25 profee coding auditor jobs found

Medical Coding Specialist Key Responsibilities: Analyze patient charts, physician notes and discharge summaries Ensure documentation is complete and accurate before coding Translate diagnoses and procedures into standardized codes using: ICD-10-CM (diagnoses) CPT (procedures) HCPCS (supplies/services) Make sure codes correctly represent services provided Follow healthcare laws and regulations (HIPAA, Medicare/Medicaid guidelines) Company Policies Prevent coding errors that could lead to claim denials or audits Stay updated on coding changes and updates Work with billing teams to submit coded claims to insurance companies Verify claim accuracy to ensure proper reimbursement Fix rejected or denied claims by reviewing and correcting codes Communicate with healthcare providers and insurance companies Protect sensitive patient information Follow strict privacy and data security standards Clarify documentation with physicians when needed Collaborate with billing...

BO Coder FT CMMC South Campus - Floresville, TX 78114 Overview Position Type Full Time Job Shift Day Education Level High School Travel Percentage None Category Admin - Clerical Description Summary Under general supervision and according to established procedures, assigns diagnostic codes to medical record information. Codes charts under the ICD 9 CM and HCPCS System for statistical and DRG assignment purposes. Abstracts required data into hospital abstracting system. The outcome of information gathered is used to determine the hospital database and reimbursement of hospital claims. Essential Duties and Responsibilities include the following. Other duties may be assigned. Abstracts and codes diagnoses, operations, and procedures from health records by using appropriate classification systems, standards, and procedures. Prepares statistical reports required by applicable legal, accrediting, and/or licensing regulations and hospital policy. Assigns patient...

Job Title: Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Auditors to contribute their specialized expertise to an innovative healthcare AI project. In this role, you will help improve next-generation AI systems by reviewing, evaluating, and refining medical coding and audit-related content. This opportunity is ideal for professionals with strong experience in outpatient professional fee coding, auditing, and academic medical center environments. No prior AI experience is required—your healthcare expertise is what matters most. Key Responsibilities Conduct detailed reviews and audits of outpatient professional fee coding records for accuracy, compliance, and quality. Identify coding trends, gaps, risks, and opportunities for improvement. Evaluate audit findings using knowledge of academic medical center protocols and industry best practices. Document audit results and provide clear written explanations to support AI...

Clinical Nurse Supervisor, Medical Specialties AUSTIN, TX Hiring Department Dell Medical School Position Open To All Applicants Weekly Scheduled Hours 40 FLSA Status Exempt from FLSA Earliest Start Date Immediately Position Duration Expected to Continue Job Details Purpose The Clinical Nurse Supervisor oversees the daily operations of outpatient services, ensuring high-quality patient care and compliance with healthcare regulations. Reporting to the Nurse Manager, this role manages clinical staff, coordinates patient care, and implements policies and procedures. Responsibilities Supervision and Management Supervises and evaluates clinical staff performance. Coordinates staff schedules and assignments. Provides training and development opportunities for staff. Patient Care Coordination Ensures efficient patient flow and timely care. Addresses patient concerns and resolves issues. Collaborates with healthcare providers to develop care plans. Compliance and Quality...

Coder IIUnder general supervision of the Director, the Coder II provides consistency and efficiency in outpatient claims processing and data collection to optimize APC reimbursement and facilitate data quality in outpatient services. Reviews, audits, and reports on charge capture. Maintains patient confidentiality at all times.ESSENTIAL JOB FUNCTIONSEvery effort has been made to make this job description as complete as possible. However, it in no way states or implies that these are the only duties the incumbent will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or is a logical assignment to the position.Analyzes IP, OP, Recurring, & SDC records and appropriately codes per coding guidelines, ICD-10-CM and CPT rules and updates, creating APC or DRG group assignments.Queries physicians when code assignments are not straightforward or documentation in the record is inadequate,...

Citizens Medical Center is a not-for-profit hospital known for compassionate patient care, clinical expertise, and bringing advanced medical services to the South Texas region since 1956. Today, Citizens is a 338-bed acute care hospital with over 1,000 dedicated employees. Citizens offers a generous benefit package that includes retirement plans upon hire, and an excellent medical plan with optional insurance plans to choose from. If you are interested in pursuing a career with an award-winning hospital, welcome home. 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 Assigns...

