20 professional coding auditor jobs found

Join Newport Healthcare: Transform Lives Through Meaningful Work! Are you ready to embark on a rewarding career in psychiatric healthcare? At Newport Healthcare, we are passionate about delivering exceptional mental health services to individuals in need. Our comprehensive approach covers the entire spectrum of care, creating a wealth of diverse roles for those who aspire to make a real impact. We believe in nurturing talent and fostering professional growth in a supportive environment. Here, you won't just find a job-you'll discover a fulfilling career path in the mental health field. If you're eager to contribute to a mission-driven organization and help change lives for the better, we invite you to join our dedicated team at Newport Healthcare. Together, we can make a profound difference in the lives of those we serve! Position Summary The coding auditor reviews and audits medical coding for accuracy, compliance, and adherence to healthcare regulations, providing feedback,...

Become a part of our caring community and help us put health first 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 Durable Medical Equipment (DME) auditing and is part of the PPI Coding Disputes Team with Humana. The Disputes Auditor - DME Outpatient Coding 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 DME coding disputes and expertise in...

Work Where You Matter! At St. Croix Hospice we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient's quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Position Overview The Compliance Auditor is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that St. Croix Hospice complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations while collaborating with leadership to mitigate risks and strengthen internal controls....

DRG auditor Location: Maplewood Mn Pay Rate: Negotiable Duration: 12 months potential for extension Summary: We are seeking two experienced inpatient DRG Auditors for an asneeded role offering flexible hours (8-40 hours per week). Candidates may already have fulltime jobs, and the position is open to applicants on either the East or West Coast. The role will likely include two interviews . Ideal candidates will have: 5-7+ years of inpatient hospital coding/auditing experience Experience working in acute care hospitals, large hospital systems, or academic medical centers Strong expertise with ICD10CM/PCS , MSDRG and APRDRG methodologies Understanding of Elixhauser scoring , HACs , PSIs , and clinical validation Prior exposure to Clinical Documentation Improvement (CDI) preferred Ability to independently perform DRG audits with high accuracy Strong analytical, communication, and documentation skills Role Responsibilities: Perform...

DRG Coding Auditor Principal _Virtual: _ _ _ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group...

Position Type Full Time Description Work Where You Matter! At St. Croix Hospice we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient’s quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Position Overview The Compliance Auditor is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that St. Croix Hospice complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations while collaborating with leadership to mitigate risks and...

DRG auditor Location: Maplewood Mn Pay Rate: Negotiable Duration: 12 months potential for extension Summary: We are seeking two experienced inpatient DRG Auditors for an as-needed role offering flexible hours (8-40 hours per week). Candidates may already have full-time jobs, and the position is open to applicants on either the East or West Coast. The role will likely include two interviews . Ideal candidates will have: 5-7+ years of inpatient hospital coding/auditing experience Experience working in acute care hospitals, large hospital systems, or academic medical centers Strong expertise with ICD-10-CM/PCS , MS-DRG and APR-DRG methodologies Understanding of Elixhauser scoring , HACs , PSIs , and clinical validation Prior exposure to Clinical Documentation Improvement (CDI) preferred Ability to independently perform DRG audits with high accuracy Strong analytical, communication, and documentation skills...

Professional Coder - Cardiology & Interventional Radiology Pride Health is hiring a Professional Coder - Cardiology & Interventional Radiology for one of its clients in Minnesota. This is a 12-month contract with the possibility of an extension with competitive pay and benefits. This is 100% Remote PRN Role. Location - Fully Remote (Maplewood, MN) Pay range - $45 - $50 per hour on a W2. Length of assignment -12 months (With the possibility of an extension) Shift - Flexible Job Summary The Professional Coder - Cardiology & Interventional Radiology is responsible for accurate and timely assignment of CPT®, HCPCS Level II, and ICD 10 CM diagnosis codes for physician (professional) services in cardiology and interventional radiology. This role ensures coding compliance with AMA CPT®, CMS, NCCI, LCD/NCD, and payer specific guidelines, supports optimal reimbursement, and minimizes compliance risk. The coder reviews provider documentation to validate medical necessity,...

Thank you for considering a career at Ensemble Health Partners! Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together. The Medical Coder performs concurrent review of FFS coding rules within Epic, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. Schedule : Monday to Friday, 8 AM- 5 PM Location : Remote Nationwide You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary...

Medical Coder Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Schedule: Monday to Friday, 8 AM- 5 PM Location: Remote Nationwide You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes Apply...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Senior Medical Coder performs concurrent review of FFS coding rules, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. This position will support coding functions within charge review, claim edits, and denials and play a critical role in maintaining coding accuracy and supporting revenue cycle integrity. Schedule: Monday to Friday, 6 AM- 11...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. ***** FT and PRN Openings *** Up to $5,000 Sign On Bonus ***** What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical...

