25 professional coding auditor jobs found

Professional Coding Auditor And Educator - Remote This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation...

Job Summary The Senior Compliance Auditor ensures the integrity and accuracy of facility and professional compliance audits, monitoring, and provides compliance education for facility and professional documentation, coding, and billing. The Senior Compliance Auditor serves as a mentor for Compliance Auditors and assists management with the onboarding process for new Compliance Auditors. This position requires the use of judgement and critical thinking skills to determine appropriate corrective actions for non-compliance and ensure corrective actions are fully implemented by the entity service line area. Job Duties One of the following coding or auditing certifications are required (CCS, CPC, RHIA, RHIT or CPMA). Performs scheduled facility and/or professional audits on the adequacy of medical record documentation to support coding (DRG, CPT, ICD 10) and billing as required by the Compliance work plan reflecting scheduled activities and target dates. Performs audits resulting...

Company : Allegheny Health Network Job Description : *This role will cover Inpatient Auditors and will require Inpatient (AHIMA) credentials. GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants...

Multispecialty Surgery Coder II The Multispecialty Surgery Coder II will code for multispecialty surgery physicians primarily single path coding. Multi-specialty surgical coding experience, any trauma, urology, ENT, plastics, gen surg, OB/GYN, cardiovascular, interventional radiology, etc. Ability to extract data and apply appropriate ICD-10 diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding managerthe coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM official guidelines for coding and reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve...

Professional Medical Coder II CCG Talent Management is not only a business solutions company but a company that believes success starts with the individual. CCG Business Solutions has been consulting and providing talent placement services since 2007. Our team understands the principles of connecting purpose to business. We are currently recruiting for a Professional Medical Coder II. Job Description Remote Role - Must be located in the Portland, OR Metro Area. The Professional Medical Coder II will focus on review of documentation and coding. The Professional Medical Coder II will ensure accurate coding and claim submission and conformity to applicable guidelines and regulations. Responsibilities: Perform documentation and coding reviews within work queues across various specialties as assigned. Utilize available coding tools and knowledge to assist in appropriate assignment of coding. Maintain current knowledge to ensure that coding and documentation meets regulatory...

Date Posted 2025-10-02 Country United States of America Location Florida - Remote WHY JOIN FCS At Florida Cancer Specialists & Research Institute, we believe our people are our strength and we invest in them. In addition to having a positive impact on the people and communities we serve, associates benefit from significant professional opportunities, career advancement, training and competitive wages. Offering competitive salaries and comprehensive benefits packages to include tuition reimbursement, 401-K match, pet and legal insurance. A LITTLE BIT ABOUT FCS Since 1984, Florida Cancer Specialists & Research Institute & Research Institute (FCS) has built a national reputation for excellence. With over 250 physicians, 220 nurse practitioners and physician assistants and nearly 100 locations in our network. Utilizing innovative clinical research, cutting‑edge technologies, and advanced treatments, we are committed to providing world‑class cancer care. We are...

Compliance Auditor Senior - Healthcare Legal and Regulatory (Eastern United States resident) Job Summary The Senior Compliance Auditor ensures the integrity and accuracy of facility and professional compliance audits, monitoring, and provides compliance education for facility and professional documentation, coding, and billing. They serve as a mentor for Compliance Auditors and assist management with onboarding new auditors. The position requires judgment and critical thinking to determine appropriate corrective actions for non‑compliance and ensure those actions are fully implemented. Job Duties Performs scheduled facility and/or professional audits on the adequacy of medical record documentation to support coding (DRG, CPT, ICD‑10) and billing as required by the compliance work plan. Performs audits resulting from unplanned investigations. Reviews peers’ work products and serves as a mentor for compliance staff. Serves as primary lead for facility/professional billing...

Physician Coding Auditor 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! The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW....

