79 profee coding auditor jobs found

Sustainable World, Inc. is seeking a remote Health Information Management Auditor to support the Director of HIM by conducting comprehensive audits of hospital outpatient and ProFee claims, evaluating coding accuracy, and identifying revenue integrity improvements. Using proprietary software, you will develop client reports, present findings to leadership, and help create educational materials on coding and billing best practices, while collaborating with consultants and clients. #J-18808-Ljbffr

Colorado Psychiatric is seeking an experienced HIM Auditor to support audit of hospital outpatient and ProFee claims, focusing on coding accuracy, revenue integrity, and billing compliance. The role leverages proprietary software to analyze findings, develops client reports, and presents recommendations to healthcare clients in a remote setting. Ideal candidates will have 5+ years in hospital outpatient facility coding audits and AHIMA/AAPC certification. #J-18808-Ljbffr

JOB SUMMARY The Dental Coding Specialist is responsible for accurately reviewing, assigning, and validating dental procedure codes (CDT codes) for patient services to ensure proper billing, insurance claim submission, and regulatory compliance. This role works closely with dental providers, billing teams, and insurance companies to maximize reimbursement and maintain accurate patient records. SPECIFIC RESPONSIBILITIES Review dental records and documentation for coding accuracy with high attention to detail Assign appropriate CDT and related codes for dental procedures and diagnoses. Audit and submit insurance dental claims. Resolve claim denials, coding discrepancies, and reimbursement issues. Ensure compliance with dental coding guidelines, payer rules and regulations. Maintain accurate patient billing and coding records. Communicate with providers, staff, and insurance carriers regarding coding questions. Stay current on coding updates, regulations, and industry best practices....

Job Description Job Description Under general supervision, reviews, analyzes and assures the final diagnoses and procedures as stated by the practicing providers are valid and complete. Accurately codes office and hospital procedures for providers to ensure proper reimbursement. Provides education to the providers to ensure proper documentation and assignment of ICD-10-CDM, HCPCS and CPT codes. Reports to the Coding Operations Manager. Will support Meeting House Lane Medical Practice, PC and SB Administrative Services. Responsibilities: Audits records to ensure proper submission of services prior to billing on pre-determined selected charges. Receives hospital information to properly bill provider services for hospital patients. Supplies correct ICD-10-CM diagnosis codes on all diagnoses provided. Supplies correct HCPCS code on all procedures and services performed. Supplies correct CPT code on all procedures and services performed. Contacts providers to train and...

Become a part of our caring community 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. Where you Come In 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 of provider...

About Us At Alteva RCM, we’re dedicated to helping healthcare providers thrive through expert revenue cycle management, strategic insight, and innovative solutions. We’re always looking for passionate, driven professionals who want to make a meaningful impact, grow their careers, and be part of a collaborative team committed to excellence. Position Summary The Professional Coder is responsible for accurately reviewing clinical documentation and assigning diagnosis codes, CPT codes, and other required codes for professional services across assigned specialties. This role applies official coding guidelines, regulatory requirements, and payer-specific rules to ensure accurate code selection, clean claim submission, and timely reimbursement. By ensuring coding accuracy and compliance, the Professional Coder plays a critical role in optimizing revenue cycle performance, reducing claim denials and audit risk, supporting regulatory compliance, and contributing to the organization’s...

Medical Biller/Coder Job Description CNSO is a vibrant, well-established neurosurgery, spine surgery, orthopedic spine surgery, pain management, and physical therapy practice with multiple office locations throughout Northern New Jersey.Due to continued expansion, CNSO has an exciting opportunity to join its revenue cycle department in its Wayne location.We are seeking an experienced Medical Biller/Coder with strong surgical coding expertise to accurately assign CPT, ICD-10-CM, and HCPCS Level II codes for neurosurgery, orthopedic spine, pain management, physical therapy, and E/M services.The ideal candidate has in-depth knowledge of CMS guidelines, NCCI edits, and payer policies, and communicates professionally with providers, internal teams, and insurance carriers.This position will serve as a subject matter resource for surgical coding and can work both independently and collaboratively.CNSO provides a two-month orientation and training process, and our highly organized revenue...

