22 profee coding auditor jobs found

Physician Associate Director of Medical Operations Location US-TX-Corpus Christi Job ID 359898 Pos. Category Medical - Physician Pos. Type Full Time Recruiter : Full Name: First Last Crissy Krc Overview $125K Bonus! Monthly and Quarterly Bonus Incentives! 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 provide you with unmatched support, education, career advancement opportunities, and benefits. The Associate Director...

Job Family : Operational Effectiveness Consulting Travel Required : Up to 25% Clearance Required : Ability to Obtain Public Trust What You Will Do: Guidehouse is seeking a Revenue Integrity Analyst (Medical Biller) with strong billing, coding, and revenue cycle expertise to support the modernization of MHS GENESIS, the DoD's enterprise EHR. The role ensures accurate billing, compliant charge capture, and efficient claim resolution by analyzing data, auditing documentation, and collaborating with clinical, coding, IT, and financial teams across the Military Health System. Responsibilities of this role are as follows, to include but not limited to: Revenue Integrity & Charge Capture Optimize and validate MHS GENESIS / Cerner charge capture workflows, CDM logic, billing rules, and revenue cycle configuration. Conduct charge capture validation, reconciliation of clinical activity to billing outputs, and identification of DNFB risks and...

Certified Professional Coder Think of yourself as someone who will provide world-class service to our customers or clients in an accurate, efficient, and respectful manner on every call as measured by different performance metrics, so not everyone can qualify for this role. We make sure we get the best of the best, after all, we are a ridiculously good company so we make sure our employees are top-notch. So come on, now we need your full concentration because it's time to imagine what it's like being a Certified Professional Coder. As a Certified Professional Coder you will... Audit charts to ensure accurate ICD-10 CM and CPT code assignment as well as documentation integrity to prevent claim denials. Use critical and logical thinking skills in chart-auditing based on the guidance set forth by the client. Uphold netiquette and professionalism in any interaction with the TaskUs team, other vendors and the client. Job Summary: The CPC will be responsible for reviewing...

Job Family : Operational Effectiveness Consulting Travel Required : Up to 25% Clearance Required : Ability to Obtain Public Trust What You Will Do: The Revenue Integrity Analyst (Medical Coding) supports accurate documentation, compliant coding, and optimized charge capture within MHS GENESIS, the Military Health System's enterprise EHR. The role ensures correct configuration of revenue cycle workflows and reduces revenue leakage through data analysis, system support, and cross-functional collaboration. Responsibilities of this role are as follows, to include but not limited to: System Configuration & Workflow Validation Validate, test, and troubleshoot MHS GENESIS / Cerner coding workflows, including charge capture pathways, coding forms, charge router logic, and billing system integrations. Ensure accurate mapping and configuration of ICD-10-CM, CPT/HCPCS, modifiers, clinical documentation, and charge codes across departments....

Revenue Integrity Analyst (Medical Coding) The Revenue Integrity Analyst (Medical Coding) supports accurate documentation, compliant coding, and optimized charge capture within MHS GENESIS, the Military Health System's enterprise EHR. The role ensures correct configuration of revenue cycle workflows and reduces revenue leakage through data analysis, system support, and cross-functional collaboration. Responsibilities of this role are as follows, to include but not limited to: Validate, test, and troubleshoot MHS GENESIS / Cerner coding workflows, including charge capture pathways, coding forms, charge router logic, and billing system integrations. Ensure accurate mapping and configuration of ICD-10-CM, CPT/HCPCS, modifiers, clinical documentation, and charge codes across departments. Utilize HealtheAnalytics / HDI and related tools to identify system defects, data inconsistencies, and workflow gaps. Support enterprise-level remediation planning, translating findings into...

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:...

