28 professional coding auditor jobs found

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

Job Type Full-time Description University Health Network is seeking a Full-Time Coding Auditor. This role requires normal business hours Monday-Friday and is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region. UHN Auditor provides superior customer experience by educating internally and externally of errors and opportunities for improvement discovered during routine auditing. This individual will work closely with management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. The UHN Auditor performs duties in a professional manner while exercising good judgment and ethical standards, interacts effectively and builds respectful working relationships across the organization, and demonstrates integrity by adhering to high standards of personal and professional conduct. This...

Galen Medical Group is seeking an EMR Coding Auditor II to improve documentation quality and ensure HCC coding accuracy. You will review charts, validate chronic conditions, and coordinate with physicians to maintain up-to-date problem lists in the EMR. You will train new staff and support the team under the Population Health Manager. The role requires expertise in ICD-10/CPT, strong communication skills, and a commitment to quality and compliance. #J-18808-Ljbffr

Position Summary The Coding Auditor conducts quality audits to ensure that medical diagnostic codes submitted to CMS (Centers for Medicare and Medicaid Services), New York State Department of Health (NYSDOH), and other entities are accurate based on the practitioners' medical record documentation of Healthfirst members' health conditions. Duties & Responsibilities Audits data, claim submissions, and member medical records for completeness, accuracy, and compliance with Healthfirst policy and documents findings per departmental procedure Identifies patterns of under-performance, noncompliance, and inconsistencies and recommends resolutions Evaluates the quality of medical coding and notifies management of discrepancies, as needed. Conducts internal audits of medical record reviews performed by colleagues Collaborates with other departments to improve compliance with coding conventions and clinical practice guidelines Supports continuous improvement and quality initiatives...

Ranked one of Tennessee’s top places to work, MHC is a rare and special place where outstanding company culture is intentional. Where clients and associates are treated the same, as equals. Mental Health Cooperative, Inc. (MHC) was formed in 1993 to serve individuals with severe and persistent mental illness. Since then, we have expanded our services to children and adolescents with severe emotional disorders across Middle and East Tennessee. Our sole purpose is to support and treat those challenged with serious mental illness and poverty. Although based out of Nashville, we serve several communities across middle and East Tennessee with satellite offices in Antioch, Gallatin, Dickson, Columbia, Cleveland, Murfreesboro, Clarksville, Cookeville, Chattanooga, and Memphis. If you are interested in joining a team that is caring, collaborative, innovative and energizing this might be a great place for you! Job Title: Compliance Auditor Department: Compliance Reports To: Director of...

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...

Job description 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...

Location :RemoteSalary :$85,000depending on experienceSkills :Auditing, Inpatient Coding, DRG Validation, Quality ReviewAbout the Company / Opportunity :Are you passionate about upholding quality standards in health information management and coding practices? Our client, an industry leader in the hospitals and health care sector, provides nationwide revenue cycle services to a vast network of hospitals and physician practices.This remote opportunity allows you to leverage your expertise in coding quality review, ensuring compliance with national guidelines and maintaining data integrity.Join a mission-driven organization focused on supporting patient outcomes and enhancing health care delivery through excellence in coding quality.Responsibilities :Lead, coordinate, and perform all functions of quality review for inpatient and outpatient coding across multiple facilities.Conduct routine, pre-bill, policy-driven, and incentive plan-driven coding quality audits to ensure compliance...

Coder AnalystAnalyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding initiatives. Abstracts and enters data from the medical records in order to maintain a database for statistics and reporting. Assists the Billing Department in timely billing and rebilling of patient information.ResponsibilitiesReviews documentation in the medical record to determine ICD-10 CM and CPT-4 coding that is needed to comply with billing and reimbursement guidelines set forth by government entities.Verifies data in the medical record and accurately abstracts pertinent information for charge entry.Appropriately utilizes CPT-4 and ICD-10 current procedural coding standards in assisting the provider with proper selection and assignment of the principal procedure(s) and related diagnosis.Edits unbilled...

