Professional coding auditor jobs

Full Time

Risk Adjustment Auditor & Physician Educator - Remote

Valley Medical Center Remote

Risk Adjustment Auditor and Physician Educator Health Information Management | Full-Time | Renton, Washington Help Improve Clinical Documentation and Support Better Patient Care Valley Medical Center is seeking an experienced Risk Adjustment Auditor and Physician Educator to join our Health Information Management team. This role combines clinical documentation expertise, risk adjustment auditing, coding knowledge, data analysis, and physician education to help ensure the accurate and complete capture of patient conditions and the clinical complexity of the care we provide. The ideal candidate brings strong experience in Medicare risk adjustment, medical record auditing, ICD-10-CM coding, and physician education , along with the ability to translate complex coding and documentation requirements into practical guidance for providers. This is an opportunity to play a meaningful role in improving documentation quality, supporting value-based care initiatives, and...

Full Time

Billing Compliance Curriculum Development Specialist

Dana-Farber Cancer Institute Remote (Boston, MA)

Billing Compliance Curriculum Development Specialist Dana-Farber Cancer Institute Boston, MA Full Time, Remote (Occasional Onsite) Overview Reporting to the Manager of Billing Compliance, the Billing Compliance Curriculum Development Specialist is responsible for designing, implementing, and maintaining a comprehensive billing compliance education and awareness program that supports adherence to federal and state regulations and aligns with industry standards. This role develops and delivers training for billing providers, including physicians and advanced practice providers, and provides post-review education and feedback in collaboration with Billing Compliance Reviewers and Senior Billing Compliance Reviewers, as needed. The Specialist creates, updates, and manages instructional materials such as presentations, tip sheets, slide decks, and other training resources, and tracks training completion and effectiveness. The position also supports the...

Contract

Multi-Specialty Professional Coder - Contractor

AAPC Remote

AAPC is seeking a highly motivated and dedicated coding professional to join our team as a Contract Coder. This position is a fully remote contract role. The ideal candidate must have at least 5 years of coding experience for physician practices, with various surgical specialties as well as E/M. The position requires one to be resourceful, organized, and extremely driven. The ideal candidate will possess the following: Minimum 5 years of coding experience Extensive coding in multiple specialties including: all primary care specialties, anesthesia, general surgery, dermatology, and orthopedics. Excellent written and verbal communication skills Detail oriented and deadline driven attitude Sound knowledge of medical terminology Strong computer skills (Excel, Word, and internet) Ability to multitask and keep a sense of urgency Excellent customer service skills Strong time management, organization skills, and work ethic Job Duties:...

MG

Full Time

Certified Coding Auditor - Outpatient

Marwood Group Hybrid (New York, NY)

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for an outpatient Certified Coding Auditor to work in its New York office or remotely. Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payors....

EP

Full Time

Ophthalmology Coding Auditor

Eye Physicians & Surgeons Milford, CT

This is a non-remote position. We are seeking a detail-oriented, on-site Ophthalmology Coding Auditor to join our premier private practice. Under direct supervision of the Billing Manager, the Coding Auditor audits ophthalmology and optometry medical records for compliance with federal coding regulations and guidelines. Successful candidates will have extensive knowledge of auditing and education on CPT, ICD-10, and HCPCS codes and guidelines. In this role, you will work directly alongside our clinic team to review clinical documentation, surgical charts, and diagnostic reports, ensuring accurate coding, regulatory compliance, and optimal reimbursement. You will serve as our internal expert, identifying billing risk areas and providing face-to-face feedback and education to our providers and staff to support the financial health of our practice. Key Responsibilities Perform On-Site Audits: Conduct regular retrospective and prospective reviews of clinical...

