36 professional coding auditor jobs found

Job Summary and Responsibilities As our Coding Auditor and Educator Professional Fee, you will utilize ICD-10-CM, HCPCS, and CPT-4 classification systems to support the professional fee coding team. You will serve as a key resource for coding and billing inquiries while facilitating the standardization of coding practices across the organization. Every day, you will perform internal audits and provide necessary follow-up education to ensure accuracy and compliance. You will also monitor evolving regulatory changes, effectively communicating these updates to ensure timely and precise implementation within the PB coding teams. In this role, you will be responsible for the onboarding and training of new staff, as well as the development and deployment of ongoing educational programs. Working in conjunction with leadership, you will participate in both short-term and long-term strategic planning to maintain excellence in compliant coding and regulatory billing practices....

CommonSpirit Health is seeking a Coding Auditor and Educator for Professional Fee coding. You will audit ICD-10-CM, CPT-4, and HCPCS classifications, educate staff, and standardize coding practices across the organization. You’ll monitor regulatory changes and implement timely updates within PB coding teams. You will train new staff, develop ongoing education programs, and collaborate with leadership on short- and long-term strategic planning to maintain compliant coding and billing practices. #J-18808-Ljbffr

CommonSpirit Health is seeking a Coding Auditor and Educator for the Professional Fee team. The role involves using ICD-10-CM, HCPCS, and CPT-4 to support coding accuracy and educate staff across the organization. Responsibilities include audits, onboarding, and ongoing education while monitoring regulatory changes and ensuring compliant billing practices. Strong knowledge of professional fee coding, plus Epic experience, is essential. #J-18808-Ljbffr

Coding Auditor And Educator Professional FeeInspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.The posted compensation range of $34.00 - $56.10 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law. Job Summary and Responsibilities As our Coding Auditor and Educator Professional Fee, you will utilize ICD-10-CM, HCPCS, and CPT-4 classification...

Coding Auditor And Educator Professional FeeInspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.The posted compensation range of $34.00 - $56.10 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.Job Summary and ResponsibilitiesAs our Coding Auditor and Educator Professional Fee, you will utilize ICD-10-CM, HCPCS, and CPT-4 classification...

Lakeshore Talent is in search of a Code Review Specialist – Medical Coding Methodology & Litigation SupportGreenwood Village, CO (Denver Tech Center)Schedule:Monday–Friday, with Wednesdays remote and the remaining days in the officeLakeshore Talent is in search of a detail-oriented Medical Coding Review Organize medical records and billing documentation into a clear, logical structure that supports efficient and thorough review. Compare captured billing information against medical records to validate CPT and HCPCS procedure codes and modifiers, making corrections when supported by the documentation. Evaluate procedures across applicable billing components, including professional services, facility charges, anesthesia, and other related services. Apply established coding review methodologies consistently and document the rationale behind decisions to ensure transparency and reproducibility. Manage multiple cases and review assignments while meeting established deadlines and...

Become a part of our caring community Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Outpatient Behavioral Health Coding disputes and is part of the PPI Coding Disputes Team with Humana. The Outpatient Behavioral Health Coding Auditor on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient Behavioral Health coding disputes and expertise in CPT/HCPCS code...

Lakeshore Talent is in search of a Code Review Specialist – Medical Coding Methodology & Litigation Support Location: Greenwood Village, CO (Denver Tech Center) Position Type: Direct Hire Salary: $75,000–$85,000 annually Schedule: Monday–Friday, with Wednesdays remote and the remaining days in the office Start Time: 7:00 AM or 8:00 AM Position Overview Lakeshore Talent is in search of a detail-oriented Code Review Specialist to join a growing team specializing in medical coding methodology, billing review, and litigation support. This role is ideal for an experienced medical coding professional who enjoys analytical work, takes pride in accuracy, and is interested in improving processes rather than simply following established procedures. Beyond day-to-day code review, you will play an important role in refining coding methodologies, improving workflows, developing training resources, and establishing clear guidelines that help the team work more efficiently. You will also...