COMPANY OVERVIEW PACS Group, Inc. is a holding company investing in post-acute healthcare facilities, professionals, and ancillary services. Founded in 2013, PACS Group is one of the largest post-acute platforms in the United States. Its independent subsidiaries operate 400 post-acute care facilities with 50,000 employees across 17 states serving over 31,000 patients daily. PACS business support division, PACS Services, provides technology and administrative support services — accounting, finance, human resources, compliance, payroll, AR/AP, legal, risk management, information technology, corporate communication, and other business advice and support — to their healthcare facilities, reducing administrative burdens so their leadership and care teams can focus on the care, well-being, and quality of life of their patients and residents. PACS is one of Utah's Best Companies to work for. It has also been recognized as one of Utah's Fastest Growing Companies for multiple years. JOB...

Job TitleValidates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record.Seeking RN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Remote position in New York.Job Responsibility1. Leverages clinical expertise to identify and validate DRG code assignment.2. Full review of CDI suggested code changes.3. Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.4. Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations.5. Applies coding rules and regulations to the validation review process.6. Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions.7. Communicates DRG changes and rationale to the coding and CDI staff.8. Identifies appropriate coding...

Scale Up Philippines is partnering with a progressive healthcare organization to hire a skilled Medical Biller with specialized orthopedic billing experience. This is an excellent opportunity for a detail-oriented billing professional to join a growing practice focused on delivering exceptional patient care while maintaining strong revenue cycle operations. The ideal candidate brings deep expertise in orthopedic billing procedures, payer follow-up, and workers’ compensation claims. You’ll be a critical member of the revenue cycle team, ensuring accurate claim submissions, timely reimbursements, and compliance with payer requirements. Key Responsibilities: Orthopedic Billing & Coding: Process and submit medical claims for orthopedic procedures, surgeries, and treatments with accuracy and efficiency Apply appropriate CPT, ICD-10, and HCPCS codes specific to orthopedic services Ensure compliance with Medicare, Medicaid, and commercial payer guidelines for orthopedic billing...

Where compassion meets innovation and technology and our employees are family. Thank you for your interest in joining our team! Please review the job information below. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or hospital administration as required. Always maintains utmost level of confidentiality. Adheres to hospital policies and procedures. Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines. Reviews the medical record and assigns the appropriate ICD and CPT codes....

Select how often (in days) to receive an alert: At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. Coding for Interventional radiology Occ Summary The Medical Coder Specialist will have frequent and daily interactions with internal and external clients including but not limited to Physician and Non-physician Surgical Providers. Responsibilities include primary diagnosis and procedural coding for the designated major surgical specialty areas and other major procedural...

Acute Inpatient Coding Validation Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibility Leverages clinical expertise to identify and validate DRG code assignment. Full review of CDI suggested code changes. Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. Applies coding rules and regulations to the validation review process. Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. Communicates DRG changes and rationale to the coding and CDI staff. Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations. Operates under general guidance...

Select how often (in days) to receive an alert: Date: Sep 9, 2026 Location: Any city, TN, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for aSenior Coding Auditor, Itemized Bill Reviewer who is responsible for performing itemized bill review, chart review, and coding validation to ensure that billed services were ordered, allowable, and accurately documented in the patient record....

UnitedHealth Group seeks an Evaluation & Management Medical Coder to provide coding and auditing services for providers nationwide. You will translate clinical diagnoses into codes, educate provider offices, and audit claims to ensure proper coding. The role requires telecommunication with physicians and staff and supports remote work within the U.S. The position is full-time with standard hours 8:00 AM–4:00 PM CST, with occasional overtime as needed. #J-18808-Ljbffr

Date: Aug 21, 2026 Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for anOutpatient Coding Auditor, Senior Associatewho is responsible for performing coding reviews of medical records and/or other documentation to determine correct coding as defined by review methodologies specific to the contract for which review services are being provided. This involves accessing...