Description JOB SUMMARY The Physician Coder I performs evaluation/management coding for clinic, inpatient, and outpatient encounters as well as coding for in-office ancillary services and minor procedures. Assigns and sequences all codes for services rendered. Collaborates with coders, billers, clinical staff, managers, and healthcare professionals to ensure accurate coding assignment and to resolve any coding-related claim denials. JOB DUTIES AND RESPONSIBILITIES: Job Specific: Physician Coder I Duties: Assigns codes to diagnoses, hospital visits, office visits, and in-office ancillary services and minor procedures using correct CPT®, HCPCS Level II, and ICD-10-CM codes. (EF) Ensures that assigned codes are accurate and sequenced correctly in accordance with coding guidelines, as well as insurance and government regulations. (EF) Examines patient medical record to ensure coding accurately reflects the documented medical care provided. (EF) Demonstrates...

Overview Join Our Team as a Medical Coder at MPOWERHealth! At MPOWERHealth , we're not just a healthcare company-we're innovators, dreamers, and doers . For over a decade, we've been empowering independent musculoskeletal physicians with state-of-the-art clinical services, groundbreaking technology, and seamless back-office solutions . Our mission? To simplify the complex, predict the unpredictable, and create better outcomes for patients and providers alike. Now, we're looking for a detail-oriented Medical Coder to join our team and help us ensure precision, compliance, and excellence in medical coding and reimbursement. Compensation: Based on experience: Low Range: Entry-level experience with foundational skills. Mid Range: Solid experience with demonstrated proficiency. High Range: Extensive experience with a proven track record of success. Pay will be evaluated based on experience, skills, and qualifications during the hiring...

Location: Virtual Employee PRIMARY PURPOSE Conducts audits of medical record coding to ensure compliance with established guidelines, provides results of audits, and assists with educational activities related to findings to promote adherence to state/federal laws and regulatory requirements. MINIMUM SPECIFICATIONS Education: - Must be a graduate of a Health Information Management program or must have successfully completed an approved Coding educational program. Experience - Must have six (6) years of proven coding experience in an acute care setting. Equivalent Education and/or Experience - May have an equivalent combination of education and experience in lieu of specified requirements. Certification/Registration/Licensure - Because of the lag in SCCE, HCCA, NCRA, and AHIMA updating the status of certifications, current employees whose certification is granted through one of these associations are allowed up to seven (7) calendar days, after expiration, to...

At Houston Methodist, the Lead Inpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to inpatient encounters based upon documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. FLSA STATUS Non-exempt...

About CLS Health At CLS Health, we are redefining healthcare delivery. As Houston's largest physician-owned, physician-led healthcare system, our mission is to provide patient-centered care through innovation and operational excellence. With over 200 providers in 35 locations and 40+ specialties, we're building a scalable healthcare system that empowers physicians and delivers unmatched quality and access for patients. Summary Assigns and aligns predefined codes, tabulates the data into the computer system, generates new codes, resolves edits and denials, and maintains proper records in accordance with CLS guidance and procedures. Conducts regular reviews to ensure billing is timely, accurate, and in compliance. Job Description Assist with implementing and maintaining system-wide billing and coding quality audits. Understands, interprets and applies coding guidelines for coding audits. Review of medical records to determine coding accuracy of all documented...

Thank you for considering a career at Ensemble Health Partners! Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

Join Datavant, a pioneering data platform company transforming health data exchange. Our mission is to ensure that every healthcare decision is guided by accurate data at the right moment and in the most useful format. As a leading health data network, our platform offers secure, accessible, and actionable data, empowering various healthcare stakeholders, including life sciences firms, government agencies, and care providers. By becoming part of Datavant's high-performing and values-driven team, you'll play a vital role in creating innovative technology solutions that tackle significant challenges in healthcare. We celebrate a diverse team bringing together a wealth of professional, educational, and personal experiences to achieve our ambitious goals in the healthcare sector. Key Responsibilities: Conduct thorough audits of coded medical charts according to specific client guidelines as directed by the quality supervisor. Efficiently navigate and apply various client...

About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: • Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women • Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR • Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions. • Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits,...

