41 professional fee coding auditor jobs found

Job Description Job Description     PYA is seeking an Inpatient/Outpatient Facility Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will  support PYA’s Revenue and Compliance Advisory Program . RESPONSIBILITIES : Apply inpatient and outpatient facility/hospital coding and reimbursement methodologies to provide advisory services to PYA clients with a focus on the following: ICD-10-CM and PCS/CPT/HCPCS code assignment MS-DRG and other DRG validation APC validation and charge capture Clinical documentation improvement Regulatory compliance for third party payors Work in collaboration with the PYA executive team and other service lines to offer complete business solutions to clients Manage the preparation of excellent client deliverables and exhibit exceptional project management skills while balancing firm risk and compliance with appropriate professional...

Job Description Job Description Job Title: Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Auditors to contribute their specialized expertise to an innovative healthcare AI project. In this role, you will help improve next-generation AI systems by reviewing, evaluating, and refining medical coding and audit-related content. This opportunity is ideal for professionals with strong experience in outpatient professional fee coding, auditing, and academic medical center environments. No prior AI experience is required—your healthcare expertise is what matters most. Key Responsibilities Conduct detailed reviews and audits of outpatient professional fee coding records for accuracy, compliance, and quality. Identify coding trends, gaps, risks, and opportunities for improvement. Evaluate audit findings using knowledge of academic medical center protocols and industry best practices. Document audit results and...

Job Description Job Description Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Auditors with strong expertise in outpatient professional fee coding and coding audits , preferably within academic medical centers. You will review coding records, identify compliance risks, and provide expert feedback to support AI-focused projects. No prior AI experience is required. Key Responsibilities Conduct detailed audits of outpatient professional fee coding records. Review coding accuracy, documentation, and compliance. Identify coding trends, gaps, risks, and improvement opportunities. Apply academic medical center standards and coding guidelines. Document audit findings and provide clear recommendations. Evaluate complex coding and documentation scenarios. Contribute to AI training through expert coding and audit feedback. Support audit program management and quality improvement initiatives. Required Qualifications...

Job Description The Coder III reviews inpatient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines with a 97% accuracy rate, while maintaining coding standards for productivity. This position must preserve confidentiality of health information. This position must be able to use tact and diplomacy when communicating with employees, physicians, administration, and public, under complex or emotional situations. Responsibilities Responsibilities include: Reviews patient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines. Meets Productivity Standard for Inpatient Coding: 17 charts/day. Understands appropriate assignment of MS-DRG, POA, and discharge disposition. Assists with all levels of coding including inpatient, outpatient, and psych. Works as a team member to achieve goals for the department. Assists with data integrity audits, and corrects errors as needed (invalid codes,...

Overview Work Style: Remote Location Requirement: Must reside in an authorized state (FL, GA, MO, PA, SC, NC, TN, or TX) FTE: Full-Time (1.0 FTE) Turn accurate coding into cleaner claims, reliable data, and stronger reimbursement. Reviews and analyzes medical records to assign appropriate diagnostic and procedural codes in compliance with established coding guidelines and organizational policies. Collaborates with healthcare providers to clarify documentation and resolves coding discrepancies, ensuring the integrity of coded data for billing and reporting purposes. Maintains current knowledge of coding standards such as ICD, CPT, and HCPCS, and supports the billing department by providing precise coded information for claims submission. Includes auditing coded data, training staff on coding procedures, and monitoring coding productivity and quality metrics to enhance departmental performance. Responsibilities Key Responsibilities Reviews and analyzes medical records to assign...

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...

Medical Coding Specialist Turn accurate coding into cleaner claims, reliable data, and stronger reimbursement. Work Style: Remote Location Requirement: Must reside in an authorized state (FL, GA, MO, PA, SC, NC, TN, or TX) FTE: Full-Time (1.0 FTE) Reviews and analyzes medical records to assign appropriate diagnostic and procedural codes in compliance with established coding guidelines and organizational policies. Collaborates with healthcare providers to clarify documentation and resolves coding discrepancies, ensuring the integrity of coded data for billing and reporting purposes. Maintains current knowledge of coding standards such as ICD, CPT, and HCPCS, and supports the billing department by providing precise coded information for claims submission. Includes auditing coded data, training staff on coding procedures, and monitoring coding productivity and quality metrics to enhance departmental performance. Key Responsibilities Reviews and analyzes medical records to...

