27 professional coding auditor jobs found

Corporate Professional Coding Auditor And Educator If you are a current University Health or University Health Physicians employee and wish to be considered, you must apply via the internal career site. Please log into myWORKDAY to search for positions and apply. Corporate Professional Coding Auditor and Educator - Audit and Compliance - University Health (Some flexibility on remote work option; 5 days per week; 8:00a-4:30p; Mon-Fri) 101 Truman Medical Center University Health Truman Medical Center Kansas City, Missouri Audit And Compliance Full time 8:00AM - 4:30PM 40 hours per week Job Description Corporate Professional Coding Auditor and Educator is responsible for ensuring accurate, compliant, and optimized professional (physician) coding across the organization. This role performs proactive and reactive coding audits, identifies risk and revenue opportunities, and provides targeted education to physicians, APPs, and coding staff to support regulatory compliance,...

A leading healthcare system in Kansas City, MO is seeking an experienced Coding Specialist / Auditor and Educator to join their Audit & Compliance team! This role is ideal for a professional coder with auditing and/or provider education experience who wants to support coding accuracy, compliance, documentation integrity, and appropriate reimbursement across the organization. Title: Coding Specialist / Auditor and Educator Job Type: Permanent / Direct Hire Location: Kansas City, MO (Onsite, some flexibility for hybrid) Schedule: Full-time, Monday-Friday, 8:00 AM-4:30 PM Position Overview: The Professional Coding Auditor and Educator ensures accurate, compliant, and optimized professional/physician coding across the organization. This position performs coding audits, identifies compliance risks and revenue opportunities, and provides education to physicians, APPs, and coding staff. The role partners with Compliance, Revenue Integrity, CDI, and Provider Leadership to reduce...

Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to medical coding and...

Risk Adjustment Coding Auditor Job Description: The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy, completeness, specificity and...

Favorite Healthcare Staffing Inc. is seeking an experienced Coding Specialist, Auditor, and Educator to join the Audit & Compliance team in Kansas City, MO. This permanent/direct-hire role focuses on accurate, compliant professional and physician coding across the organization. You will perform coding audits, identify risk areas and revenue opportunities, and educate physicians, APPs, and coding staff. The role requires collaboration with Compliance, Revenue Integrity, CDI, and provider #J-18808-Ljbffr

Certified Medical Coding Auditor (CPC or CCS-P) Join to apply for the Certified Medical Coding Auditor (CPC or CCS-P) role at Accelerated Urgent Care Certified Medical Coding Auditor (CPC or CCS-P) 2 weeks ago Be among the first 25 applicants Join to apply for the Certified Medical Coding Auditor (CPC or CCS-P) role at Accelerated Urgent Care About Us Simply put, our purpose at Accelerated Urgent Care is to get you quality care when you need it. We aim to foster a supportive environment where our team members can develop their careers. To promote this goal, we’ve built a diverse and driven team of employees who are all eager to learn from one another and reach Accelerated Urgent Care’s mission of delivering exceptional healthcare to the patients and communities that we are privileged to serve. We are ... a fast-growing company that doubles in size year after year since 2012! Recognized as Kern County’s Top Urgent Care center 6 years in a row! Dedicated to our employees’ career...

A leading healthcare provider is seeking a Certified Medical Coding Auditor (CPC or CCS-P) in Bakersfield. This full-time role involves conducting audits, providing regulatory education, and ensuring compliance with billing standards. The ideal candidate will have an active certification, strong communication skills, and at least 3 years of experience. Benefits include medical, dental, vision insurance, and PTO, supporting professional growth within the organization. #J-18808-Ljbffr

Experienced Associate, Healthcare ForensicsThe Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients.Job Duties:Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance mattersContributes to forensic engagements related to medical coding and...

Medical Billing Coder (Staff Specialist) Salary may be negotiable within the range listed above, based on position requirements and successful candidate's qualifications, subject to appropriate authorization. OPEN TO THE PUBLIC This recruitment will establish an open eligible list that will be used to fill current and future Medical Billing Codepositions. The eligible list established may also be used to fill positions in similar and/or lower classifications throughout the County of Orange. DEADLINE TO APPLY This recruitment will be open for a minimum of five (5) business days and will close on Wednesday, September 9, 2026 at 11:59 P.M. (PST) AUDITOR-CONTROLLER The Auditor-Controller Department is committed to serving Orange County by ensuring accountability over public spending, transparency of Taxpayer dollars, and engaging the public in government. We carry out our vision and mission by conducting the Public's business with the highest ethical and due diligence standards by...