Option to be Hybrid/Remote. Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic’s policies and procedures and accepted guidelines for medical coding. Works closely with the Compliance Officer and Compliance coding Audit Coordinator to perform audits outlined in the work plan. Requires ability to present detailed analysis of audits in both written and spoken form. Relies on professional judgement to ensure Internal Audit and Compliance standards are used to assess compliance with CPT, ICD-9/10, HCPCS, Payor, CMS guidelines and TGC policies Experience: - Working knowledge of medical terminology, anatomy and physiology, and coding guidelines including CPT, ICD- 9 /10-CM, and HCPCS coding systems and guidelines, payer guidelines and requirements. - Minimum 1-year experience in Physician coding and billing and/or compliance field required 5 year of clinical experience and/or knowledge and understanding of Medical Records auditing...

General Summary Performs clinical documentation audits, evaluations and other reviews for the System to ensure and assess compliance with applicable laws and regulations. Prepares and presents written and oral reports summarizing audit work, issues identified and recommendations to correct issues to management. Develops and disseminates education and training programs to employees. Duties and Responsibilities Essential Functions: Performs proactive or reactive coding compliance reviews as needed to identify or quantify potential issues. Investigates and recommends action to be taken when compliance issues are found. Monitors implementation of recommended corrective action and performs follow up reviews where necessary. Assists with coding compliance implementation throughout the WellSpan. Assists in the development and dissemination of education and training processes for the employees regarding coding compliance related activities. Assists...

Job Description Job Description The Coding Network, LLC (TCN) is the country’s premier broker of remote coding and auditing services, structured as a virtual company connecting healthcare professionals and health systems across the country with over 800 US based single specialty coders and auditors. Flexible Hours: We understand that everyone’s schedule is different and, as such, auditors enjoy the flexibility to commit to as few as 15 hours a week to however many hours work for them to render auditing services. It is one thing to have the freedom to work from home, but TCN coders possess the freedom to utilize the full 24 hour clock and choose when to work beyond the traditional 9-5. Whether you’re looking for extra income in addition to your day job or to make a more robust commitment, we are able to accommodate you. Position & Responsibilities: In order to support the growing need for E&M services and surgical divisions, there are abundant opportunities for...

Hospital/Facility Revenue Cycle Manager Trajectory RCS joined the MedHQ family in the beginning of 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing healthcare cash flow through teamwork and collaboration. MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. MedHQ, LLC, is a 2022 Becker's Top 150 Places to Work in Healthcare company. The MedHQ LLC service line offerings have grown organically over the years, beginning by providing high quality traditional human resource, accounting, and staff...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Medical Oncology Coder UPMC Hillman Cancer Center at the Divine Providence Campus in Williamsport is currently hiring a full-time Medical Oncology Coder. This position offers a consistent day shift schedule from 8:00 AM to 4:30 PM, totaling 40 hours per week. The ideal candidate will hold a Certified Professional Coder (CPC) credential and have at least two years of experience in physician coding using Physician CPT and ICD-9. This is a great opportunity to join a dedicated oncology team and contribute to accurate, compliant coding that supports high-quality patient care. This is a hybrid position. The initial phase of employment will require on-site work at UPMC Hillman Cancer Center in Williamsport, PA for several months. After this period, mandatory attendance for monthly meetings and other required on-site sessions will continue. Ideally, the candidate will work minimum one day per week in the office at UPMC Hillman Cancer Center, with the remaining time remote....

Job Title Revenue Cycle Coding Specialist Job Description Apply the appropriate diagnostic and procedural code to patient health records for purposes of document retrieval, analysis and claim processing. Abstract pertinent information from patient records. Assign the International Classification of Diseases, Clinical Modification (ICD), Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes, creating Ambulatory Patient Classification (APC) or Diagnosis-Related Group (DRG) assignments. Perform complex coding. Obtain acceptable productivity/quality rates as defined per coding policy. Query physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Maintain knowledge of, comply with and keep abreast of coding guidelines and reimbursement reporting requirements. Conduct chart audits for physician documentation requirements & internal coding....

Allegheny Health Network Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching plans in accordance with federal and state regulations and...