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...

Job Description Job Description Description: Role Summary   Responsible for reviewing medical records and assigning accurate CPT, HCPCS, ICD-10-CM, and appropriate modifiers for outpatient services. This role supports compliant coding and consistent performance across a variety of outpatient encounter types.  Core Responsibilities   Review medical records and assign accurate CPT/HCPCS, ICD-10-CM, and modifiers.  Ensure documentation supports coded services and identify/escalate discrepancies or gaps.  Ensure compliance with CMS, payer-specific rules, and official coding guidelines (including NCCI edits).  Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards.  Requirements:   Minimum Qualifications   Credentials: CPC, CCS, RHIA, or RHIT (active).  Experience: Minimum 3+ years outpatient coding experience across multiple outpatient service types.  Skills & Knowledge: Strong knowledge of CPT, HCPCS, ICD-10-CM,...

Job Description Job Description Description: The Professional Fee (ProFee) Coder is responsible for reviewing provider documentation and assigning accurate CPT, HCPCS, and ICD-10-CM codes for physician services. This role supports compliant coding, accurate charge capture, and overall revenue integrity across a variety of specialties and client environments.   Coders may support single-specialty or multi-specialty engagements depending on client needs and experience. Requirements:   Core Responsibilities (Sage Standards)   Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes   Ensure documentation supports coded services and identify discrepancies  Apply appropriate modifiers, NCCI edits, and payer-specific coding rules   Ensure compliance with CMS, AMA, and payer guidelines   Maintain =95% coding accuracy and meet established productivity standards  Identify documentation gaps and escalate for clarification when needed   Participate in...

Job Description Job Description Senior Clinical Coder (Inpatient Facility Coding) – Remote $80,000–$90,000 | Contract-to-Hire | 100% Remote Are you an experienced Inpatient Facility Clinical Coder with strong DRG validation expertise? We're seeking a Senior Clinical Coder to join a collaborative clinical operations team supporting complex medical claims reviews and coding accuracy. This is a fully remote opportunity with long-term potential for permanent employment. Position Details Contract-to-Hire (average conversion: 6–9 months) 100% Remote Salary: $80,000–$90,000 annually (based on approved work state and geographic location) Full-time What You'll Do Perform retrospective reviews of inpatient and outpatient medical claims Validate DRGs and ensure accurate reimbursement Apply ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding guidelines Review claims for coding accuracy, compliance, and payment integrity Prepare coding determinations and...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Certified Coder Full Time Admin - IC Clearwater, FL, US 3 days ago Requisition ID: 3213 Join Evara Health—Driven by Purpose, Powered by People. Evara Health provides essential, high-quality care to the communities who need it most through 17 centers and mobile units offering primary care, dental, behavioral health, pediatrics, and more. Evara Health is recognized for its innovative, team-based approach, commitment to community health, and dedication to making healthcare accessible for all. Our people fuel our impact. Team members come for the purpose and stay for the supportive culture and strong, community-focused teams. Build a career that goes beyond a job—it changes lives. About this Role: Medical Coding & Charge Review Review and validate diagnosis and procedure codes to ensure accuracy, compliance, and...

Overview FTE: 1.0 Hours: Monday - Friday, 8:00 AM - 5:00 PM Location: Remote (eligible only within FL, GA, MO, PA, SC, TN, and TX) Position Summary This role is responsible for reviewing, analyzing, and assigning final diagnoses and procedures as documented by the practicing provider, following all compliance policies and guidelines. The position ensures accurate coding of office and hospital procedures to guarantee proper reimbursement. Key Responsibilities Providing physician education to ensure proper completion of Electronic Health Records (EHR). Ensuring correct assignment of ICD-10-CM, HCPCS, and CPT codes. Delivering education verbally, in writing, and through hands‑on training as needed. Responsibilities Review clinical documentation and code to the highest level of specificity for accurate charge capture. Interact with providers to provide feedback and education using verbal, written, and hands‑on communication methods. Assign and sequence appropriate codes and...