CVS Health is seeking a Certified Professional Coder (CPC) for its Special Investigations Unit to conduct medical claim reviews, ensure coding accuracy, and uphold state, federal, and company guidelines across medical, behavioral, transportation and other services. You will present findings to investigators and leadership, audit records for CPT/HCPCS codes, identify billing errors and fraud, and help drive savings while maintaining up-to-date coding knowledge. #J-18808-Ljbffr

AAPC Certified Medical Coder - Remote Join a dedicated healthcare team serving a broad regional community in the Midwest. This role is perfect for a detail-oriented medical coder who thrives in a remote work environment and is passionate about accurate and ethical coding practices. General Summary The medical coder ensures that services are billed correctly according to the American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. This position involves insurance credentialing and educating providers and staff on coding and billing standards. Routine chart audits are conducted to maintain compliance and accuracy. Essential Duties and Responsibilities Assign ICD-10-CM, CPT, and HCPCS Level II codes to finalized medical documentation to create accurate medical claims. Abstract specific data from patient records to determine appropriate claim modifiers. Query providers for clarification when documentation is unclear or incomplete,...

Job DetailsJob Location: Windsor Mill, MD 21224Position Type: Full TimeEducation Level: NoneSalary Range: $45,000.00 - $55,000.00 Salary About Us: At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact—whether we’re supporting data-driven decisions, modernizing systems or safeguarding critical programs. We are seeking a detail-oriented and experienced Medical Coder to support Risk Adjustment and Medicare Part C audits by accurately coding inpatient, outpatient, and physician office medical records. The ideal candidate has a strong understanding of ICD-9-CM/ICD-10-CM coding guidelines and consistently demonstrates high accuracy...

Coder Reimbursement Specialist - Hospital Full‑time position. The Coding and Reimbursement Specialist (CCS) is responsible for coding and abstracting clinical data from the medical record, including inpatient, outpatient, commercial, Medicare, Medicaid, Illinois Public Aid, and all other payor types. Accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis and DRG in accordance with rules and regulations and coding methodologies, resulting in reimbursement and billing compliances as set forth by the Office of Inspector General. The CCS manages workload, assigns work to three inpatient and two outpatient coders, and oversees day‑to‑day operations of the coding/reimbursement area. The CCS monitors regulatory sources to keep HIM coding and other staff informed and trained on coding rules, regulations and related issues, works closely with patient financial services to resolve claim denials, assists in...

Medical Coding Professional Shift: Monday Friday Days Department: Mizzou Therapy Services, Capital Region Medical Center Compensation: Base Pay Range: $19.25 - $30.23/hour, based on experience About The Job MU Health Care is looking for a detail-oriented and driven medical coding professional who thrives at the intersection of healthcare, compliance, and continuous learning. The ideal candidate is a critical thinker with a passion for accuracy, an eye for uncovering important details, and a commitment to supporting high-quality patient care through precise documentation and coding practices. We value professionals who enjoy collaborating with physicians, residents, and multidisciplinary teams while serving as a trusted resource on evolving regulatory and billing requirements. Success in this role requires strong analytical skills, integrity, and the confidence to navigate complex medical records and reimbursement processes with accuracy and professionalism. If you are...

RELI Group in Windsor Mill, MD is seeking an experienced Medical Coder to support Risk Adjustment and Medicare Part C audits. You will code inpatient, outpatient, and physician office records according to ICD-9-CM/ICD-10-CM guidelines, while maintaining high accuracy and productivity. The role requires a minimum of 1 year of coding experience, active credentials (CPC/CCS/RHIA/RHIT), and proficiency with Microsoft Office. CRC certification is a plus. #J-18808-Ljbffr

We are seeking a highly skilled Full-Cycle Medical Biller with extensive experience in U.S. healthcare billing, particularly within California insurance systems. This role requires a deep understanding of the end-to-end billing cycle, including claim submission, payment posting, accounts receivable (A/R), and denial management. The ideal candidate is a proactive problem-solver who can independently navigate complex payer systems while also supporting front-office functions, including patient intake and communication. Key Responsibilities Manage the full-cycle medical billing process from claim creation to final payment resolution Perform accurate claim submission and generation using ICD-10 and CPT coding Handle payment posting , reconciliation, and adjustments Monitor and manage Accounts Receivable (A/R) to ensure timely collections Conduct denial management and follow-ups , including appeals and resubmissions Perform insurance verification and eligibility checks Process...

