15 professional coding auditor educator jobs found

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Job Description Interpret clinical documentation/records from patient records to ensure all diagnoses and procedures are documented and coded accurately. Ensure highest level of reimbursement practice efficiencies and compliance related to coding procedures. Provide feedback and support to physicians. Responsibilities Responsible for translating healthcare providers' diagnostic and procedural documentation into coded form, applying regulatory and organizational guidelines. Review patient reports and extract data necessary to apply appropriate ICD and CPT codes for billing, internal and external reporting, research and regulatory compliance. Utilize technical coding principals and reimbursement rule expertise to assign appropriate ICD diagnosis and CPT procedures as appropriate, with understanding of E/M coding elements. Collaborates with direct supervisor and or team lead prior to communication with assigned healthcare providers to ensure documentation and coding...

SummaCare - 1200 E Market St, Akron, OH Full-Time / 40 hours / Days Hybrid or Remote Join a mission‑driven health plan where precision and expertise protect both members and resources—we’re seeking a certified coder who can identify discrepancies others miss, analyze coding patterns with accuracy, and turn complex clinical data into clear, actionable insights; if you bring deep knowledge of coding standards, a sharp analytical mindset, and a passion for ensuring integrity in healthcare claims, this is your opportunity to make a meaningful impact and strengthen the quality of care delivery. Summary Performs review of medical claims to ensure compliance with industry standard coding practices and plan payment policies through a comprehensive medical record evaluation for all provider types. Determines correct coding and appropriate documentation required while ensuring state, federal and company policies are met. Makes recommendations to Medical Directors, Compliance, Internal...

Job Description Using established policies and procedures; the Certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing. The Certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and may be called upon to code highly complex inpatient records (to include trauma, burns, open heart and transplant cases) based on experience and skill set. Responsibilities Coding quality: Reviews inpatients, ambulatory, observation, emergency and outpatient accounts to assign accurate ICD-10 and/or CPT codes and DRG's. Interprets health record content to ensure that all diagnoses and procedures coded are supported by physician documentation. Maintains a coding accuracy rating of at least 95% on records assigned. Queries physicians when necessary to ensure documentation...

Overview Looking to join our dynamic team at Ohio State University Physicians where excellence meets compassion? Who We Are With over 100 cutting‑edge outpatient center locations, dedicated to providing exceptional patient care while fostering a collaborative work environment, our buckeye team includes more than 1,800 nurses, medical assistants, physicians, advanced practice providers, administrative support staff, IT specialists, financial specialists and leaders that all play an important part. As an employee of Ohio State University Physicians (OSUP), you'll be an integral part of a team committed to advancing healthcare, education, and professional growth. Our culture At OSUP, we foster a culture grounded in the values of inclusion, empathy, sincerity, and determination. We meet our teams where they are, coming together to serve each other and our community. Our Benefits We know that having options and robust benefit plans are important to you. OSUP prioritizes the wellbeing...

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...

# Hospice Medical CoderOffice: Marysville, OH Work: Marysville, OhioHospice Medical CoderA Great Opportunity/ PRNAt ViaQuest Hospice we take a holistic approach, offering services to treat the physical, emotional and mental needs of our patients and their loved ones. Apply today and make a difference in the lives of the patients we serve!Responsibilities may include:* Review admission, recertification, and discharge documentation for coding accuracy, completeness, and compliance.* Assign ICD-10-CM diagnosis codes in accordance with CMS, LCDs, Conditions of Participation (CoPs), and ACHC standards.* Sequence diagnoses appropriately to support hospice eligibility and coverage determinations.* Collaborate with physicians, clinicians, and interdisciplinary team members to clarify documentation and resolve coding questions.* Ensure coding documentation supports accurate claims submission, Medicare billing requirements, and reimbursement.* Submit coding documentation within established...

Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process. Department: Health Information Management Shift/schedule: Full Time (40 hrs/wk), Remote GENERAL SUMMARY Works under the supervision of the Health Information Reimbursement Manager. The primary job function of the HIM Coder Level I is to assign correct ICD-10 and CPT codes to established diagnoses and procedures for outpatient (emergency room, same-day surgery, interventional radiology, observation and/or Urgent Care Center) and/or limited inpatient records. In some instances, may audit OP and/or IP records for charging accuracy. May be asked to add or delete charges for optimal reimbursement as well as compliance following coding and governmental guidelines. The level one coder has mastered a maximum of 2 work types. Performs other duties as assigned. QUALIFICATIONS Education: High School Diploma or successful completion of an equivalent High School Exam...

Certified Coder, Special Investigations Unit (SIU) (Job ID: 59225) SummaCare - 1200 E Market St, Akron, OH Full‑Time / 40 Hours / Days Hybrid or Remote Join a mission‑driven health plan where precision and expertise protect both members and resources—we’re seeking a certified coder who can identify discrepancies others miss, analyze coding patterns with accuracy, and turn complex clinical data into clear, actionable insights; if you bring deep knowledge of coding standards, a sharp analytical mindset, and a passion for ensuring integrity in healthcare claims, this is your opportunity to make a meaningful impact and strengthen the quality of care delivery. Summary Performs review of medical claims to ensure compliance with industry standard coding practices and plan payment policies through a comprehensive medical record evaluation for all provider types. Determines correct coding and appropriate documentation required while ensuring state, federal and company policies are met....

The Ohio State University Physicians, Inc. is seeking a coding/billing professional in Columbus, OH to ensure accurate CPT, HCPCS, and ICD-10-CM coding for physician services. The role supports billing processes, payer compliance, and ongoing staff education. Responsibilities include audits of denials, documentation improvement, and interactions with providers to resolve coding questions, ensuring regulatory adherence and efficient reimbursement. #J-18808-Ljbffr

LMHS Compliance Auditor Licking Memorial Health Systems (LMHS) is a leading, non‑profit healthcare organization, passionately dedicated to improving the health and well‑being of our community. With a history dating back to 1898, LMHS remains a cornerstone of healthcare excellence, catering to the evolving needs of Licking County. Our cutting‑edge facility provides a comprehensive spectrum of patient care services, from life‑saving emergency medicine to the comforting embrace of home healthcare, with a unique range of specialized medical services, including cancer, heart health, maternity, and mental wellness. When you join the LMHS team, you become a vital part of your local community hospital. Working at LMHS is not just a job, it is a unique opportunity to directly impact the health and well‑being of your friends, family, and neighbors, and the impact of your work extends beyond the hospital doors into the heart of our community. Position Description Under the general direction...

Anderson Hills Pediatrics' Expectations of all Employees Adhere to all Anderson Hills Pediatrics' Policies and Procedures Conduct self in a manner that represents Anderson Hills Pediatrics' core values at all times Maintain a positive and respectful attitude with all work-related contacts Consistently reports to work prepared to perform the duties of the position Meets productivity standards and performs duties as workload necessitates Primary Function Assists the Billing Manager with the claims submission and revenue cycle of the practice. Major Duties and Responsibilities Adherence to current HIPAA regulations and federal/state laws for patient protected health information (PHI) and/or medical records; adherence to all AHP policies/procedures as they pertain to patient PHI and the medical record; maintain strict confidentiality of all patient information Update patient demographic information including insurance coverage; make changes/corrections as needed;...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2814 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced...

Job Description Job Description Corporate Compliance LMHS Compliance Auditor Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare organization, passionately dedicated to improving the health and well-being of our community. With a history dating back to 1898, LMHS remains a cornerstone of healthcare excellence, catering to the evolving needs of Licking County. Our cutting-edge facility provides a comprehensive spectrum of patient care services, from life-saving emergency medicine to the comforting embrace of home healthcare, with a unique range of specialized medical services, including cancer, heart health, maternity, and mental wellness. When you join the LMHS team, you become a vital part of your local community Hospital. Working at LMHS is not just a job, it is a unique opportunity to directly impact the health and well-being of your friends, family, and neighbors. You will be providing care in a place in which you are personally connected, where...