Job Description Job Description Description: Role Summary   Responsible for reviewing provider documentation and assigning accurate CPT, HCPCS, and ICD-10-CM codes for physician services. This role supports compliant coding, accurate charge capture, and overall revenue integrity across a variety of specialties, supporting single-specialty or multi-specialty engagements.  Core Responsibilities   Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes.  Ensure documentation supports coded services and identify/escalate discrepancies or gaps.  Ensure compliance with CMS, payer-specific rules, and official coding guidelines (including AMA and NCCI edits).  Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards.  Requirements: Minimum Qualifications   Credentials: CPC, CCS-P, RHIA, or RHIT (active and in good standing).  Experience: Minimum 2–3+ years professional fee coding experience....

Job Description Job Description oin Evara Health—Driven by Purpose, Powered by People.  At Evara Health, we believe healthcare is about more than treating patients—it’s about transforming lives and strengthening the communities we serve. As a nonprofit community health center with 17 locations and mobile health units across Pinellas County, we provide high-quality, accessible care while creating meaningful opportunities for our employees to make a difference every day. Recognized as a USA TODAY Top Workplace, Evara Health is proud to foster a mission-driven culture where people are valued, collaboration matters, and employees can grow while doing work that has a real impact. If you’re looking for more than just a job—and want to be part of a team committed to improving lives and serving our community—we invite you to explore a career with Evara Health. Build a career that goes beyond a job—it changes lives.    About This Role: The Certified Coder is responsible...

Overview Work Style: Remote Location Requirement: Must reside in an authorized state (FL, GA, MO, PA, SC, NC, TN, or TX) FTE: Full-Time (1.0 FTE) Turn accurate coding into cleaner claims, reliable data, and stronger reimbursement. Reviews and analyzes medical records to assign appropriate diagnostic and procedural codes in compliance with established coding guidelines and organizational policies. Collaborates with healthcare providers to clarify documentation and resolves coding discrepancies, ensuring the integrity of coded data for billing and reporting purposes. Maintains current knowledge of coding standards such as ICD, CPT, and HCPCS, and supports the billing department by providing precise coded information for claims submission. Includes auditing coded data, training staff on coding procedures, and monitoring coding productivity and quality metrics to enhance departmental performance. Responsibilities Key Responsibilities Reviews and analyzes medical records to assign...

The Coder III reviews inpatient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines with a 97% accuracy rate, while maintaining coding standards for productivity. This position must preserve confidentiality of health information. This position must be able to use tact and diplomacy when communicating with employees, physicians, administration, and public, under complex or emotional situations. Responsibilities Reviews patient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines. Meets Productivity Standard for Inpatient Coding: 17 charts/day. Understands appropriate assignment of MS-DRG, POA, and discharge disposition. Assists with all levels of coding including inpatient, outpatient, and psych. Works as a team member to achieve goals for the department. Assists with data integrity audits, and corrects errors as needed (invalid codes, discharge codes, etc.). Monitors backlog of un-coded...

Requisition No: 883023 Agency: Department of Health Working Title: MEDICAL CODER Pay Plan: Career Service Position Number: 64035562 Salary: $36,004.80 - $38,001.60 Posting Closing Date: 09/23/2026 Total Compensation Estimator Tool HEALTH INFORMATION SPECIALIST Open Competitive Your Specific Responsibilities: Are you a whiz with a knack for navigating the intricate world of healthcare? Look no further! We're on the hunt for a dynamic individual to join our squad! As Medical Coding Specialist, you'll be the unsung hero behind the scenes, turning complex medical information into a symphony of perfectly coded data. DOH Sarasota requires a Medical Coder/Referral specialist to ensure accurate, timely coding for clinical services such as family planning, Obstetric care, STI care, and HIV/AIDs and Hepatitis C treatment. The coder will also be responsible for referral tracking. Proper coding is essential for compliant reporting, reimbursement, and data...