Tennessee Orthopaedic Alliance, the largest orthopaedic surgery group in Tennessee, seeks a Certified Coder to ensure accurate coding and documentation for professional services. This role emphasizes CPT-4, ICD-10, HCPCS knowledge and collaboration with providers for audits. The position may involve work-at-home options within the Middle Tennessee region; candidates should reside near Knoxville or Columbia areas for on-site requirements. #J-18808-Ljbffr

Tennessee Orthopaedic Alliance (TOA) is the largest orthopaedic surgery group in Tennessee. We are seeking a Certified Coder to ensure accurate coding of charges and compliance with CPT-4, ICD-10, HCPCS in a busy practice. Responsibilities include reviewing records, abstracting diagnoses and procedures, and educating providers on audit results while maintaining professionalism. Must reside in Middle TN, Columbia, or Knoxville area and hold CPC or CCS-P certification. #J-18808-Ljbffr

Coder Analyst Specialist Full Time, 80 Hours Per Pay Period, Day Shift Covenant Medical Group Overview: Covenant Medical Group is the employed and managed medical practice organization of Covenant Health, providing comprehensive care across East Tennessee. With more than 300 physicians and advanced practice providers in 20 communities, our team delivers expertise across a broad spectrum of specialties from primary care and walk-in clinics to preventive medicine and advanced surgical and subspecialty services. We are committed to offering coordinated, patient-centered care that spans the continuum of health needs, ensuring access to exceptional providers close to home. Position Summary: Analyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding initiatives. Abstracts and...

Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state. There are a number of reasons why TOA is an employer of choice; here are a few of them: Stability - TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state! Impact - TOA's team members use our careers — whether in our clinics or our business office to make a positive difference in the community by building relationships and helping patients live their best life. Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. Total Rewards - TOA offers a comprehensive suite of benefits, including...

Physician Coder III, RemoteErlanger Health hires employees for telecommuting/remote positions in the following states: AL, AZ, GA, FL, IN, KY, LA, MD, MI, MS, MO, NC, NV, OH, PA, SC, TN, TX, VA, WI, WYJob Summary: The Physician Coder III is responsible for coding of physician and/or mid-level provider professional services. Recognizes and completes a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follows set procedures to achieve goals. Displays professional office skills and ability to navigate a practice management system. Functions as liaison between management, the physician practices and employees working within physician practices. Coder will provide CPT, HCPCS and ICD-10-CM coding a minimum of 1-4 specialties. Specialties could include UR, Podiatry, Plastics, Pediatrics, OB, Pain Management, Ortho, Addiction, General Surgery, Internal Medicine, Urgent Care, Pulmonary, or ED. Facility Chart types could include OT, PT, Urgent Care, ED,...

Quorum Health is seeking a Senior Outpatient Coder to lead inpatient and outpatient coding workflows with a focus on accuracy and compliance. The role supports denials reviews, audits, and staff education while aligning with organizational goals for revenue integrity. You will collaborate with Coding Leadership and CDI teams, applying official guidelines and payer requirements to ensure timely, compliant coding across hospital-based services in a fully remote capacity. #J-18808-Ljbffr

Tennessee Orthopaedic Alliance, the largest orthopaedic surgery group in Tennessee, seeks a Certified Coder to support accurate coding for professional services and surgical procedures. You will review records, ensure proper diagnoses and CPT/HCPCS codes, and educate providers on audit results. Applicants must have 1 year of surgical coding experience and CPC or CCS-P certification, with strong medical terminology knowledge. #J-18808-Ljbffr

Tennessee Orthopaedic Alliance Job OpportunityWork at HomeTennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state.There are a number of reasons why TOA is an employer of choice; here are a few of them:Stability - TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state!Impact - TOA's team members use our careers — whether in our clinics or our business office to make a positive difference in the community by building relationships and helping patients live their best life.Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement.Total Rewards - TOA offers a...

