24 professional coding auditor jobs found

Working Conditions Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure The Coding Auditor, Senior performs code audits and is responsible for chart auditing processes as well as contributing to the education of providers and internal stakeholders on coding topics. The position is responsible for keeping up to date on the newest coding guidelines and best practices while promoting compliance with existing American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. Specific approaches to job duties vary depending on the department. Estimated Hiring Range $81,000.00 - $99,000.00 Bonus Target Bonus - SIP Target, 5% Annual Current CareOregon Employees: Please use the internal Workday site to submit an application for this job. Essential Responsibilities Perform and lead a variety of coding-related audits for providers and other entities. Review medical records to verify that complete and accurate...

Risk Adjustment Coding Auditor, Sr page is loaded## Risk Adjustment Coding Auditor, Srremote type: Remotelocations: Remote Oregon: Remote Utah: Remote Texas: Remote Idaho: Remote Wisconsintime type: Full timeposted on: Posted 2 Days Agojob requisition id: JR100739Risk Adjustment Coding Auditor, Sr---------------------------------------------------------------The Coding Auditor, Senior performs code audits and is responsible for chart auditing processes as well as contributing to the education of providers and internal stakeholders on coding topics. The position is responsible for keeping up to date on the newest coding guidelines and best practices while promoting compliance with existing American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. Specific approaches to job duties vary depending on the department.**Estimated Hiring Range:**$81,000.00 - $99,000.00**Bonus Target:**Bonus - SIP Target, 5% AnnualCurrent...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

Working Conditions Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure The Coding Auditor, Senior performs code audits and is responsible for chart auditing processes as well as contributing to the education of providers and internal stakeholders on coding topics. The position is responsible for keeping up to date on the newest coding guidelines and best practices while promoting compliance with existing American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. Specific approaches to job duties vary depending on the department. Estimated Hiring Range $81,000.00 - $99,000.00 Bonus Target Bonus - SIP Target, 5% Annual Current CareOregon Employees: Please use the internal Workday site to submit an application for this job. Essential Responsibilities Perform and lead a variety of coding-related audits for providers and other entities. Review medical records to verify that complete and accurate...

A healthcare organization is seeking a Senior Coding Auditor to lead coding audits, ensure compliance with regulations, and educate internal stakeholders. The ideal candidate will have over 5 years of experience as a certified coder, with strong knowledge of diagnosis coding conventions. The role requires maintaining active coding certification and engaging in continuous education on coding topics. Benefits include competitive pay and a comprehensive rewards program, along with opportunities for professional development. #J-18808-Ljbffr

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world. At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you're interested in joining a health care system that is changing the face of care and well-being in our community, we...

Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for anInpatient Coding Auditor, Senior Associatewho is responsible for performing coding reviews of inpatient medical records and/or other documentation to determine correct coding as defined by review methodologies specific to the contract for which review services are being provided. This involves accessing...

Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) Summary We are seeking a talented individual for an Outpatient Coding Auditor, Senior Associate who is responsible for performing coding reviews of medical records and/or other documentation to determine correct coding as defined by review methodologies specific to the contract for which review services are being provided. This involves accessing proprietary systems to audit medical records, accurately documenting findings and providing policy/regulatory support for determination. The candidate must have an extensive background in outpatient coding edits and a high level of understanding in reimbursement guidelines specifically an understanding of the EAPG, ASC and APC payment systems. What you will do Perform audits of medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCC & CC) and procedure codes. Adhere to official coding guidelines, coding clinics...

