...

Job Description Job Description Description: Position Overview The Professional Billing Coder – Vascular Surgery is responsible for accurate coding of professional services related to vascular procedures. This role supports compliant billing practices and contributes to revenue integrity and audit readiness. Requirements:   Key Responsibilities Assign accurate CPT, HCPCS, and ICD-10-CM codes for vascular surgery procedures  Review operative and procedural documentation for coding accuracy and completeness  Apply appropriate modifiers and NCCI edits • Ensure adherence to CMS, AMA, and payer guidelines  Maintain accuracy and productivity standards in a high-volume environment  Support internal audits and quality improvement initiatives Required Qualifications Minimum 2+ years of professional billing coding experience   Proven experience with vascular surgery coding   Strong knowledge of CPT, ICD-10-CM, modifiers, and NCCI edits  CPC or equivalent...

POSITION SUMMARY This position is responsible for investigating, resolving, and appealing denied medical insurance claims to maximize revenue and minimize outstanding accounts receivable. This role requires a strong understanding of insurance guidelines, billing codes, and medical documentation standards. ESSENTIAL DUTIES AND RESPONSIBILITIES Process denied claims and follow up with insurance companies to resolve discrepancies or reimbursement issues. Audit patient charts to confirm proper coding and documentation for billing accuracy. Read, analyze, and interpret Explanation of Benefits (EOBs) to determine next steps for claim resolution. Ensure all denials are submitted with complete and accurate information. Ensure that denials are worked on daily and assist with tasks as assigned. Process electronic and paper payment postings efficiently and accurately. Communicate regularly with administrative and clinical staff, preparing detailed reports for...

Coding AuditorThe Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals.ResponsibilitiesReviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment Informs manager of any activities which do not meet federal or state coding and billing requirements Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and responds within 5...

The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals. Responsibilities Reviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment Informs manager of any activities which do not meet federal or state coding and billing requirements Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and responds within 5 working...

Job DescriptionThe Coder III reviews inpatient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines with a 97% accuracy rate, while maintaining coding standards for productivity. This position must preserve confidentiality of health information. This position must be able to use tact and diplomacy when communicating with employees, physicians, administration, and public, under complex or emotional situations.ResponsibilitiesResponsibilities include:Reviews patient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines.Meets Productivity Standard for Inpatient Coding: 17 charts/day.Understands appropriate assignment of MS-DRG, POA, and discharge disposition.Assists with all levels of coding including inpatient, outpatient, and psych.Works as a team member to achieve goals for the department.Assists with data integrity audits, and corrects errors as needed (invalid codes, discharge codes,...

The Coder III reviews inpatient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines with a 97% accuracy rate, while maintaining coding standards for productivity. This position must preserve confidentiality of health information. This position must be able to use tact and diplomacy when communicating with employees, physicians, administration, and public, under complex or emotional situations. Responsibilities Reviews patient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines. Meets Productivity Standard for Inpatient Coding: 17 charts/day. Understands appropriate assignment of MS-DRG, POA, and discharge disposition. Assists with all levels of coding including inpatient, outpatient, and psych. Works as a team member to achieve goals for the department. Assists with data integrity audits, and corrects errors as needed (invalid codes, discharge codes, etc.). Monitors backlog of un-coded...

About Us We are a fast-growing, innovative medical billing company committed to transforming the healthcare revenue cycle through technology, transparency, and top-tier customer service. Our team is passionate about simplifying the complexities of medical billing so healthcare providers can focus on what matters most—patient care. Benefits 401(k) matching Competitive salary Dental insurance Health insurance Paid time off About Us We are a fast-growing, innovative medical billing company committed to transforming the healthcare revenue cycle through technology, transparency, and top-tier customer service. Our team is passionate about simplifying the complexities of medical billing so healthcare providers can focus on what matters most—patient care. We're seeking a highly motivated and experienced Charge Posting (Coder) Supervisor to join our leadership team and help us continue delivering exceptional results to our clients across the country. Job Overview As the Medical...