Full Time

Claims Processing Supervisor

AllCare Health Hybrid (Grants Pass, OR)

Claims Processing Supervisor AllCare Health | Claims Department We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages and an excellent benefits package, including affordable healthcare, 401(k) retirement, wellness programs, and flexible scheduling options. Summary of the Position The Claims Processing Supervisor ensures that internal and external departmental performance requirements are consistently met. This role oversees the day-to-day activities of the Claims Processing team, assigns work and coordinates efficient workflows to meet contractual and operational requirements, and serves as a hands-on resource for staff regarding training, questions, and claims processing best practices. Essential Duties Provides one-on-one support and initial training for new hires and facilitates monthly mandatory training sessions for Claims Processing staff. Establishes and maintains a professional, supportive, and provider...

Full Time

Coding Auditor

AllCare Health Hybrid (Grants Pass, OR)

Coding Auditor AllCare Health | Quality Department | Grants Pass, Oregon We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages and an excellent benefits package, including affordable healthcare, 401(k) retirement, wellness programs, and flexible scheduling options. Summary of the Position The Coding Auditor is responsible for developing, implementing, and maintaining auditing practices related to medical record coding and documentation to support accurate and complete risk adjustment outcomes for Medicare members. This position reviews medical records and coding for accuracy and compliance with Centers for Medicare & Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) requirements, identifies coding and documentation trends, and works collaboratively with providers and internal teams to improve documentation, coding accuracy, and risk adjustment outcomes. Essential Duties Ensures the accuracy and...

Full Time

Coding Educator

SSM Health Remote

Bring your coding expertise to SSM Health in a role where education, quality, and compliance come together. As a Coding Educator, you’ll partner with providers and coders, lead training initiatives, and influence documentation and coding practices that support accuracy, consistency, and revenue integrity across the organization. PRIMARY RESPONSIBILITIES Drives optimal clinical and financial outcomes through thorough assessment of provider documentation and coding competency, identification of improvement opportunities. Develops and delivers training and education of all coding processes. Stays abreast of regulatory changes and works with leadership to ensure compliance and revenue integrity. Act as subject matter expert for providers and coders while providing guidance and clarification on issues which present in their daily account processing. Establishes and coordinates internal quality review processes and corresponding training for providers and coders....

Contract

Medical Coders (ER, SDS and IP) and Data Quality Auditors

Pena4 Inc. Remote

Multiple ED, SDS and IP Coding Assignments Available & Data Quality Auditors Needed Description: Coders and Auditors with 3-5+ years of facility coding experience are needed to provide coverage to Pena4’s clients. Responsibilities : Pena4 M edical Coders are responsible for accurately assigning ICD-10-CM/PCS diagnosis and CPT procedure codes for inpatient and outpatient hospital services. This role ensures coded data is complete, compliant, and supports appropriate reimbursement, quality reporting, and regulatory requirements. Coders must meet or exceed determined productivity and quality standards for respectively assigned client engagements in order to ensure the highest level of coding. Summary: Position Type: 1099 Independent Consultant 100% Remote Assignments Schedule/Shift varies per assignment. See current assignment details below. Credentials: CPC, CCS, RHIA, RHIT (preferred) 3-5+ years of Facility Coding Will be required to complete ED,...

Full Time

Coding Specialist

Bridge Remote

About Bridge Bridge is the fastest, most compliant way to scale insurance billing nationwide. We enable virtual care companies to go in-network nationally in as little as 30 days, without the operational lift. Our platform handles payer contracting, credentialing, real-time benefit verification, medical coding, claim submission, denial management, and compliance in a single integrated solution. Backed by leading investors including General Catalyst, Andreessen Horowitz, Thrive Capital, Khosla Ventures, Greenoaks, and Mischief, we're scaling rapidly. The Role We are seeking a detail-oriented and experienced RCM Coding Specialist with CPC (Certified Professional Coder) certification to join our Revenue Cycle Management team. This role is responsible for accurate and timely medical coding in accordance with current coding guidelines, payer requirements, and company standards. The ideal candidate has strong analytical skills, in-depth knowledge of CPT, ICD-10, and...