A healthcare solutions provider is seeking an Outpatient Coding Auditor, Senior Associate to perform coding reviews of medical records. This remote role requires strong understanding of outpatient coding and auditing. Candidates must have active professional credentials and at least 2 years of experience in outpatient medical record coding. The position offers comprehensive benefits from the first day of employment. Join a company where innovation and collaboration drive growth. #J-18808-Ljbffr

This position is full-time and will work 40-hours per week. It is full-time benefit eligible. Remote and/or hybrid can be an option after 6-months of on-site training. Coder Certified Come work where we specialize in you! We have nearly 2,000 reasons for you to consider a career with Prevea Health-they're our employees. We're an organization that values kindness, responsibility, inclusivity, wellness and inspiration. At Prevea, we provide continuous education, training and support so every member of the team contributes to our success. Together we are the best place to get care and the best place to give care. Job Summary The Certified Coder is responsible for accurately translating medical records and patient services into standardized numerical codes for billing and reimbursement purposes. This role ensures compliance with federal, state, and organizational regulations, while maintaining the highest standards of patient confidentiality. The Certified Coder works...

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....

A healthcare organization is seeking a Coder Inpatient III to manage coding for complex inpatient cases in a remote setting. The ideal candidate will have at least 3 years of coding experience, exceptional skills in anatomy and physiology, and be familiar with various software tools. Responsibilities include accurate coding assignments and performing audits. This position offers a competitive pay range and various employment benefits. #J-18808-Ljbffr

Location: Remote (WI/IL preferred). Candidates must reside in the U.S.; not eligible from CA, CO, CT, IL, ME, MN, NJ, NY, OR, or WA. Schedule: Full-time, remote | Flexible hours after training Work Setup: Private, dedicated workspace with a door required About the Role We're seeking a detail-oriented and experienced Inpatient Coder (Coder Inpatient II) to join our Health Information Management team. In this remote role, you will accurately assign ICD diagnosis/procedure codes and MS-DRGs for inpatient hospital services at an academic, Level I Trauma environment. You'll code across complex specialties (e.g., Neurology, Oncology, Urology, Transplant, OB/Newborn, Orthopedics, Cardiology, Critical Care), collaborate with providers via compliant queries, and partner closely with CDI to ensure documentation supports the most appropriate DRG assignment. This is an advanced, independent role where accuracy, communication, and sound judgment are essential. What You'll Do...

A healthcare solutions company seeks an experienced CPC certified medical coder to conduct medical coding audits and utilization reviews. The ideal candidate must reside in Texas and have at least 5 years of coding experience, with strong knowledge of Texas Medicaid policies. Responsibilities include performing audits, preparing reports, and providing litigation support. The position may be part-time, offering comprehensive benefits such as medical coverage, paid time off, and a 401k plan with a company match. #J-18808-Ljbffr

*Location:* *Remote (WI/IL preferred).* Candidates must reside in the U.S.; *not eligible* from CA, CO, CT, IL, ME, MN, NJ, NY, OR, or WA. *Schedule:* Full-time, remote | Flexible hours after training *Work Setup:* Private, dedicated workspace with a door required *About the Role* We're seeking a detail-oriented and experienced *Inpatient Coder (Coder Inpatient II)* to join our Health Information Management team. In this remote role, you will accurately assign *ICD diagnosis/procedure codes* and *MS-DRGs* for inpatient hospital services at an academic, Level I Trauma environment. You'll code across complex specialties (e.g., Neurology, Oncology, Urology, Transplant, OB/Newborn, Orthopedics, Cardiology, Critical Care), collaborate with providers via compliant queries, and partner closely with CDI to ensure documentation supports the most appropriate DRG assignment. This is an advanced, independent role where accuracy, communication, and sound judgment are essential. *What...

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. 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 terminology. This role is fully remote with a flexible schedule, allowing...

POSITION PURPOSE Areas of emphasis will include inpatient and outpatient coding of provider charges as well as documentation reviews and audits. Secondary responsibilities will include assisting Physicians Billing staff and clinic staff with coding questions. SITE(S) Kenosha Campus Urgent Care Physicians Billing Service MINIMUM EDUCATION REQUIRED High School or Equivalent (GED) MINIMUM EXPERIENCE REQUIRED 1-3 years Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician (CCS-P) MINIMUM EXPERIENCE PREFERRED LICENSES / CERTIFICATIONS REQUIRED Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician (CCS-P). SUPERVISES N/A KNOWLEDGE, SKILLS & ABILITIES REQUIRED Knowledge of CPT and ICD-10 codes Ability to accurately audit provider documentation to ensure all CPT codes and ICD-10 codes are accurately assigned...

