42 professional coding auditor educator jobs found

Senior Compliance Auditor The Senior Compliance Auditor reviews complex audits, performs quality assurance reviews, acts as a peer mentor, and assists management with onboarding process of new auditors. The Senior Compliance Auditor supports the audit supervisor with the development and maintenance of the quarterly audit work plan and audit workflow processes. The Senior Compliance Auditor recommends changes to improve business operations by using professional judgement and knowledge of best practices. This position contributes to special projects, as applicable. The Senior Compliance Auditor performs documentation/chart audits on inpatient and outpatient records, and to provide analysis of the records (provider and facility) reviewed, education and other assistance, as needed. The Senior Compliance Auditor audits VCUHS coding and billing (DRG, CPT, HCPCS, ICD-10) based on a review of medical record documentation and/or billing claim data. Essential Job Statements Audit...

\*\*\*To be considered for the role, you must permanently reside in one of the following states: Alabama, Arkansas, Florida, Georgia, Kentucky, Kansas, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, South Carolina, Tennessee, Texas, Virginia, or West Virginia\*\*\* The Senior Compliance Auditor reviews complex audits, performs quality assurance reviews, acts as a peer mentor, and assists management with onboarding process of new auditors. The Senior Compliance Auditor supports the audit supervisor with the development and maintenance of the quarterly audit work plan and audit workflow processes. The Senior Compliance Auditor recommends changes to improve business operations by using professional judgement and knowledge of best practices. This position contributes to special projects, as applicable. The Senior Compliance Auditor performs documentation/chart audits on inpatient and outpatient records, and to provide analysis of the records (provider and facility)...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Become a part of our caring community Become a part of our caring community and help us put health first The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while...

Accountant 1 – Medical Billing Specialist Salem, OR – Equitable Center. Salary: $4,519.00 – $6,904.00. Put your medical billing expertise to work for Oregon’s youth. The Oregon Youth Authority (OYA) is hiring an Accountant 1 – Medical Billing Specialist to manage Medicaid billing and reimbursement that directly funds treatment and services for youth in our care. The hybrid role handles Medicaid Management Information System billing, Title XIX eligibility reviews, and remittance reconciliations, ensuring accurate, compliant, timely claims. Responsibilities Review and verify medical billing codes and reimbursement rates for payments to providers. Track and maintain records supporting reimbursement claims, ensuring accuracy, completeness, and compliance with audit requirements. Analyze remittance advice from the Oregon Health Authority to verify accuracy, identify discrepancies, and ensure compliance with Medicaid billing and reimbursement requirements. Minimum Qualifications...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

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:...

Base Pay $20.00 / Hour Job Category Accounting, Finance Industry Continuing Care Retirement Communities, Senior Health Care, Medical Billing Employee Type Full Time Required Degree 2 Year Degree Manage Others No Contact information Phone 804-264-6583 At Westminster Canterbury of Richmond, you can learn, grow and make a lasting impact on residents and families. You'll experience the support of a collaborative work environment and a sense of collegiality unlike any other! We offer: A comprehensive benefits package including health, vision, dental life insurance, disability insurance and 403B retirement savings with company match. On Site Amenities ! Including a gym, fitness classes, Chesapeake Bank Branch, Employee Dining Room with discounted meals and an award-winning Child Development Center with a generous employee discount for both full and part-time employees ! Educational Assistance : We support your continuing education and career advancement by offering tuition...

Brief Description At Westminster Canterbury of Richmond, you can learn, grow and make a lasting impact on residents and families. You'll experience the support of a collaborative work environment and a sense of collegiality unlike any other! Benefits A comprehensive benefits package including health, vision, dental, life insurance, disability insurance and a 403(b) retirement savings plan with company match. On‑site amenities include a gym, fitness classes, a bank branch, an employee dining room with discounted meals, and an award‑winning Child Development Center with generous employee discounts. We also provide educational assistance through tuition reimbursement and paid time off. Salary Range $20 to $26.19 per hour. Actual compensation depends on experience, skills and internal equity. Job Overview The Medical Billing Specialist ensures the accuracy of accounts receivable functions for residents' billings, Medicare, Medicaid and third‑party claims. Responsibilities include...