Revenue Cycle Coder Lead-Inpatient CodingInspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.As our Lead Inpatient Coder, you will be a cornerstone of our medical coding department, providing essential leadership and strategic direction for our inpatient coding team. You will be instrumental in driving coding accuracy, ensuring regulatory compliance, and optimizing revenue cycle performance for complex medical cases, making a direct impact on our healthcare data integrity and financial health.Every day you will provide expert technical guidance, conduct comprehensive quality...

Lakeshore Talent is in search of a Code Review Specialist – Medical Coding Methodology & Litigation Support Location: Greenwood Village, CO (Denver Tech Center) Position Type: Direct Hire Salary: $75,000–$85,000 annually Schedule: Monday–Friday, with Wednesdays remote and the remaining days in the office Start Time: 7:00 AM or 8:00 AM Position Overview Lakeshore Talent is in search of a detail-oriented Code Review Specialist to join a growing team specializing in medical coding methodology, billing review, and litigation support. This role is ideal for an experienced medical coding professional who enjoys analytical work, takes pride in accuracy, and is interested in improving processes rather than simply following established procedures. In this position, you will review medical records and billing documentation, validate CPT and HCPCS procedure codes and modifiers, and ensure that coding decisions are accurate, consistent, and well-documented. Your work will...

Lakeshore Talent is in search of a Code Review Specialist – Medical Coding Methodology & Litigation Support Greenwood Village, CO (Denver Tech Center) Schedule: Monday–Friday, with Wednesdays remote and the remaining days in the office Lakeshore Talent is in search of a detail-oriented Code Review Specialist to join a growing team specializing in medical coding methodology, billing review, and litigation support. This role is ideal for an experienced medical coding professional who enjoys analytical work, takes pride in accuracy, and is interested in improving processes rather than simply following established procedures. In this position, you will review medical records and billing documentation, validate CPT and HCPCS procedure codes and modifiers, and ensure that coding decisions are accurate, consistent, and well-documented. Your work will support the development of transparent, defensible medical damage valuations used in litigation-related cases. Beyond day-to-day code...

This is a remote based position. Applicants can be located nationwide Outpatient Coding Auditor #2972 United States Remote/Nationwide Position Description About You You are a person who enjoys ensuring coding accuracy and solving documentation and compliance challenges. We need someone who demonstrates skills in organization, prioritization, professionalism, and coaching others. In the role of Outpatient Coding Auditor, you will be responsible for quality reviews and audits and coordinating with department managers to ensure standards are met in accordance with department and organization policies. Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM), Procedural Coding System (PCS), Current Procedural Terminology (CPT-4 and Healthcare Common Procedure Coding System...

Lakeshore Talent is in search of a Code Review Specialist – Medical Coding Methodology & Litigation Support Greenwood Village, CO (Denver Tech Center) Schedule: Monday–Friday, with Wednesdays remote and the remaining days in the office Lakeshore Talent is in search of a detail-oriented Code Review Specialist to join a growing team specializing in medical coding methodology, billing review, and litigation support. This role is ideal for an experienced medical coding professional who enjoys analytical work, takes pride in accuracy, and is interested in improving processes rather than simply following established procedures. In this position, you will review medical records and billing documentation, validate CPT and HCPCS procedure codes and modifiers, and ensure that coding decisions are accurate, consistent, and well-documented. Your work will support the development of transparent, defensible medical damage valuations used in litigation-related cases. Beyond day-to-day code...

Lakeshore Talent is in search of a Code Review Specialist – Medical Coding Methodology & Litigation Support Location: Greenwood Village, CO (Denver Tech Center) Position Type: Direct Hire Salary: $75,000–$85,000 annually Schedule: Monday–Friday, with Wednesdays remote and the remaining days in the office Start Time: 7:00 AM or 8:00 AM Position Overview Lakeshore Talent is in search of a detail-oriented Code Review Specialist to join a growing team specializing in medical coding methodology, billing review, and litigation support. This role is ideal for an experienced medical coding professional who enjoys analytical work, takes pride in accuracy, and is interested in improving processes rather than simply following established procedures. In this position, you will review medical records and billing documentation, validate CPT and HCPCS procedure codes and modifiers, and ensure that coding decisions are accurate, consistent, and...

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 may vary based upon position type and/or level. Job...