MUST RESIDE IN TEXAS AND HAVE CODING AND AUDITING EXPERIENCE. Counter Affidavit as well as Testimony experience is preferred. We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong Texas based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. Counter Affidavit experience is preferred. Responsibilities Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS) Conduct utilization reviews to determine medical necessity and documentation compliance Review and prepare demand packages and audit response materials Analyze records for payer disputes and recoupments Prepare written audit findings and defensible reports Provide expert support for depositions and testimony as needed Review...

A leading medical coding firm is seeking an experienced CPC certified medical coder in Texas to conduct coding audits and provide litigation support. Candidates should have a minimum of 5 years of coding experience, with at least 3 years in Texas. The role includes performing audits, conducting reviews for medical necessity, and preparing documentation. The firm offers a comprehensive benefits package, including medical, dental, vision coverage and a 401k plan with company match. #J-18808-Ljbffr

CODER INPATIENT III – Froedtert Health Location: Menomonee Falls, WI – Woodland Prime 400 facility (Remote) Sign-On Bonus: Eligible for a $2,000 sign‑on bonus. Job Summary This is a remote, high‑level coding position functioning under general supervision. The Coder III accurately assigns ICD diagnosis and procedure codes, MS‑DRGs, and APR‑DRGs for inpatient hospital services at Froedtert Health, which includes an academic Level I Trauma Center. The role focuses on highly complex trauma and acutely ill patients, including mortality, extended length of stay, and high‑dollar cases. A key responsibility is performing chart audits for levels I and II coders, applying official and departmental coding rules, regulations, and guidelines, and meeting or exceeding productivity and quality standards. Coding staff communicate directly with care providers to clarify information needed for complete and accurate coding and partner with clinical documentation improvement specialists....

A leading health services provider is seeking an experienced medical coding professional to conduct audits and reviews of medical records. The ideal candidate must have a minimum of 5 years in medical record documentation review and possess relevant certifications such as CPC or CCS-P. This position offers a competitive salary range from $46,988.00 to $112,200.00 and great benefits including medical options and a 401(k) plan. Join a team that prioritizes quality and accountability. #J-18808-Ljbffr

Major Responsibilities This role will have all responsibilities of coder I, II and III in addition to: reviews complex inpatient documentation at a highly skilled and proficient level to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software. Adhere to organizational and internal department policies and procedures to ensure efficient work processes. Responsible for coding high dollar and long length of stay cases for all patient types. Expertise in query guidelines, and coding standards. Follow up and obtain clarification of inaccurate documentation as appropriate. Serves as a subject matter expert to Coding department leaders and peers. Recommends modifications to current policies and procedures as needed to coincide with government regulations. Maintain...

Education/Experience Minimum of five years' of coding experience in an academic medical center or an equivalent combination of coding experience and education with demonstrated competency of knowledge base. Coding QA background or similar experience preferred. Satisfactory completion of college level courses in anatomy, physiology and medical terminology preferred. EPIC health information system experience preferred. Licensure, Certification, and/or Registration Coding certification CCA, CIC, CPC-H, CPC, CCS, RHIT, or RHIA required Essential Functions Ensures the timely and accurate coding and completion of patient accounts within established departmental accuracy and productivity standards. Applies correct ICD CM/PCS (Inpatient) and ICD CM/CPT codes (Outpatient) guidelines meeting departmental policy regarding compliant methods, timeframes, use of applications and productivity. Assists in demonstrating medical necessity for procedures performed by ensuring that all...

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings and...