VP

Full Time

Director of Documentation Integrity and Coding

Vistec Partners NY

The goal is this position is to educate providers on proper use of CPT codes, ICD10 codes, modifiers and audit activities related to health plan operations, risk adjustment, payer audits and regulatory requirements. This role ensures accurate medical coding, documentation integrity, and adherence to federal, state, and payer-specific guidelines. The ideal candidate will possess advanced CPC coding expertise, strong analytical skills, and extensive experience supporting compliance initiatives within a managed care or health plan environment. This is a full-time position, on site, 5 days a week. Responsibilities: • Serve as subject matter expert on CPT, HCPCS, ICD10 and modifier coding for physicians and coders. • Ensure provider documentation and coding practices comply with CMS, Medicare, Medicaid, commercial payer, and applicable federal and state regulatory requirements. • Conduct coding compliance audits to identify...

Part Time Contract

Outpatient Coder/CDI Specialist (Contractor)

Ambience Healthcare Remote (United States)

We are expanding our outpatient coding and clinical documentation capabilities and are looking for an experienced outpatient coding or CDI professional to support this work on a contract basis. - Location: Remote - Type: 1099 Contractor About Ambience Healthcare Ambience Healthcare is a clinical documentation AI company building tools that improve the accuracy and efficiency of medical documentation. Role Overview We are seeking a meticulous outpatient coding or CDI specialist to review outpatient encounters, analyze clinical documentation, and determine accurate ICD-10-CM diagnosis codes. Your work will directly inform how we evaluate and improve the accuracy of clinical coding at scale. This is not a traditional role embedded in a health system — you will be reviewing outpatient data and making determinations about ICD-10-CM codes, identifying gaps, and providing expert-level feedback. What we value most: We are looking for someone with...

Full Time

Coding and Compliance Analyst

Family Health Center Hybrid (WI)

* This is a hybrid position to be located in WI with travel required. * JOB SUMMARY The Coding and Billing Compliance Analyst plays a critical role in safeguarding the accuracy, integrity, and regulatory compliance of coding and billing operations across all service lines. This position supports the organization’s revenue cycle and compliance initiatives by conducting detailed coding and billing reviews, identifying areas of risk, and contributing to the development of corrective action plans and educational programs. The analyst ensures adherence to federal and state billing regulations, including Medicaid/Medicare guidelines, HRSA program requirements, and Office of Inspector General (OIG) guidance specific to Federally Qualified Health Centers (FQHCs). The Analyst collaborates with providers, billing teams, compliance officers, and revenue cycle leadership, to improve clinical documentation, optimize reimbursement, and maintain full compliance with all applicable...

Full Time

Medical Coder - Remote Nationwide

Optum Remote

REMOTE NATIONWIDE At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The key challenge of this role centers around your ability to work quickly, accurately, and independently. You'll be challenged with daily production goals as well as maintaining a high accuracy rate to achieve your quality goals. Extensive use of electronic medical records in an ICD-10 environment is also required. Hours : This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 5am - 5pm. We offer 2-3 weeks of paid training. The...

Full Time

Facility Coding Auditor & Claim Review Specialist

CorroHealth Remote

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. The ideal candidate is an experienced outpatient facility coding professional with strong analytical skills, extensive knowledge of revenue cycle operations, and the ability to communicate complex coding concepts clearly to both clients and internal team members. This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of...

Full Time

Risk Adjustment Coder & Provider Engagement Specialist

ASAAR Medical Boca Raton, FL

ASAAR Medical is seeking a HCC Coder & Provider Engagement Specialist ***This is NOT a REMOTE Position *** May require travel *** Duties: Reporting to the Director of MRA and Risk Adjustment Coding. The HCC / MRA Coder will offer real-time support and coordination for Primary Care Providers and Care Coordinators for MRA Risk Coding in a value-based care setting. Engages providers by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts ASAAR Medical's overall success first. Review patient charts and pursues excellence: Seeks out learning, strives to develop and expand personally, and continuously helps practices upgrade their capability to contribute to the ACO. Helps to educate clinician and non-clinician office staff on coding guidelines, documentation standards, and appropriate Medicare Risk Adjustment (MRA) procedures. Assists in education and transition with onboarding new providers, optimally within...

16 professional coding auditor jobs found