Medical Coding SpecialistKey Responsibilities:Analyze patient charts, physician notes and discharge summariesEnsure documentation is complete and accurate before codingTranslate diagnoses and procedures into standardized codes using: ICD-10-CM (diagnoses)CPT (procedures)HCPCS (supplies/services)Make sure codes correctly represent services providedFollow healthcare laws and regulations (HIPAA, Medicare/Medicaid guidelines) Company PoliciesPrevent coding errors that could lead to claim denials or auditsStay updated on coding changes and updatesWork with billing teams to submit coded claims to insurance companiesVerify claim accuracy to ensure proper reimbursementFix rejected or denied claims by reviewing and correcting codesCommunicate with healthcare providers and insurance companiesProtect sensitive patient informationFollow strict privacy and data security standardsClarify documentation with physicians when neededCollaborate with billing and administrative teamsRegularly update...

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. General Purpose of Job: Ensures that coding compliance initiatives are met with all record types. Reviews and analyzes medical records and abstracted data submitted by the coding staff to determine the accuracy of code assignment and adequacy of clinical documentation according to regulatory requirements. Performs frequent internal reviews and education maintenance long-term to ensure accuracy in the ever-changing environment of coding, documentation, quality initiatives, and impact to reimbursement. Can code, train, and educate on all types of outpatient medical records to provide timely coverage in all coding areas helping to ensure accuracy, stability, and efficiency in our revenue cycle. Code several different specialties, help train new coders, review records for provider audits, assist with new physician...

Hiring fully remote Medical Coders, ONLY WITHIN THE US! This is a 1-2 year-long contract,Must have:At least 2 years of Medical Coding (Inpatient, outpatient, or Profee experience)Ideally handling close to 100+ charts/dayActive CPC CertLive in the USDescriptionReview emergency department medical records to assign accurate ICD-10-CM diagnosis codes, CPT/HCPCS procedure codes, and applicable modifiers.Accurately assign facility Evaluation and Management (E/M) levels in accordance with client-specific emergency department leveling guidelines and facility charging methodologies, including knowledge of the ACEP tool.Analyze documentation from nursing staff, physicians, ancillary departments, and diagnostic services to ensure complete code assignment and charge capture.Apply official coding guidelines, CMS regulations, National Correct Coding Initiative (NCCI) edits, and payer-specific requirements.Review accounts for appropriate assignment of procedural services and injections/infusions...

Summary About the Position: This is an open continuous announcement. Multiple vacancies exist and may be filled from this announcement at any of the locations listed. We accept applications on an ongoing basis; qualified applicants will be considered as vacancies become available. Salary negotiation may be available for those candidates who are new to Federal service. This is a Direct Hire Solicitation Responsibilities Perform retrospective audits of diagnoses, E/M levels, procedures, and documentation to identify inaccurately coded services and ensure regulatory compliance. Review medical records, analyze coding accuracy trends, prepare finding reports, and coordinate results with leadership to drive performance improvement. Use encounter audits to identify operational and regulatory issues, ensures complete data capture, and support development of compliance plans. Develop and deliver one-on-one and group training on documentation and coding requirements; updates clinical...

Duties Perform retrospective audits of diagnoses, E/M levels, procedures, and documentation to identify inaccurately coded services and ensure regulatory compliance. Review medical records, analyze coding accuracy trends, prepare finding reports, and coordinate results with leadership to drive performance improvement. Use encounter audits to identify operational and regulatory issues, ensures complete data capture, and support development of compliance plans. Develop and deliver one-on-one and group training on documentation and coding requirements; updates clinical templates and recommends coding resources. Review and code medical records, validates ICD and CPT accuracy, assists providers with documentation needs, and ensures proper RVU/RWP capture. Prepare monthly progress reports, monitors coding performance, conducts special audits/projects, and communicates findings to leadership.

