27 professional coding auditor educator jobs found

POSITION DESCRIPTION :The Compliance Auditor / Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services.Provides professional expertise and education in CPT, ICD and HCC coding.The Compliance Auditor / Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations.This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution.Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance.ESSENTIAL JOB FUNCTIONS :Develops and leads audit projects for medical record integrity, service line or issues-related audits, identifies...

Back-End Medical Biller Full-Time, Temp to Hire Opportunity - Onsite Hours: 8 am to 4:30 pm M-F (30-minute lunch) $19-$20 per hour DOE Professional Summary This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities General Responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days Accurately post all insurance payments by line item Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely* Collects outstanding...

Job Opportunity Positions Location: Lansing, MI Job Description Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine Sparrow policies and procedures and maintains required quality and productivity standards. Essential Duties :...

Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry‑standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana’s internal standards. WORK STYLE Remote / Work at home WORK HOURS Associates will work on EST, regardless of where the associate resides. All associates must start between 6 AM‑9 AM EST, Monday‑Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Responsibilities Conduct comprehensive...

Company Description More Than Just Care, It’s Community Imagine doing meaningful work in a place where people vacation. That’s life at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties. If you want a career in healthcare and a lifestyle most people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be Munson Material. To us, that means teammates who live by our values of excellence, teamness, positivity, creativity, and a commitment to creating exceptional experiences for our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country. Invested in You Grow: Tuition reimbursement, in-person and online development, and access to our career hub to help you advance. Thrive: Full benefits, paid holidays,...

Employment Type: Full time Shift: Day Shift Description: Highlights: Full-time role in a fast-paced professional central billing environment. Remote position The Professional Office coder will review all assigned charge review errors and claim edits, ensuring correct charge capture and coding with proper ICD-10 , CPT, HCPCS codes, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. May require analyzing medical documentation to verify principle and secondary diagnoses and procedures; assigning diagnostic codes, procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS); performing data entry to capture charges not submitted by provider . and performing discrepancy resolution. Serves as a liaison between Centralized Coding/Revenue Site Operations and clinical sites/departments. Assists in orienting and training new employees in the coding...

Job Description Job Description Description: A Certified Professional Medical Auditor is responsible for reviewing and auditing medical documentation, including patient records, charts, and clinical notes, to ensure accuracy, compliance with regulations, and adherence to industry standards. This role is crucial in maintaining the integrity of medical records, billing processes, and healthcare facilities' compliance with applicable laws and regulations. Requirements: Key Responsibilities: Medical Documentation Review: Conduct thorough audits of patient medical records, including physician notes, progress notes, discharge summaries, and other relevant documentation. Examine medical records to verify their completeness and conformity with established standards, ensuring they accurately reflect the patient's condition, diagnosis, treatment, and other pertinent information. Verify that documentation adheres to established coding guidelines, such as ICD-10 and CPT, and...

Job Description Job Description Why Professionals Love Theoria Medical At Theoria Medical, accuracy, integrity, and collaboration matter. Our compliance and coding professionals play a critical role in supporting quality patient care while ensuring our clinical and billing practices remain aligned with evolving industry standards and regulations. We believe meaningful work should come with flexibility, support, and opportunities for growth. Our teams are empowered with advanced technology, collaborative leadership, and a mission-driven culture that values expertise and innovation. Build a career where your knowledge drives impact across a growing national healthcare organization. About Theoria Theoria Medical is leading the charge in healthcare innovation and quality of care — offering a unique blend of medical excellence and technological advancement, serving the post-acute sector. Our network includes multispecialty physician services covering skilled nursing...

Medical Billing Specialist Administration - Flint, MI 48502 Overview Position Type Full Time Education Level High School Category Health Care Description This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third-party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities. General responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks. Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days. Accurately post all insurance payments by line item. Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely* Collects...

Location: Thrive2Liv Headquarters, Ann Arbor, MI | Remote Eligible Reports To: Revenue Cycle Manager or Director of Finance Employment Type: Full-Time About Thrive2Liv Powered by Philips Thrive2Liv, powered by Philips, is a people-centered healthcare platform that delivers mobile, virtual, and community-based care to underserved and dual-eligible populations. Our integrated model addresses barriers to care by combining technology, clinical excellence, and personalized service to improve access, outcomes, and equity. Position Summary The Medical Biller is responsible for accurately preparing, submitting, and following up on healthcare claims to ensure timely reimbursement from payers. This role plays a vital part in the revenue cycle process by ensuring all billing activities are compliant, efficient, and accurate. The ideal candidate has a strong knowledge of medical billing procedures, attention to detail, and a commitment to supporting access to quality care. Key Responsibilities...

Are you an experienced inpatient coder who thrives in fast‑paced, academic environments and wants to make a lasting impact beyond the chart? This Senior Medical Records Coder role sits at the heart of two dynamic Family Medicine Residency programs—Corewell Health Troy Beaumont and CHMG East–Grosse Pointe—supporting highly productive faculty physicians, community preceptors, and more than 24 residents and medical students. In this highly visible and influential position, you’ll serve as both coding expert and educator, guiding providers through complex documentation, billing, and compliance requirements while helping shape the next generation of primary care physicians through audits, one‑on‑one education, resident orientation, and ongoing regulatory review. Job Description Under general supervision and according to established procedures, provides technical support to the Inpatient Coding Staff and coordinates daily workflow based on the needs of the department. On a daily...

Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry-standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana's internal standards. The Medical Coding Auditor Evaluation & Management will report to the Manager, Medical Coding. WORK STYLE: Remote/Work at home WORK HOURS: Associates will work on EST, regardless of where the associate resides. All associates must start between 6AM-9AM EST, Monday - Friday as a dedicated schedule. Work...

Back-End Medical Biller Full-Time, Temp to Hire Opportunity - Onsite Hours: 8 am to 4:30 pm M-F (30-minute lunch) $19-$20 per hour DOE Professional Summary This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities General Responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days Accurately post all insurance payments by line item Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and...

Job Opportunity Job ID:51909 Positions Location: Lansing, MI Job Description General Purpose of Job: Advanced Description: Positions Location: Lansing, MI Job Description General Purpose of Job : Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows...

Health Information Management Coder Inpatient Level 2 The Health Information Management Coder Inpatient Level 2 provides timely and accurate clinical and administration data to ensure optimal reimbursement for inpatient, rehab and/or skilled nursing coding to support the facility needs. Primary patient contact is only social. Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation. Responsibilities Contributes to organization success targets for patient satisfaction. Formulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients, and other department staff members. Adheres to current coding rules, regulations and requirements for inpatient coding, DRG/APR-DRG assignment, rehab coding,...

Health Information Management Coding Specialist Outpatient The Health Information Management Coding Specialist Outpatient provides timely and accurate clinical and administration data to ensure optimal reimbursement for facility outpatient, ambulatory surgery, observation, recurring accounts to support the facility coding needs. This may include coverage on some Rehab or Skilled Care accounts. Primary patient contact is only social. Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation. Responsibilities Contributes to organization success targets for patient satisfaction. Formulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients, and other department staff members. Adhere to...

Yeo & Yeo Medical Billing & Consulting Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future – we...

Health Information Management Professional Contributes to organizational success targets for patient satisfaction. Formulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients and other staff members of departments encountered. Adhere to coding rules for coding professional services for multiple specialties (such; neurosurgery, pediatric surgery, rehab, orthopedic, cardiology, etc.), urgent care, occupational health, family practice and other to ensure quality coding based upon documentation within the patient record. Follows policies, procedures and guidelines to assure consistent coding quality. At the same time utilizes analytical skills when reviewing charts, interpreting documentation and applying codes, sufficing edits, etc. Assures coding is completed timely and all work queues are maintained at a reasonable completion rate/turnaround timeframe. This includes the willingness to help others,...

Back-End Medical Biller Full-Time, Temp to Hire Opportunity - Onsite Hours: 8 am to 4:30 pm M-F (30-minute lunch) $19-$20 per hour DOE Professional Summary This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities General Responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days Accurately post all insurance payments by line item Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely*...

Job Opportunity Positions Location: Lansing, MI Job Description Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine – Sparrow policies and procedures and maintains required quality and productivity standards. Essential Duties:...

MetroEHS Pediatric Therapy is expanding our exceptional team of professionals! We are looking for a passionate and dedicated Billing Specialist to join our growing team and help us Reveal the Super in Every Child! Billing specialists maintain accurate financial records and payment procedures. They create claims billings and work closely with payor providers to resolve discrepancies for successful reprocessing. This role is a good fit for those with a high school diploma or higher education, at least 2+ years direct healthcare revenue cycle experience, as well as a high knowledge of CPT/ICD-10 medical coding. Prior experience with Raintree Systems EMR software is also highly preferred but not required. Prior experience with Community Mental Health (CMH) billing is highly preferred. About MetroEHS Pediatric Therapy For over 20 years, MetroEHS Pediatric Therapy has been a leader in providing integrated pediatric therapy services throughout Southeast Michigan. Our mission is...

Certified Coder Huron Gastro, P.C. is an adult medical gastroenterology practice specializing in the diagnosis, treatment, and management of disorders that affect the esophagus, stomach, small intestine, large intestine (colon), rectum, liver, gallbladder, bile ducts, and pancreas. Our practice includes 25 physicians who are board-certified in gastroenterology by the American Board of Internal Medicine, 9 Advances Practice Providers, and an outstanding staff of clinical and administrative personnel. Huron Gastro has been a leader in the field for over 5 decades, with expertise in every leading-edge technology that is currently available for the practice of gastrointestinal medicine. Huron Gastro is committed to high quality, efficient, compassionate, cost-conscious care. We value our culture which holds high the values of dignity and respect, and we focus much time and effort on continuing education for our health care professionals. We currently have an opportunity for a...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and or level. Job...

Data Quality Senior Medical Coder - Remote Full-time Shift: Day Shift Status: Full Time More Than Just Care,It’sCommunity Imagine doing meaningful work in a place where peoplevacation. That’slife at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties. If you want a career in healthcare and alifestylemost people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just beMunson Material. To us, that means teammates who live by our values of excellence,teamness, positivity, creativity,and a commitment to creating exceptional experiences for our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country. Invested in You Grow: Tuition reimbursement, in-person and onlinedevelopment,and access to ourcareer hubto help...