11 professional coding auditor jobs found

About Our Company AccuMed is the premier provider of litigation support including expert witness services for medical damages. We offer historical and future cost analysis to support quick and successful pre-litigation outcomes using our database of over 20 billion patient encounters to establish the reasonable value of healthcare costs. We provide powerful and transparent data to establish, refute, or defend the reasonable value of medical charges. Job Overview AccuMed is seeking an operationally driven and strategically minded professional to continue development and expansion of our largest business segment: Expert Witness Services . This role centers on delivering expert witness services to our clients, including the formation and defense of expert opinions related to the reasonable value of medical costs. The position will involve case-by-case analysis, deposition, and courtroom testimony. Candidates must be confident in articulating and defending their...

The Certified Professional Medical Auditor is responsible for performing comprehensive audits of medical records, coding, and billing to ensure accuracy, compliance with federal and state regulations, and alignment with payer policies. This role helps protect the organization from financial risk, supports accurate reimbursement, and promotes high standards of documentation and clinical integrity. Key Responsibilities Perform prospective and retrospective audits of medical records, coding, and billing across assigned service lines (e.g., outpatient, inpatient, behavioral health, SUD/MH, lab). Verify that documentation supports ICD‑10‑CM, CPT, and HCPCS coding; identify under‑coding, over‑coding, unbundling, and other compliance risks. Review claims for adherence to Medicare/Medicaid, commercial payer, and regulatory guidelines; ensure compliance with NCCI edits and payer‑specific policies. Prepare clear, detailed audit reports summarizing findings,...

Professional Coding Provider Educator & Reviewer RWJBarnabas Health Oceanport, NJ Full-Time Day Pay Range: $75,597.00 - $106,780.00 per year Pay Transparency: The above reflects the anticipated annual salary range for this position if hired to work in New Jersey. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience. Job Overview: The Professional Coding Provider Educator/Reviewer is responsible for preparing educational materials and delivering instruction to Medical Group physicians, Advance Practice Providers, and staff across all RWJBH medical centers, as directed by the System Professional Provider Education Coding Manager and Coding Leadership. Education may be provided in response to compliance reviews, physician onboarding, proactive training, or coding and regulatory updates. This role also conducts...

Coding Operations Manager is responsible for overseeing the medical coding team and ensuring the accurate and efficient coding of patient records for billing, compliance, and reimbursement purposes. Oversee insurance verification department.  Needs skills with operational leadership, compliance oversight, team management, and process improvement within the healthcare revenue cycle. Experience: Equivalent of an Associate’s degree and two to three years of relevant emergency department or general medical coding experience. CPC required, CEDC additionally preferred.  Strong expertise in all professional medical coding, including ICD-10, CPT and HCPCS coding.  Excellent organizational skills and ability to multi-task. This is a hybrid position.  (Two days remote and three days in-house.) JOB RESPONSIBILITIES Oversee day-to-day operations of the medical coding team, ensuring timely and accurate coding and allocation of duties Ensure that all codes (ICD-10, CPT,...

Supporting the Vice President & Chief Compliance Officer, the Compliance Specialist assists in carrying out the activities of the Frederick Health Compliance Program, including risk assessment, training & education, audits, policy development and internal investigations. Requirements: BA/BS required. MBA/MHA preferred. 5-10 years' experience in healthcare compliance and internal auditing. Certification preferred. Knowledge of laws, regulations, policies and procedures of governmental authorities and payers. Experience in developing and carrying out training and education of staff. Excellent oral and written communication skills. Strong organizational skills and ability to prioritize and manage multiple tasks. Ability to maintain a high level of confidentiality. The following experience & credentials are strongly preferred: Experience in healthcare revenue cycle or patient accounting (coding and/or billing) internal auditing and compliance....

Location : Remote Reports To:  Director of Revenue Cycle Employment Type:  Full-Time   Position Summary The RCM Account Manager is responsible for managing all aspects of the revenue cycle for a cardiovascular-focused Ambulatory Surgery Center (ASC), including  medical coding, billing, claims management, payment posting, and collections . This role ensures compliant, timely, and accurate reimbursement for cardiology and peripheral vascular procedures while providing high-touch service to internal stakeholders and physician partners. Key Responsibilities Coding & Charge Capture Accurately code cardiovascular procedures (e.g., peripheral interventions, pacemakers, stents) using CPT, HCPCS, and ICD-10 guidelines. Ensure documentation compliance with CMS and payer-specific policies. Stay current with cardiology-specific coding updates and NCCI edits. Billing & Claims Management Submit clean claims to Medicare, commercial payers, and...

Planned Parenthood Association of Utah is looking for a bold, mission-driven  Director of Revenue Cycle  who is ready to make a powerful impact on the future of reproductive healthcare in our state. This is a dynamic leadership role for someone who thrives on solving complex challenges, elevating systems, and building strong, motivated teams. You will play a pivotal role in strengthening our financial foundation—ensuring every visit, every service, and every patient experience is supported by accurate, efficient, and forward-thinking revenue cycle operations. As a key collaborator across Health Services, Finance, and administrative leadership, you’ll bring fresh ideas, innovation, and strategic insight to identify new revenue opportunities and optimize the resources that keep our mission strong. If you’re passionate about protecting access to essential healthcare and want your work to truly matter, this is your opportunity to make a lasting difference at Planned...

A Certified Inpatient and Outpatient Professional Documentation Expert is responsible for ensuring the accuracy, completeness, and compliance of clinical documentation across both inpatient and outpatient settings. They collaborate with physicians, nurses, and other providers to clarify diagnoses, procedures, and treatment plans so that the medical record supports the patient’s severity of illness, risk of mortality, medical necessity, and appropriate reimbursement. Key duties include concurrent and retrospective chart review, generating and tracking provider queries, applying official coding and documentation guidelines, educating clinical staff on best practices, and monitoring documentation quality metrics to support regulatory, audit, and revenue cycle integrity.