HIM Coder-Non-Exempt FT Main 499 - Floresville, TX 78114 Overview Position Type Full Time Job Shift Day Education Level High School Travel Percentage None Category Admin - Clerical Description Summary Under general supervision and according to established procedures, assigns diagnostic codes to medical record information. Codes charts under the ICD 9 CM and HCPCS System for statistical and DRG assignment purposes. Abstracts required data into hospital abstracting system. The outcome of information gathered is used to determine the hospital database and reimbursement of hospital claims. Essential Duties and Responsibilities include the following. Other duties may be assigned. Abstracts and codes diagnoses, operations, and procedures from health records by using appropriate classification systems, standards, and procedures. Prepares statistical reports required by applicable legal, accrediting, and/or licensing regulations and hospital policy. Assigns patient...

Benefits: 401(k) 401(k) matching Bonus based on performance Competitive salary Employee discounts Health insurance Paid time off Woodlands Primary Healthcare is seeking an experienced Medical Biller and Coder to join our growing family medicine practice. We are looking for a detail-oriented professional with proven expertise in medical billing, coding, revenue cycle management, and a strong background in family or internal medicine. This position is in-person or hybrid. Candidates must reside within a reasonable commuting distance of The Woodlands, TX. Fully remote candidates will not be considered. ⚠️ IMPORTANT: Any individual or company reaching out about this position outside of this platform will be automatically disqualified. KEY RESPONSIBILITIES • Accurately code diagnoses, procedures, and visit documentation using ICD-10, CPT, and HCPCS coding systems • Review and audit daily charts to ensure complete, accurate, and compliant coding • Prepare and...

Medical Biller And Coder Woodlands Primary Healthcare is seeking an experienced Medical Biller and Coder to join our growing family medicine practice. We are looking for a detail-oriented professional with proven expertise in medical billing, coding, revenue cycle management, and a strong background in family or internal medicine. This position is in-person or hybrid. Candidates must reside within a reasonable commuting distance of The Woodlands, TX. Fully remote candidates will not be considered. IMPORTANT: Any individual or company reaching out about this position outside of this platform will be automatically disqualified. Key Responsibilities Accurately code diagnoses, procedures, and visit documentation using ICD-10, CPT, and HCPCS coding systems Review and audit daily charts to ensure complete, accurate, and compliant coding Prepare and submit insurance claims to payers in a timely and compliant manner Monitor and manage accounts receivable (A/R), including...

Medical Biller And CoderWoodlands Primary Healthcare is seeking an experienced Medical Biller and Coder to join our growing family medicine practice. We are looking for a detail-oriented professional with proven expertise in medical billing, coding, revenue cycle management, and a strong background in family or internal medicine. This position is in-person or hybrid. Candidates must reside within a reasonable commuting distance of The Woodlands, TX. Fully remote candidates will not be considered. IMPORTANT: Any individual or company reaching out about this position outside of this platform will be automatically disqualified.Key ResponsibilitiesAccurately code diagnoses, procedures, and visit documentation using ICD-10, CPT, and HCPCS coding systemsReview and audit daily charts to ensure complete, accurate, and compliant codingPrepare and submit insurance claims to payers in a timely and compliant mannerMonitor and manage accounts receivable (A/R), including follow-ups on unpaid...

URGENTLY HIRING | 100% REMOTE | Emergency Department Medical CoderLooking for a fully remote coding opportunity with a stable workload and a team that values your expertise? We're partnering with a leading healthcare organization seeking experienced Emergency Department Medical Coders to support high-volume facility coding operations.This is an excellent opportunity for certified coders with Emergency Department experience who are looking to work from home while continuing to grow their coding knowledge and make a meaningful impact on healthcare operations.Why This Opportunity Stands Out100% remote positionMultiple openings availableOpportunity to support a large healthcare organizationLong-term contract opportunity with consistent workCollaborative team environment with coding leadership supportExposure to coding quality initiatives, audits, and process improvementsOpportunity to expand your Emergency Department coding expertiseKey ResponsibilitiesReview emergency department...