Baylor Scott & White Health is seeking a DRC Coding Auditor to join the Denial Resource Center. You will review and appeal complex coding denials across Hospital and Professional Billing, ensuring documentation supports billed services and reported diagnoses. The role requires advanced coding knowledge, CMS/payer policy understanding, and collaboration with RNs, coders, and revenue cycle teams to improve coding accuracy and reduce denials. #J-18808-Ljbffr

Outpatient Coder LeadInspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.As our Outpatient Coder Lead, you will code and abstract outpatient records for data retrieval, analysis, reimbursement, and research, ensuring complete charge capture, and providing expert guidance to coding and hospital staff.Every day you will direct Outpatient Coding Service Center operations including personnel management, training, education, productivity, work assignments, and quality reviews. You will assist with coding education, audits, denials, claim edits, and CHA data submissions, promoting...

Clinical Risk Adjustment Coder Alpine Physician Partners partners with independent physician groups to deliver coordinated, value-based care that improves outcomes and lowers the total cost of care. Our clinical and coding teams support providers with the accurate, compliant documentation and coding practices that make value-based care possible. The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding guidelines. Review medical records, encounter notes, and provider documentation to identify and validate diagnosis codes relevant to HCC and other risk adjustment models. Conduct in-home or virtual health assessments with patients, evaluating...

Title: Medical Coding/ Education Specialist Location: Remote, preferably in Texas Compensation: $65,000 - $75,000 per year *Must have Post Acute Care Experience* Responsibilities Conduct regular coding audits and reviews to ensure compliance with coding guidelines, regulatory requirements, and reimbursement policies. Develop and deliver educational materials, training modules, and resources on coding guidelines, regulatory updates, and documentation requirements specific to post-acute care settings. Collaborate with providers and operations personnel to clarify documentation and coding issues, providing ongoing feedback and support for improvement. Work closely with the technology team to optimize EMR processes, enhance documentation workflows, and implement improvements aimed at reducing coding denials and improving reimbursement rates where necessary. Stay informed about changes in healthcare regulations, coding guidelines, and reimbursement practices relevant to post-acute...

Position Summary This position is responsible for the accurate coding and billing of inpatient and outpatient professional services provided to patients working from the appropriate documentation in the medical record. Classification systems include the current versions of CPT and ICD as well as other specialty systems as required by diagnostic category. All work is carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association, Centers for Medicare and Medicaid Services, and organizational coding guidelines. Essential Duties Reviews and audits documentation for verification of type and level of professional services rendered using the current version of the Evaluation and Management Guidelines and CPT coding rules and guidelines. Queries providers and/or appropriate staff when documentation is missing, inadequate, ambiguous or unclear for coding purposes. Utilizes proper written and verbal communication skills....

Clinical Risk Adjustment CoderAlpine Physician Partners partners with independent physician groups to deliver coordinated, value-based care that improves outcomes and lowers the total cost of care. Our clinical and coding teams support providers with the accurate, compliant documentation and coding practices that make value-based care possible.The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding guidelines.Review medical records, encounter notes, and provider documentation to identify and validate diagnosis codes relevant to HCC and other risk adjustment models.Conduct in-home or virtual health assessments with patients, evaluating and...

National Jewish Health in Colorado is seeking a Medical Coder with 1+ year physician coding experience to ensure accurate inpatient and outpatient billing using CPT/ICD guidelines. This full-time, 100% remote role requires attention to documentation quality and compliance with AHA, CMS, and internal coding guidelines.You will query providers, audit records, and support education to clinicians, contributing to proper reimbursement while maintaining professional standards.J-18808-Ljbffr

Clinical Risk Adjustment CoderAlpine Physician Partners partners with independent physician groups to deliver coordinated, value-based care that improves outcomes and lowers the total cost of care. Our clinical and coding teams support providers with the accurate, compliant documentation and coding practices that make value-based care possible.The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding guidelines.Review medical records, encounter notes, and provider documentation to identify and validate diagnosis codes relevant to HCC and other risk adjustment models.Conduct in-home or virtual health assessments with patients, evaluating 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. The Medical Coding Specialist responsible for accurate...