Job Description Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibility 1. Leverages clinical expertise to identify and validate DRG code assignment. 2. Full review of CDI suggested code changes 3. Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. 4. Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5. Applies coding rules and regulations to the validation review process. 6. Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7. Communicates DRG changes and rationale to the coding and CDI staff. 8. Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations. 9. Operates under...

**Your role****JOB OBJECTIVES:**The Social Compliance Auditor will independently plan, conduct, and report social-compliance and responsible-sourcing audits at manufacturing, processing, distribution, agricultural, and other operational facilities.Assignments may include SMETA, RBA, RSCI, SA8000, amfori BSCI, SLCP, customer-specific codes of conduct, and other social-compliance or responsible-business programs based on the auditor’s qualifications and client requirements.This is an assurance role requiring professional independence, sound judgment, objective evidence collection, and clear communication. The auditor may not provide consulting, remediation implementation, or internal-audit services to a facility being assessed.**ESSENTIAL FUNCTIONS:*** Plan and prepare for audits by reviewing facility profiles, scope, prior findings, applicable standards, client requirements, and relevant legal requirements.* Conduct independent on-site audits, including opening and closing meetings,...

Rockstar is an industry-leading staffing company based in Arizona that helps healthcare businesses across the United States streamline operations by connecting them with skilled remote professionals. We partner with talented individuals from around the world, providing meaningful remote career opportunities that empower personal and professional growth. At Rockstar, we are committed to placing team members who not only meet our clients' operational needs but who also reflect our core values of integrity, excellence, and long-term service. Every placement is an opportunity to make a meaningful difference, for the practice, for patients, and for you. Job Description This is a remote position. Rockstar is seeking an experienced Medical Billing Specialist to support U.S.-based healthcare practices on a full-time remote basis. This is a billing-first role built for professionals who know the full revenue cycle, not just one piece of it, and who take ownership of the financial health...

Xtensys is a rapidly growing managed service provider delivering innovative technology solutions to health systems, beginning in New York and expanding nationwide. Owned by two industry leaders with a strong focus on advancing rural and community healthcare, Xtensys is executing several major initiatives and scaling quickly. With a team of more than 500 professionals, we are building a people-centered culture rooted in collaboration, innovation, and strategic thinking. We are seeking an experienced Medical Coding Auditor to support our continued growth and commitment to deliver exceptional client outcomes. Why Join Us? Mission-Driven Work: You are the "bridge" ensuring technology serves health systems and their patients when they need it most. Autonomy & Ownership: We trust you. You’ll lead projects, define success, and manage complexities with total support. A Culture of Innovation: Have a fresh perspective? We want it. We encourage risk-taking and continuous...

Inpatient Coder III The Inpatient Coder III at United Health Services (UHS) plays a key role in ensuring the accuracy, integrity, and quality of complex inpatient coding. Using advanced ICD-10-CM/PCS expertise, this position supports compliant coding practices, appropriate reimbursement, and reliable data that informs patient care and organizational performance. Working closely with physicians, HIM partners, and coding colleagues, the Inpatient Coder III contributes to audits, continuous improvement efforts, and team development while helping strengthen healthcare outcomes across the communities UHS serves. Primary Department, Division, or Unit: Facility Coding, UHS Revenue Cycle Operations Primary Work Shift: Day Regular Scheduled Weekly Hours: 40 Compensation Range: $33.63 - $50.45 per hour, depending on experience Job Responsibilities Essential Functions: Review and code complex inpatient medical records using ICD-10-CM and ICD-10-PCS to ensure accurate...

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. This is a remote position Key Responsibilities Perform detailed audits of hospital outpatient and ProFee claims to identify coding, billing, charging, and revenue cycle improvement opportunities. Review and recommend coding, charge capture, revenue integrity, and claim optimization strategies. Utilize proprietary software to analyze audit findings and develop standardized client reports. Present audit results and recommendations to clients in a clear, professional manner. Respond to coding and compliance-related inquiries with...

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...