Professional Fee Coding Specialist Required Skills & Experience• 3+ years of professional fee coding experience. • Active coding certification through AAPC or AHIMA. • Active RHIT, RHIA, CPC, COC, CCS-P, CCS, CEDC, or equivalent coding credential. • Experience coding clinic visits/professional services. • Strong experience with Evaluation & Management (E/M) coding, diagnosis coding, injections, and procedure coding. • Strong knowledge of ICD-10-CM, CPT, HCPCS, modifiers, and coding compliance guidelines. • Experience with Cerner EMR. • Experience working remotely. • Proficiency in Microsoft Outlook, Excel, and Teams. Strong communication, organization, and multitasking skills. Nice to Have Skills & Experience• Emergency Department (ED) coding experience. • Multi-specialty Pro-Fee coding background. • Experience with regulatory reporting and data abstraction. • Prior hospital or health system coding experience. • Experience partnering with AR/billing teams on claim...

***Work at Home*** Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state. There are a number of reasons why TOA is an employer of choice; here are a few of them: Stability - TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state! Impact - TOA's team members use our careers — whether in our clinics or our business office to make a positive difference in the community by building relationships and helping patients live their best life. Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. Total Rewards - TOA offers a comprehensive suite...

Senior Outpatient Coder Position Details: Full-Time Remote Reports to Coding Operations Manager You must reside in one of these states to be eligible for this position: Arkansas California Kentucky Massachusetts Nevada New Mexico Oregon Utah Tennessee Texas Wyoming Job Summary: The Senior Coder supports assigned inpatient and/or outpatient coding operations through day-to-day workflow leadership and may provide oversight of coding quality, coding edits, auditing, and staff education. Assigned functions may include inpatient, observation, emergency department, ambulatory surgery, ancillary, clinic, and other hospital-based coding services. The position supports Revenue Cycle Operations with special projects, including denial review, appeals, discharge-not-final-billed management, regulatory and payer edit review, and process improvement efforts designed to meet organizational goals while promoting accurate, complete, and compliant coding and billing....

Job Details Job Location: Midtown Plaza (PLZ) - Nashville, TN 37203. Position Type: Full Time. Job Shift: Day. Job Category: Finance. Summary The Charge Entry Specialist captures and reviews all billing codes prior to electronic claims filing, for accuracy and adherence to payer specific coding guidelines, for a multi-specialty physician group practice. Essential Duties and Responsibilities Captures and reviews daily charges from the Electronic Health Record’s Charge Passing System to ensure standard coding and billing guidelines are followed correctly. Utilizes CPT, ICD-10CM, and HCPCS coding as well as correct Modifier usage during daily reviews of Primary Care services. Other specialties may be added based on performance level. Communicates effectively and respectfully, both in verbal and written form, with providers or clinical staff to obtain missing or incomplete information. Audits the imported encounters against the daily appointment schedule to ensure all encounters have...

OneOncology is seeking a Senior Medical Coding Specialist to ensure accurate CPT/ICD-10/HCPCS coding across oncology services. You will audit documentation, answer coding questions, and coach junior coders within a remote RCM team, while supporting compliance and ongoing education. Requires CPC or CCS-P certification and 4+ years in physician practice/hospital coding, with oncology experience and strong communication skills to drive coding accuracy and efficiency. #J-18808-Ljbffr

Health Information Director / Coder Full-Time│InHouse Position Summary Sullivan County Memorial Hospital is seeking a Health Information Director / Coder to oversee Health Information Management operations, physician billing and coding, and HIPAA/privacy compliance. The ideal candidate is detail-oriented, organized, professional, and able to work independently while maintaining strict confidentiality. Essential Job Functions Oversee daily Health Information Management operations and medical record processes. Ensure health information is accurate, complete, secure, confidential, and compliant. Perform and oversee physician and APP billing and coding. Review documentation and assign appropriate ICD-10-CM, CPT, and HCPCS codes. Prepare and submit insurance and patient claims. Resolve billing, coding, and documentation issues. Serve as the hospital’s HIPAA/Privacy Officer and oversee privacy compliance. Maintain HIPAA policies, training, and required documentation. Supervise, train,...

OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology's mission and vision. Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve. Job Description: Role Summary: The Medical Coding Specialist, is under general supervision, performs daily charge review of visits, diagnosis, radiation oncology or surgeries for accurate level and coding. Responsible for input...