Service Warranty Booker/CoderAutoNation is one of the largest automotive retailers in the United States, offering innovative products, exceptional services, and comprehensive solutions, empowering our customers to make the best decisions for their needs. With a network of dealerships nationwide strengthened by a recognized brand, we offer a wide variety of new and used vehicles, customer financing, parts, and provide expert maintenance and repair services. Through DRV PNK, we have raised over $40 million for cancer-related causes, demonstrating our commitment to making a positive difference in the lives of our Associates, Customers, and the communities we serve. So what do you say? Are you ready to be part of something big?The Service Warranty Booker/Coder is responsible for reviewing and coding warranty repairs and claims. This includes booking, coding, researching warranty claims and billing them to the appropriate operation codes.What Are The Day-To-Day Responsibilities?Process...

Location: Sarasota, Florida, United StatesCompany: State of FloridaPosted: The State Personnel System is an E-Verify employer. For more information click on ourE-Verify Website .Are you a whiz with a knack for navigating the intricate world of healthcare? Look no further! We're on the hunt for a dynamic individual to join our squad! As Medical Coding Specialist, you'll be the unsung hero behind the scenes, turning complex medical information into a symphony of perfectly coded data. DOH Sarasota requires a Medical Coder/Referral specialist to ensure accurate, timely coding for clinical services such as family planning, Obstetric care, STI care, and HIV/AIDs and Hepatitis C treatment. The coder will also be responsible for referral tracking. Proper coding is essential for compliant reporting, reimbursement, and data accuracy. A dedicated coder improves documentation quality, supports audits, maintains regulatory compliance, and protects the department’s financial and data integrity....

Overview North Florida Surgeons is a leading healthcare provider committed to delivering exceptional patient care and service. We have over 300 medical providers and physician extenders and are currently seeking a detail-oriented and motivated Medical Coding Specialist to support our revenue cycle department. This role is essential in ensuring accurate coding for services rendered, which directly impacts reimbursement and compliance. The Medical Coder is responsible for reviewing clinical documentation and assigning appropriate ICD‑10, CPT, and HCPCS codes for billing and reimbursement. This position works closely with providers, billing staff, and insurance companies to ensure coding accuracy and compliance with federal regulations. Key Responsibilities Review medical records and documentation to assign accurate diagnosis and procedure codes Responsible for coding office visits and surgeries Collaborate between clinical, billing and patient services departments to ensure...

Overview North Florida Surgeons is a leading healthcare provider committed to delivering exceptional patient care and service. We have over 300 medical providers and physician extenders and are currently seeking a detail-oriented and motivated Medical Coding Specialist to support our revenue cycle department. This role is essential in ensuring accurate coding for services rendered, which directly impacts reimbursement and compliance. The Medical Coder is responsible for reviewing clinical documentation and assigning appropriate ICD-10, CPT, and HCPCS codes for billing and reimbursement. This position works closely with providers, billing staff, and insurance companies to ensure coding accuracy and compliance with federal regulations. Key Responsibilities Review medical records and documentation to assign accurate diagnosis and procedure codes Responsible for coding office visits and surgeries Collaborate between clinical, billing and patient services departments to ensure...

Overview FTE: 1.0 Hours: Monday - Friday, 8:00 AM - 5:00 PM Location: Remote (eligible only within FL, GA, MO, PA, SC, TN, and TX) Position Summary This role is responsible for reviewing, analyzing, and assigning final diagnoses and procedures as documented by the practicing provider, following all compliance policies and guidelines. The position ensures accurate coding of office and hospital procedures to guarantee proper reimbursement. Key Responsibilities Providing physician education to ensure proper completion of Electronic Health Records (EHR). Ensuring correct assignment of ICD-10-CM, HCPCS, and CPT codes. Delivering education verbally, in writing, and through hands‑on training as needed. Responsibilities Review clinical documentation and code to the highest level of specificity for accurate charge capture. Interact with providers to provide feedback and education using verbal, written, and hands‑on communication methods. Assign and sequence appropriate codes and...