Ensure SEARHC meets federal and state regulations and internal policies in regard to healthcare coding, documentation, and billing practices. Review health records to verify coding and clinical docu… Full-time Farmington Hills, Michigan, United States. Under the direction of the Director of Compliance Audit, the Compliance Auditor is responsible for designing, planning, and executing internal compliance a… Full-time Join Endeavor as a detail-driven Compliance Auditor! The Compliance Auditor functions as staff to the Corporate Compliance Officer (CO) and serves as an in-house subject matter expert with respect … Full-time We are searching for a Medical Compliance Auditor – someone who works well in a fast-paced setting. In this position, you will review and approve or deny medical claim appeals and perform clinical a… Full-time When you're the best, we're the best. We instill an environment where employees feel engaged, satisfied and able to contribute their unique skills and...

Become a part of our caring community Become a part of our caring community and help us put health first The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while...

Become a part of our caring community We are looking for a consultative coding professional to provide medical coding expertise and support to IPA affiliates nationwide. The IPA Consultative Coding Professional will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value‑based care initiatives. They will analyze trends, triage, answer questions in real‑time, research and interpret coding guidelines, and respond to inquiries and issues. Assignment will include a panel of up to 30 providers within a defined market or region. The professional will deliver ongoing education, support coding workflows, and ensure agreement on documentation and coding standards, while collaborating with STARS leaders and champions to identify gaps and deficiencies. They will support IPA‑affiliated clinicians—physicians and advanced practice providers—to ensure documentation supports accurate diagnostic coding...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder is responsible for reviewing inpatient medical record documentation to ensure the accuracy, completeness, and clinical validity of reported diagnoses and procedures. This role evaluates coding accuracy, DRG assignment, reimbursement impact, and regulatory compliance in accordance with official coding guidelines, CMS regulations, payer policies, and organizational standards. The reviewer retrieves, analyzes, and documents medical record information to support appropriate reimbursement, documentation integrity, and audit outcomes for hospital inpatient services. Responsibilities Review medical record documentation and accurately code the primary/secondary diagnoses and procedures using ICD-10-CM and CPT-4 coding conventions. Review inpatient medical records to validate the accuracy and appropriateness of reported primary and secondary diagnoses and procedures using ICD-10-CM/PCS guidelines. Evaluate diagnosis and procedure sequencing to ensure...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Tidewater Community College has served South Hampton Roads – both students and employers – for 50 years. It has grown from 1 campus into a regional educational and economic force. TCC is the largest provider of higher education and workforce services in Hampton Roads, enrolling nearly 25,000 students in 2024-25. Founded in 1968 as a part of the Virginia Community College System, Tidewater Community College (TCC) services South Hampton Roads with 4 campuses in Chesapeake, Norfolk, Portsmouth, and Virginia Beach, 7 regional centers and 2 important cultural institutions. The college had 3,399 graduates in 2024-2025, 40 percent of whom pursued degrees that would let them transfer to 4-year institutions. Of South Hampton Roads residents enrolled in higher education 33% enrolled at TCC. TCC's institutional accreditation is affirmed through 2027 by the Southern Association of Colleges and...

## Risk Adjustment CoderApplyremote type: Hybridlocations: SMG Administrationtime type: Full timeposted on: Posted Todayjob requisition id: JR-103351**City/State**Virginia Beach, VA**Work Shift**First (Days)**Overview:**# **Overview**Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual risk assessments, training,...

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:...

Position Summary The Compliance Auditor plans, schedules, and performs comprehensive internal professional fee audits to include routine audits, focused audits, for cause audits and, not for cause audits for Chesapeake Regional Healthcare (CRH) and all of its affiliated entities. Performs detection of documentation, coding, and billing errors as well as collaboration with appropriate stakeholders to ensure corrective action and/or appropriate response to identified issues. Communicates audit results to providers, coders, management, and other appropriate staff. Develops and delivers provider and coder education. Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to regulatory compliance with guidelines related to professional fee documentation, coding, and billing. Stays abreast of documentation, coding, and billing regulations and standards and serves as a subject matter expert on the interpretation and application of...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...