Hiring Department University Physicians Job Description This position is a dual post linked to Job ID 59698 - MCS-C and the department will be hiring for two positions. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records to identify potential problems with coding and reimbursement, such as edits, denials, and appeal letters. Act as liaison between third-party payers and assigned departments to coordinate all aspects of professional coding. Provide assistance to faculty, residents, and department staff in standards of medical record documentation and coding. Assist in the presentation of training sessions for faculty, residents, and staff to inform them of changes made to Medicare billing, federal laws and regulations, and other specific standards...

Position: Coding and Billing Manager-Certified Coder Location: Lee's Summit, MO Job Id: 344 # of Openings: 1 Rockhill Orthopaedic Professional Corporation CODING AND BILLING MANAGER-CERTIFIED CODER Position Description The employee in this full-time position (40-50 hours per week) is responsible for overseeing the coders, as well as coding and data entry for office and surgical charges as needed. This employee reports directly to CEO and Corporate Board of Directors. Qualifications Certifications: Certified Professional Coder Certificate. (AAPC-Preferred) - Must have at least 5 years experience. Orthopedic Office and Surgical Coding Experience Previous Management Experience Must have Medical Billing Experience. Experience with Epic a plus. Skills This employee must have knowledge of CPT and ICD-10 codes. Knowledge of health information technology as well as medical terminology, data analysis and coding systems. Must be able to code from an operative report. Educated...

Coder Reimbursement Specialist - HospitalThe Coding and Reimbursement Specialist, CCS is responsible for coding and abstracting thoroughly, clinical data from the medical record. This includes both inpatient, outpatient, commercial, Medicare, Medicaid, and Illinois Public Aid, plus any other payor types. This accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis, grouped to the DRG in accordance with rules and regulations and coding methodologies, resulting in reimbursement and billing compliances as set forth by the Office of Inspector General. Manages workload and assigns work to three inpatient and two outpatient coders and oversees the day to day workings of the coding/reimbursement area. Monitors various regulatory sources to keep HIM coding and other staff informed and trained on various coding rules, regulations and related issues. Works closely with patient financial services to resolve any...

Compliance AuditorThe Compliance Auditor is responsible for developing and executing audit plans based on research and regulatory guidelines and conducting internal and external audits of departments and their policies. They review programs, records, and systems to ensure adherence to regulations and to support an effective compliance program that prevents illegal, unethical, or improper conduct at the health center. Additionally, they compile and present audit findings to department leadership, assist in implementing procedural changes to resolve compliance issues, and may be reassigned duties as needed for accommodation or staffing reasons.Essential Functions:Developing compliance auditing plans based on thorough research on studies conducted by government agencies and professional organizations.Conducting, managing, and overseeing external and internal audits for clinical departments.Audit departments and policies for those departments and ensure that all are following said...

Coder (Business Office) Harrisonville, MO 64701 Overview Position Type Full Time Job Shift Day Description Primary Purpose: To provide customer service to both the internal and external customers of the Health Information Management Department in a timely fashion. Review all outpatient encounters, selecting appropriate ICD-10-CM* and ICD-10-PCS* codes to reflect the diagnoses and course of treatment. Formal Policy-Setting Responsibilities: No formal responsibility. The policies associated with the job's purpose and essential responsibilities are set by others. Routine Decision Making: Selects ICD-10 CM* diagnostic codes and CPT-4 procedure codes for outpatient procedures, and ICD-10-PCS codes for inpatient procedures to obtain appropriate reimbursement. Coders also verify the correct charges are on the chart in accordance to physicians' orders. Formal Supervisory Responsibility: No formal supervisory responsibility. Unusual Working Conditions: None. ESSENTIAL...

Hiring Department University Physicians Job Description #upjobs This is a dual posting with job ID 59698. The final title will depend on the qualifications of the final candidate. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of changes made to...

Description Columbia Orthopaedic Group Fast-paced. Detail-driven. Team-focused. Every claim, code, and detail matters in delivering accurate, compliant, and timely patient care behind the scenes. If you take pride in precision and enjoy working in a collaborative healthcare environment, this role is for you. Why This Role Is Different This is not just a coding role-it is a key part of the revenue cycle that directly impacts the success of orthopaedic care delivery. Your work ensures providers are accurately represented, claims are clean, and reimbursement flows efficiently. You'll partner closely with physicians, billing, and administrative teams in a highly collaborative environment where accuracy, communication, and compliance are essential. About the Role The Medical Coder is responsible for accurately coding orthopaedic services to support timely and compliant claim submission. This role ensures documentation integrity, supports revenue cycle...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...