Location: Orlando, FL Job Id: 266 # of Openings: 1 Valora Medical Group is a visionary company focused on high-quality primary care services and consisting of healthcare providers and professionals dedicated to the health and well-being of our patients. At Valora, we treat our patients like family. With multiple locations throughout the Dallas-Fort Worth and Central Florida area, we understand that providing quality medical care and an exceptional patient experience across all our centers requires having an outstanding team. A Risk Adjustment (MRA) Coder ensures all significant chronic conditions found in the patient’s chart affecting the risk score are identified to allow the Clinical Provider to determine which conditions are current so they can be addressed during the patient visit. This role is also responsible for proper identification of respective ICD-10 codes to ensure the accuracy of billing for addressed diagnoses. In addition, the MRA Coder/Auditor provides...

Summary/Objective Under limited supervision the Medical Biller reviews and verifies medical bills and invoices with accounts receivable ledger and patients. Ensures record accuracy, follow up, and makes necessary revisions. The Medical Biller processes changes in system to support accurate and efficient billing processes. The Medical Biller will be charged with maintaining the confidentiality of patient records and procedures. Essential Job Functions Analyzes, investigates, and resolves account issues, including resubmitting and updating line and claim document information. Accesses available resources to locate missing or incorrect information. Updates medical claims with corrected billing information and releases claims for transmission to the payer. Investigates and documents actions taken to resolve medical billing discrepancies and unusual charges and credits. Works high priority Third-Party Liability/MVA/WC cases according to department policies and procedures. Conducts...

Job TitleLocation: Miramar, FloridaAt Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.Job DescriptionReviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance.ResponsibilitiesCommunicates with insurance companies about coding errors and disputes (physician billing). Abstracts pertinent data points for billing and quality reviews. Communicates with various departments as needed to ensure accuracy of patient data.Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing).May assign and sequence basic CPT (Current Procedural...

Outpatient CoderLocation: Miramar, FloridaAt Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.Job DescriptionReviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance.ResponsibilitiesUsing encoder, reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments. Reviews coding edits. Reviews Local Coverage Determination (LCD) edits and guidance for codes meeting medical necessity. Research electronic medical record for any additional diagnoses documented to meet medical necessity. Codes various OP service lines for all MHS specialties that include encounters with high complexity of surgical...

Overview Baptist Health is the region’s largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 25 years, we’ve been named one of Fortune’s 100 Best Companies to Work For, and in the 2024-2025 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 45 high-performing honors. What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families...

A leading not-for-profit healthcare organization in Florida seeks an experienced E&M Coding Auditor/Educator. You will be responsible for conducting comprehensive audits to ensure the integrity of coding and billing for clinical fees and develop educational programs based on the audit results. The ideal candidate must possess certifications in coding, have at least 4 years of relevant experience, and excel in customer service. A robust understanding of E&M regulations is essential. Competitive hourly pay of $26.13 - $33.97 is offered. #J-18808-Ljbffr

North Florida Surgeons- Baptist Jacksonville division is looking for an energetic, patient focused certified medical coder. This is an excellent opportunity to join a busy surgical practice! We are located in the Pavilion Building on the Baptist Main Campus Downtown. North Florida Surgeons Baptist Jacksonville Division offers great benefits, competitive wages and opportunities for growth. Key Responsibilities: Review medical records and documentation to assign accurate diagnosis and procedure codes Responsible for coding office visits and surgeries Collaborate between clinical, billing and patient services departments to ensure correct information is obtained for accurate coding and billing Accurately review patient medical records and assign appropriate ICD-10, CPT, and HCPCS codes to diagnoses, procedures, and treatments. Ensure that coded data is correctly submitted for insurance claims, adhering to payer-specific guidelines and medical coding standards. Maintain strict...