15 professional coding auditor and educator jobs found

Medical Coding Specialist 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...

Join Datavant, a leader in health data exchange, as we revolutionize the way healthcare decisions are made. Our platform is committed to delivering the right data securely and efficiently, enhancing decisions in healthcare. At Datavant, you will be part of a dynamic and values-oriented team tackling challenging issues in healthcare with cutting-edge technology. We value diverse experiences and believe in collective ambition to drive our goals forward. What We're Looking For: We seek certified and experienced inpatient coders with a keen attention to detail and a solid grasp of medical terminology. This is a fully remote position with flexible hours, allowing you to work at your convenience while making an impact in the healthcare sector! Your Key Responsibilities: Accurately assign diagnostic and procedural codes using ICD-10-CM and ICD-10-PCS codes. Abstract and sequence medical codes from patient records, ensuring strict compliance with documentation...

Job Description: The HIM Hospital Inpatient & Same Day Surgery Coding Analyst deciphers and interprets provider documentation in the health record and assigns diagnostic information using ICD-10-CM/PCS and CPT codes for a complex range of acute care services for Intermountain Health. The caregiver provides specific coding expertise in the various fields of NCCI edits, Drugs and Biologicals, Revenue Codes, Current Procedural Terminology (CPT) codes, ICD-10 & CPT codes, DRGs, anatomy and physiology, pharmacology. The analyst also performs audits, provides feedback, and advanced training to clinical teams and physicians on ICD-10 and CPT coding best practices. Essential Functions Reviews and analyzes inpatient medical records for completeness, accuracy, and compliance for Same Day Surgery, Observation and Inpatient acute services at Intermountain Health. Performs coding at an advanced level of complexity for inpatient hospitals including governmental and/or...

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 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 telecommute* 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...

divh2Coder Quality Auditor/h2pThe Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties./ppJob Responsibilities:/pulliQuality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess...

Overview We are seeking a detail-driven and collaborative Risk Adjustment & Coding Manager to support our Senior CommUnity Care (PACE) programs. This role works closely with SCC Medical Directors and providers to ensure accurate capture and reporting of participant acuity through compliant diagnostic coding. The position plays a critical role in maintaining CMS compliance while directly supporting the financial integrity and performance of our PACE programs. About the Job: Works in concert with Senior CommUnity Care (SCC) Medical Directors and providers to ensure an accurate representation of participant acuity is captured through diagnostic coding and reported to CMS. Assists in the development and implementation of systems and processes to ensure the integrity of diagnostic coding and reporting, directly impacting the financial performance and compliance of the PACE programs. Acts as a liaison between PACE providers and contracted providers to ensure timely response to...

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. Compliance Auditor (Non-Clinical) 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...

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. Compliance Auditor (Clinical) 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...

Salary: $56,134.69 - $84,202.03 Annually Location : Downtown Minneapolis Job Type: Full-time Job Number: 26ACI078TV354 Department: Audit, Compliance, and Investigation Services Division: Internal Audit Opening Date: 02/02/2026 Closing Date: 2/17/2026 11:59 PM Central Description Hennepin County's Internal Audit division is seeking a Vendor Compliance Auditor to join their team. The position will conduct audits using the Institute of Internal Auditors (IIA) professional standards, including establishing criteria, performing testing and data analysis, preparing and organizing audit work papers, drafting written reports, and communicating results to county management and vendors. The position will also operate under the general supervision of the Vendor Compliance Manager and is expected to demonstrate effective technical and interpersonal skills to deliver high-quality audit work. Current Hennepin County employees who refer a candidate hired into an open...

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. Compliance Auditor (Non-Clinical) 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...

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. Schedule: Monday to...

We are seeking a detail-driven and collaborative Risk Adjustment & Coding Manager to support our Senior CommUnity Care (PACE) programs. This role works closely with SCC Medical Directors and providers to ensure accurate capture and reporting of participant acuity through compliant diagnostic coding. The position plays a critical role in maintaining CMS compliance while directly supporting the financial integrity and performance of our PACE programs. About the Job: Works in concert with Senior CommUnity Care (SCC) Medical Directors and providers to ensure an accurate representation of participant acuity is captured through diagnostic coding and reported to CMS. Assists in the development and implementation of systems and processes to ensure the integrity of diagnostic coding and reporting, directly impacting the financial performance and compliance of the PACE programs. Acts as a liaison between PACE providers and contracted providers to ensure timely response to inquiries...

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. Compliance Auditor (Clinical) 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...

Datavant is a leading data platform company revolutionizing health data exchange. Our mission is to ensure that every healthcare decision is made with the right data, delivered timely and in the appropriate format. Powered by the most extensive health data network in the U.S., our platform guarantees secure, accessible, and usable data to enhance health decisions. We are proud to be trusted by the foremost life sciences organizations, government bodies, and healthcare providers. By joining our team, you will be part of a high-performing and values-driven culture. Together, we are addressing some of healthcare's most challenging issues with innovative technology solutions. We embrace a diverse array of professional and personal experiences among our team members as we pursue our ambitious goals for healthcare. What We're Seeking We are on the lookout for seasoned and certified inpatient coders to join our team. The perfect candidate will have exceptional attention to...