15 profee coding auditor jobs found

Job Description Position Summary The coding auditor is responsible for ensuring the integrity of inpatient and/or outpatient medical records by auditing them to confirm that clinical documentation accurately supports the diagnosis, CPT and/or DRG assigned. This position requires a detailed understanding of medical coding principles, coding guidelines, coding clinics, CPT Assistant and the ability to perform objective medical audits. The auditor will conduct audits drawing on advanced ICD-10 and CPT coding expertise, and coding guidelines to substantiate their recommendations. In this role, the auditor will review accounts flagged by Streamline, eValuator and provide recommendations if determined necessary. The auditor will also be responsible for identifying potential trends and educational opportunities. The coding auditor will also conduct focus reviews as determined by the coding manager. The auditor must be task oriented and have strong ability to work independently...

Job Description Position Summary Responsible for the creation and maintenance of audit and education programs that will ensure success for all staff and employed providers based on their specific needs and support accurate, compliant coding practices for ECU Health Physicians in accordance with coding guidelines. Conducts internal auditing of medical coding activities using concurrent, prospective and retrospective models as appropriate and/or required. Reviews electronic health information to determine accuracy of coding, billing and documentation, including validation of ICD10CM, CPT, HCPCS and modifier assignment related to medical provider professional Part B services according to regulatory and institutional policy. Reports findings, both written and verbal, to leadership as necessary to include provision of corroborating regulatory or policy guidance. Maintains documentation of all audit activities and communicates the findings with leadership. Utilizes findings to...

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. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's 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. Occ Summary The Medical Coder Specialist will have frequent and daily interactions with internal and external clients, including but not limited to physicians and Non-physician Surgical Providers. Responsibilities include primary diagnosis and procedural coding for the designated major surgical specialty areas and other major procedural areas, including...

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. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's 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. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Virginia, South Carolina, Tennessee, Florida, and Texas. Occ Summary The medical coder specialist will have frequent and daily interactions with internal and external clients, including but not limited to physicians and...

Candidate should ideally be located in Charlotte, NC Monro’s family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach.  Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company’s regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color.  Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto service in the industry.  Do you have what it takes to shape a...

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. Patient Revenue Management Organization 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. Occ Summary The medical coder specialist will have frequent and daily interactions with internal and external clients, including but not limited to physicians and non-physician surgical providers. Responsibilities include primary diagnosis and procedural coding for the designated major surgical specialty areas and other major procedural areas, including capture of...

Supervisor Certified Professional Coder Job Summary: Under the direction of the Revenue Cycle Manager, the Supervisor Lead Certified Professional Coder provides operational oversight, leadership, and supervisory support to the coding team and Lead Certified Professional Coder. This role ensures accurate, compliant, and timely coding and charge capture for physician services, while supporting workflow optimization, staff development, performance management, and quality assurance. The position serves as a key leadership layer to support team growth, scalability, and operational excellence. Primary Job Responsibilities/Tasks may include, but not limited to: Leadership & Supervision: Provides direct supervision, mentorship, and daily operational oversight of the Lead Certified Professional Coder and coding staff. Supports staffing, scheduling, workload distribution, and productivity management. Assists with onboarding, training, coaching, and performance...

Certified Professional Coder (CPC) Independent Contractor Remote Who We Are Constellation Quality Health is a non-profit health care quality consultancy and QIO-like Entity certified by Centers for Medicare and Medicaid Services (CMS) founded by physicians in 1983. Headquartered in North Carolina's Research Triangle, we offer an array of quality improvement, clinical review, audit, technical, and consulting services and solutions to improve care delivery, system performance, and patient outcomes. What You'll Do The Certified Professional Coder (CPC) is responsible for reviewing and comparing provider service documentation to billed claims in order to determine compliance with clinical policies, state and federal regulations. We expect you to: Perform reviews in a manner consistent with contract requirements for timeliness and accuracy. Our requirement for this role: Associate or bachelor's degree required in a human services field or five (5) years...

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...

Experienced Multi-Specialty Surgery Coder The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours: Monday - Friday, working 40 hours a week Location: Fully Remote - U.S You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Provide coding and abstraction of physician or professional records Provide communications to Coordinator, Supervisors and Managers Complete RAI's, denials, charge hold reports, and coding edits Assist on special coding projects as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear...

Job Summary: Under the direction of the Revenue Cycle Manager, the Supervisor Lead Certified Professional Coder provides operational oversight, leadership, and supervisory support to the coding team and Lead Certified Professional Coder. This role ensures accurate, compliant, and timely coding and charge capture for physician services, while supporting workflow optimization, staff development, performance management, and quality assurance. The position serves as a key leadership layer to support team growth, scalability, and operational excellence. Primary Job Responsibilities Provides direct supervision, mentorship, and daily operational oversight of the Lead Certified Professional Coder and coding staff. Supports staffing, scheduling, workload distribution, and productivity management. Assists with onboarding, training, coaching, and performance evaluations of coding staff. Promotes accountability, collaboration, and professional development within the team. Acts as...

Certified Professional Coder, Independent Contractor Join to apply for the Certified Professional Coder, Independent Contractor role at Constellation Quality Health Constellation Quality Health is a non‑profit health care quality consultancy headquartered in the North Carolina Research Triangle. We offer a range of quality improvement, clinical review, audit, technical and consulting services to improve care delivery, system performance and patient outcomes. What You’ll Do Perform coding reviews in a manner consistent with contract requirements for timeliness and accuracy. Review and compare provider service documentation to billed claims to determine compliance with clinical policies and state and federal regulations. Qualifications Associate or bachelor’s degree in a human services field or five (5) years of related experience may substitute for degree. Certified Professional Coder (CPC) certification with at least two (2) years’ experience in DRG coding in an inpatient...

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. Patient Revenue Management Organization Patient Revenue Management Organization 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. Occ Summary The medical coder specialist will have frequent and daily interactions with internal and external clients, including but not limited to physicians and non‑physician surgical providers. Responsibilities include primary diagnosis and procedural coding for the designated major surgical specialty areas and other major procedural areas, including capture of applicable Physician Quality Reporting System (PQRS) and...

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. Compliance Auditor 5119 - G1 Occupational Summary Conduct health-system wide compliance audits to ensure data integrity, compliance with federal and state regulations pertaining to but not limited to: federal healthcare program requirements, clinical trials billing, privacy, conflict of interest, and anti-kickback and physician relationships. Exercise independent decisions using analytical and problem solving skills. Provides critical analytical and support with respect to third party payer external audits (i.e. RAC, ADR/TPE, UPIC, etc.). Work Performed Interpretation of applicable federal and state law and regulations to plan audit parameters, determine department's compliance with such regulations and communicate to department necessary...

Company Description Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company's regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color. Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto service in the industry. Candidate should ideally be located in Charlotte, NC Job Description Reporting to the Director of Operations Support, this individual will evaluate, inspect, audit, and determine the effectiveness of compliance and store operational tasks. This individual will visit store locations daily and perform regularly scheduled audits. They must effectively establish...