Medical CoderRevenue Cycle Management is looking for a full-time Medical Coder to join our team! Remote opportunity after in-person training.SUMMARY: The Medical Coder is responsible for reviewing medical documentation and accurately assigning CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS codes depending on the encounter type. The position ensures accurate billing, compliance, and optimized reimbursement across outpatient and/or facility (inpatient) settings.Essential FunctionsAssign accurate diagnosis and procedure codes based on medical record documentation using CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS.Review provider documentation to ensure coding is supported and complete for billing submission.Apply proper modifiers, sequencing, and coding conventions appropriate to the setting (inpatient or outpatient).Ensure compliance with coding regulations, organizational policies, and HIPAA standards.Meet coding productivity and quality benchmarks.Collaborate with clinical, billing, and...

DISCOVER IES Integrative Emergency Services ("IES") LLC, is a physician founded, owned, and led company whose goal is to empower physician leaders to create the best places to give and receive care. We are a clinically integrated and outcomes-based organization with a commitment to doing the right thing for our clinicians, patients, and communities. Through our commitment to patient care and reinvestment in our physicians, IES has a proven track record of improving patient outcomes and producing results that uphold the hospitals' reputations in which we operate. We strive to create a culture of continuous improvement, community, and recognizing our Physician leaders. To learn more, visit our website IES.Healthcare and click to see a highlight of our 12th Annual Quality Summit. POSITION SUMMARY Integrative Emergency Services, LLC ("IES") is seeking a Certified Medical Coding Specialist with emphasis on surgical services. Although a surgical related coding certification is preferred,...

Medical Coder Revenue Cycle Management is looking for a full-time Medical Coder to join our team! Remote opportunity after in-person training. SUMMARY: The Medical Coder is responsible for reviewing medical documentation and accurately assigning CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS codes depending on the encounter type. The position ensures accurate billing, compliance, and optimized reimbursement across outpatient and/or facility (inpatient) settings. Essential Functions Assign accurate diagnosis and procedure codes based on medical record documentation using CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS. Review provider documentation to ensure coding is supported and complete for billing submission. Apply proper modifiers, sequencing, and coding conventions appropriate to the setting (inpatient or outpatient). Ensure compliance with coding regulations, organizational policies, and HIPAA standards. Meet coding productivity and quality benchmarks. Collaborate...

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 Childrens 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,...

Summary About the Position: This is an open continuous announcement. Multiple vacancies exist and may be filled from this announcement at any of the locations listed. We accept applications on an ongoing basis; qualified applicants will be considered as vacancies become available. Salary negotiation may be available for those candidates who are new to Federal service. This is a Direct Hire Solicitation Learn more about this agency Duties Help Perform retrospective audits of diagnoses, E/M levels, procedures, and documentation to identify inaccurately coded services and ensure regulatory compliance. Review medical records, analyze coding accuracy trends, prepare finding reports, and coordinate results with leadership to drive performance improvement. Use encounter audits to identify operational and regulatory issues, ensures complete data capture, and support development of compliance plans. Develop and deliver one-on-one and group training on...

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:...

Benefits 401(k) 401(k) matching Bonus based on performance Competitive salary Employee discounts Health insurance Paid time off Woodlands Primary Healthcare is seeking an experienced Medical Biller and Coder to join our growing family medicine practice. We are looking for a detail-oriented professional with proven expertise in medical billing, coding, revenue cycle management, and a strong background in family or internal medicine. This position is in-person or hybrid. Candidates must reside within a reasonable commuting distance of The Woodlands, TX. Fully remote candidates will not be considered. ⚠️ IMPORTANT: Any individual or company reaching out about this position outside of this platform will be automatically disqualified. Key Responsibilities Accurately code diagnoses, procedures, and visit documentation using ICD-10, CPT, and HCPCS coding systems Review and audit daily charts to ensure complete, accurate, and compliant coding Prepare and submit insurance...

Brief Description The Harris Center for Mental Health and IDD, known as \"The HARRIS CENTER,\" is seeking an experienced Medical Coder to join our team. Under the direction of Director of Revenue Management, the Medical Coder utilizes knowledge of insurance regulations, health insurance contracts, and medical coding to perform a variety of revenue cycle support activities. Additionally, the medical coder is responsible for reviewing medical records to assure proper billing of the medical record, comparison of physician selected CPT and ICD-10 codes to the physicians' documentation to substantiate the level of coding, physician services to include identification of professional services and complete review of medical records to accurately optimize all professional services documented for billing. Your Role In Action Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and...