8 professional coding auditor jobs found

Job Title: Manager Location: System Business Office Department Name: HIM - Professional Req #: 0000207266 Status: Salaried Shift: Day Pay Range: $110,681.00 - $156,337.00 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  System Professional Coding Provider Review and Education Manager  is responsible for onboarding, educating, and reviewing medical record documentation and coding processes of the Medical Group physicians, APNs and other billing providers across all medical centers within the RWJBH enterprise. This includes onboarding education, medical record reviews, targeted education to physician groups and individual physicians, annual and quarterly...

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,...

Phoenix Behavioral Healthcare, LLC is seeking a highly skilled Executive   Director of Revenue Cycle Management (RCM) to oversee and optimize the full revenue cycle across multiple behavioral health facilities, clinics, laboratories, and E&M service lines. This onsite leadership role manages all aspects of RCM operations—including intake, UR/UM alignment, coding, billing, claims submission, collections, clinical documentation improvement, denial management, appeals, and compliance oversight. Key Responsibilities: Lead, manage, and optimize end-to-end revenue cycle operations for all Phoenix facilities Oversee billing and coding for inpatient, outpatient, lab, and professional services (UB-04 & CMS-1500) Direct UR/UM workflow integration to improve documentation quality and turnaround times Manage and mentor a full RCM support team (billers, coders, auditors, documentation trainers, compliance) Develop standardized...

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....