Certified Specialty Coder Three Rivers Orthopedics is seeking a Certified Specialty Coder to support 11 orthopedic surgeons specializing in areas including spine and foot/ankle at 200 Delafield Road, Suite 1040, Pittsburgh, PA 15215. This full-time position runs MondayFriday, 8:00 AM4:30 PM, with the potential for work-from-home flexibility after training Responsibilities: Utilize advanced, specialized knowledge of medical codes and coding procedures to assign and sequence appropriate diagnostic/procedure billing codes, in compliance with third party payer requirements. Monitor billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling and other questionable practices; prepares periodic reports for clinical staff identifying unbilled charges due to inadequate documentation. Perform all coding functions, based on staffing needs and/or department requirements. Refer problem accounts to appropriate coding or management personnel...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Job Description Job Description Description: Job Role The Clinical RN Chart Reviewer will perform clinical reviews of medical records and other documentation to validate issues of claims coding accuracy, medical necessity, and the appropriateness of treatment settings and services delivered. The Clinical RN Chart Reviewer will report to the Payment Assurance Manager and support a culture and work environment that promotes and inspires an active, continuous improvement philosophy regarding products and services in line with our company mission. This role requires certified coding expertise and a strong understanding of DRG validation, medical necessity, and regulatory guidelines. Requirements: Responsibilities will include: · Audits and analyzes neonatal intensive care unit (NICU) claims according to ICD-10 coding principles and clinical guidelines. · Analysis of claims data to optimize reimbursement by ensuring that the diagnosis codes, procedure codes, and supporting...

Job Title Collects, reviews, retrieves and codes Evaluation & Management services, Pathology, and minor procedures based on documentation in the medical record and reports for quality assessment, audit, and billing purposes. Duties And Responsibilities Essential Functions: Performs chart audits, reviewing for accuracy and compliance. Reviews operative reports and other documentation and assigns appropriate diagnosis (ICD-10) and procedure codes (CPT) for final billing. Researches and processes invoice corrections. Reviews and analyzes coding/billing procedures. Presents training and feedback concerning medical coding, compliance, and reimbursement to physicians/providers. Coordinates and implements reimbursement improvement activities with staff and providers. Adheres to WellSpan Coding Compliance Guidelines. Common Expectations: Maintains job specific standards and expectations relative to productivity and quality. Prepares and maintains appropriate...

Medical Coder Bizforce and our medical billing division, MedCore Solutions, are seeking skilled Medical Coders to join our growing team. As a Medical Coder at MedCore, you will be responsible for translating details from a patient's medical documents into medical codes for health insurance claims purposes. Additionally, you will be liaising with the client and team members for coding-related queries and concerns, performing audits for coding denials and missing information, and maintaining a tracking system for coded charts. MedCore allows the best talent in PH to work remotely from home with the latest technology and resources. We are partnering with some of the largest healthcare platforms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today! MedCore Solutions (MCS) is a single-source solution for Healthcare administration. MCS is an industry leader in medical billing, credentialing, scribing,...

Inpatient Coding Auditor (PRN) Join Our Award-Winning Team and Work with the Best! We are thrilled to share that UASI has been recognized as a Top Workplace by the Cincinnati Enquirer in 2022, 2023, and 2024! With over 40 years of experience and enduring partnerships with our valued clients, we are proud of the stability we've built and the long-term success of our dedicated team. We are currently seeking an experienced facility inpatient Coding Auditor to join our team on a PRN basis. The Coding Auditor will perform inpatient coding audits and review services to client sites remotely from a home office. Additional responsibilities include: Work with clients performing coding audit and/or review services on a variety of Inpatient facility record types Identify trends based on coding audit and review findings and formulate recommendations for corrective action plans Perform necessary research to provide to the client to support findings. Examples of this research include...

Select Medical - JobID: Jbf4ab5eb57b64893ab9f8ef4af44a996-1 [Medical Records Clerk] As an Inpatient Coder at Select Medical, you'll: Analyze medical records to assign accurate codes for inpatient services; Ensure compliance with coding guidelines and regulations; Collaborate with healthcare professionals to clarify documentation; Maintain confidentiality of patient information; Participate in coding audits and quality improvement initiatives; Stay updated with changes in coding standards and healthcare regulations...Hiring Immediately >>