Summary/Objective Under limited supervision the Medical Biller reviews and verifies medical bills and invoices with accounts receivable ledger and patients. Ensures record accuracy, follow up, and makes necessary revisions. The Medical Biller processes changes in system to support accurate and efficient billing processes. The Medical Biller will be charged with maintaining the confidentiality of patient records and procedures. Essential Job Functions Analyzes, investigates, and resolves account issues, including resubmitting and updating line and claim document information. Accesses available resources to locate missing or incorrect information. Updates medical claims with corrected billing information and releases claims for transmission to the payer. Investigates and documents actions taken to resolve medical billing discrepancies and unusual charges and credits. Works high priority Third-Party Liability/MVA/WC cases according to department policies and procedures. Conducts...

Florida Doctors Group is seeking an experienced Medical Coding Specialist with a strong background in managed care to join our team. This role requires a detail-oriented professional who understands medical coding guidelines, managed care workflows, and the importance of accuracy in a fast-paced healthcare environment. Benefits: Competitive salary Dental insurance Free uniforms Health insurance Training & development Vision insurance RESPONSIBILITIES Review, assign, and validate ICD-10, CPT, and HCPCS codes in accordance with coding guidelines and managed care requirements Ensure coding accuracy and compliance with payer, CMS, and regulatory standards Support managed care processes, including risk adjustment, quality initiatives, and utilization review Review medical records to ensure complete and accurate documentation for coding purposes Assist with audits, corrections, and coding-related inquiries Work closely with clinical and administrative teams to resolve coding issues...

Medical Billing Supervisor Location: 12490 Ulmerton Rd., Largo, FL Schedule: Monday - Friday 8am to 5pm This position performs complex, technical, analytical, and financial work specializing in supervising a variety of functions associated with the execution of an ambulance billing revenue cycle. Competences and functions include: Execution of the Emergency Medical Services (EMS) medical billing system with emphasis on ensuring funds due to the County are received from public and private insurance companies, including The Center for Medicare and Medicaid Services (CMS); Monitoring the quantity and accuracy of activities performed by subordinate staff; Development of work plans; Developing and maintaining performance standard associated with various functions; Appropriately apply Pinellas County Human Resource Rules and Departmental policies and procedures; Resolving elevated complaints from the public and professional partners; Coordination with the County Attorney’s Office as...

It's rewarding to be on a team of people that truly believe in making an impact!We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.Job SummaryThe Risk Adjustment Coder III is responsible for the accurate and timely assignment of medical diagnosis codes in accordance with established risk adjustment models, coding guidelines, and organizational standards. This role performs high-volume, production-based coding and chart review activities, following defined policies and procedures to ensure compliance and data accuracy. This position applies advanced coding knowledge but operates within established guidelines, with work subject to quality review and audit.Duties & ResponsibilitiesEssential Duties & ResponsibilitiesMedical Coding and DocumentationAssign ICD-10-CM diagnosis codes based on medical records, clinical documentation, and encounter data in accordance with established coding guidelines.Perform...

Review E/M services under 2021+ guidelines MUST RESIDE IN FLORIDA AND HAVE CODING AND AUDITING EXPERIENCE. Deposition as well as Testimony experience is preferred. Requirements 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 Florida-based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. 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...

Turn accurate coding into cleaner claims, reliable data, and stronger reimbursement. Work Style: Remote Location Requirement: Must reside in an authorized state (FL, GA, MO, PA, SC, NC, TN, or TX) FTE: Full-Time (1.0 FTE) Reviews and analyzes medical records to assign appropriate diagnostic and procedural codes in compliance with established coding guidelines and organizational policies. Collaborates with healthcare providers to clarify documentation and resolves coding discrepancies, ensuring the integrity of coded data for billing and reporting purposes. Maintains current knowledge of coding standards such as ICD, CPT, and HCPCS, and supports the billing department by providing precise coded information for claims submission. Includes auditing coded data, training staff on coding procedures, and monitoring coding productivity and quality metrics to enhance departmental performance. Key Responsibilities Reviews and analyzes medical records to assign appropriate diagnostic...