At Unifeye Vision Partners (UVP) our mission is simple: to partner with leading eye care practices and support them in their quest to improve the quality of their patients' lives. We are building the leading, nationally recognized integrated eye care community in the country through these partnerships and our commitment to upholding our mission and core values. Unifeye Vision Partners is currently hiring for a full-time Medical Billing (AR) Specialist at our Bloomington location. This position can be remote OR a hybrid position: work from home or in office/remote. SUMMARY The Medical Billing (AR) Specialist at UVP plays a vital role in the revenue cycle process by ensuring accurate and timely submission of medical claims, working denials, and supporting the financial health of the organization. This individual will work closely with clinical and administrative teams to ensure billing accuracy and compliance with payer requirements. ESSENTIAL DUTIES AND RESPONSIBILITIES...

Essential Duties and Responsibilities: - Abstract and code clinical data. - Audit medical records to ensure compliance with the organization's coding procedures and standards. - Accurately enter coded data in a system and validate data entered. - Research correct coding practices, clearly document and share findings with others. - Review denials and recommend billing corrections. - Train staff members on the coding process. Minimum Requirements - High School diploma or equivalent with 0 - 2 years of experience. - Additional clinical licensure may be required based on project. - Must be a Certified Medical Coder, Certified Professional Coder, or a Certified Coding Specialist. - Knowledge of Medical Billing and Coding Systems such as CPT and HCPCS is essential. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday required. Additional Skills and Experience: - Familiarity with retrospective payment reimbursement highly preferred....

Senior Medical Coder Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Senior Medical Coder performs concurrent review of FFS coding rules, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. This position will support coding functions within charge review, claim edits, and denials and play a critical role in maintaining coding accuracy and supporting revenue cycle integrity....

The Medical Coding Specialist will evaluate medical records and encounters to ensure completeness, accuracy, and compliance with the International Classification of Diseases Manual - Clinical Modification (ICD-10-CM), and the American Medical Associations Current Procedural Terminology Manual (CPT). The Specialist will also provide technical guidance and training on medical coding to physicians and staff. Essential Functions Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions. Assign codes to diagnoses and procedures, using ICD-10 (International Classification of Diseases) and CPT (Current Procedural Terminology) codes Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations and meet current policy coding guidelines Communication and training with provider(s) on any documentation that is insufficient or unclear to meet current policy coding guidelines...

Job SummaryWe are seeking an experienced Certified RN Medical Coder to support a full-time COC / SPD project focused on building out coding for benefit plans.This role combines clinical knowledge with technical coding expertise to ensure accuracy, consistency, and compliance across plan documentation.You'll work closely with a team of certified coders and business analysts in a collaborative, fast-paced environment where precision and partnership drive success.Why this Opportunity?Top ranked company in Fortune's 2024 World's Most Admired Companies for over a decade consecutively.This healthcare client is ranked number one in key attributes of reputation :Innovation People management Social responsibility Quality of Management Financial soundness Long-term investment value Quality of products Services and global competitiveness.Job Responsibilities :Determine and assign appropriate codes to benefit plan language as part of the COC / SPD project.Review coding selections made by peers...

A healthcare organization based in Minnesota is seeking a coding specialist to conduct chart audits and enhance billing procedures. This role requires a high school diploma, coding certification, and two years of coding experience. The position offers benefits such as paid time off, medical coverage, and a competitive salary ranging from $23.70 to $46.35 per hour based on qualifications. Join us to make a difference in health equity and improve patient care. #J-18808-Ljbffr

Remote Risk Adjustment Coder (Virginia): up to $78,000/year! HealthCare Support is actively seeking a Remote Risk Adjustment Coder II to support a growing healthcare organization’s Virginia market. This role focuses on accurate HCC risk adjustment coding, provider education, and collaboration with clinical teams to improve documentation quality and compliance across Medicare Advantage, ACO, and Commercial populations. This is a remote position with quarterly travel to provider offices within Virginia. Shift Monday – Friday 8:00am – 5:00pm EST Compensation Notes $65,000 – $78,000+/year Daily Responsibilities For Remote Risk Adjustment Coder II Review and audit medical records for accurate HCC risk adjustment coding (ICD-10). Educate providers through 1:1 and group sessions (in-person and virtual) on documentation improvement and coding accuracy. Collaborate directly with physicians and clinical staff to address coding, compliance, and audit-related questions. Support internal...