Daniel J. Leeman, MD is a well established boutique Ear, Nose, Throat practice located in the Mueller Neighborhood in Austin, Texas 78723. Our team is looking to add a Medical Billing Specialist to our growing team! Qualifications: Minimum of (1) to (3) years of billing/collections experience within a clinic or physician practice. ENT preferred. High school diploma required; formal billing education preferred. Strong working knowledge of insurance plans, including Medicare and Medicaid. Strong working knowledge of ICD-10 and CPT coding. Strong working knowledge of claim appeals, denials, and their processes. Proficiency in computer software use, including Microsoft Office, EMR and Practice Management systems. Effective time management and the ability to prioritize work. Excellent communication skills and the ability to interact with all levels of management, staff, and physicians. Ability to read and interpret medical charts. Essential Job...

Senior Coding Auditor / Quality Specialist (Automation) The Senior Coding Auditor / Quality Specialist (Automation) is a senior-level individual contributor responsible for identifying systemic coding variance and rework drivers, defining automation-ready coding logic and edge cases, and validating AI-assisted coding outputs for accuracy and compliance. Operators serve as subject matter experts in specific revenue cycle domains while maintaining literacy across the end-to-end revenue cycle. They redesign workflows, identify upstream root causes, build knowledge graphs, participate in design sessions, and validate emerging automation and AI-driven models. Core Responsibilities: Act as the domain SME while maintaining literacy across the full revenue cycle. Identify structural root causes that drive downstream rework, friction, and leakage. Design future-state workflows and operating models with measurable impact. Build and maintain domain-specific knowledge graphs capturing...

About the Clinic Luna Therapeutics is a rapidly expanding gynecological practice with a new clinic located just south of Houston’s Texas Medical Center. Our new specialty clinic focuses exclusively on chronic and recurrent urinary tract infections and complex gynecological care. After three years of significant growth, we are opening this second location to meet increasing patient demand. Our original Luna OBGYN location will continue to provide Obstetrics-only care. Across both sites, three providers rotate on assigned days within the Luna network. Position Summary We are seeking an experienced In‑House Medical Biller & Coder to manage coding accuracy, claims submission, reimbursement workflows, and compliance for a high‑volume gynecological practice. The ideal candidate has strong Medicare experience and is comfortable supporting audit processes. Responsibilities Assign accurate ICD‑10, CPT, and HCPCS codes for gynecological services and procedures....

About TaskUs TaskUs is a provider of outsourced digital services and next-generation customer experience to fast-growing technology companies, helping its clients represent, protect and grow their brands. Leveraging a cloud-based infrastructure, TaskUs serves clients in the fastest-growing sectors, including social media, e-commerce, gaming, streaming media, food delivery, ride-sharing, HiTech, FinTech, and HealthTech. We are a People First culture with approximately 45,000 employees globally in 23 locations across twelve countries such as the Philippines, India, and the United States. It started with one ridiculously good idea to create a different breed of Business Processing Outsourcing (BPO)! We understand that achieving growth for our partners requires a culture of constant motion, exploring new technologies, being ready to handle any challenge at a moment’s notice, and mastering consistency in an ever-changing world. What We Offer TaskUs prioritizes employee well-being by...

Job Description A client of Innova Solutions is immediately hiring for a HIM Coder . Position type: Full-time, Contract Duration: 5+ Months Location: Remote (looking for candidates based out in HI, CA, WA or OR) As a HIM Coder, you will: Review inpatient and outpatient medical records daily to identify and assign accurate diagnosis and procedure codes. Abstract clinical data and ensure coding is completed within required productivity and compliance timelines. Apply ICD-10-CM, CPT, and HCPCS Level II guidelines to ensure proper code selection and sequencing. Communicate with physicians and internal teams to clarify documentation, diagnoses, and procedures when needed. Monitor coding accuracy, resolve discrepancies (including DRG‑related issues), and maintain adherence to coding standards and policies. Required Skills & Qualifications 2+ years of recent hospital coding/abstracting experience within the last 5 years (inpatient and/or outpatient). Certified Coding...

Overview At Houston Methodist, the Lead Inpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to inpatient encounters based upon documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. Houston Methodist Standard...

Community Health Choice, Inc. (Community) is a non‑profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women Children’s Health Insurance Program (CHIP) for the children of low‑income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions. Community Health Choice (HMO D‑SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription...