17 professional fee coding auditor jobs found

Job Description Job Description   PYA is seeking an experienced Inpatient/Outpatient Facility Coding Auditor to join our nationally recognized  Revenue and Compliance Advisory team. As a trusted advisor to leading healthcare organizations, you will apply your expertise in coding, reimbursement, compliance, and documentation to help clients improve revenue integrity and reduce risk. WHAT YOU'LL DO Perform inpatient and outpatient facility coding audits and reimbursement reviews, including:  ICD-10-CM/PCS, CPT, and HCPCS coding validation MS-DRG and APC validation Charge capture and revenue integrity reviews Clinical documentation improvement (CDI) assessments Third-party payer compliance evaluations Deliver high-quality client reports, recommendations, and presentations  Manage multiple engagements while maintaining exceptional quality and compliance standards  Collaborate with PYA's consulting, compliance, and executive teams to deliver comprehensive...

Job Description Job Description   PYA is seeking an experienced Inpatient/Outpatient Facility Coding Auditor to join our nationally recognized  Revenue and Compliance Advisory team. As a trusted advisor to leading healthcare organizations, you will apply your expertise in coding, reimbursement, compliance, and documentation to help clients improve revenue integrity and reduce risk. WHAT YOU'LL DO Perform inpatient and outpatient facility coding audits and reimbursement reviews, including:  ICD-10-CM/PCS, CPT, and HCPCS coding validation MS-DRG and APC validation Charge capture and revenue integrity reviews Clinical documentation improvement (CDI) assessments Third-party payer compliance evaluations Deliver high-quality client reports, recommendations, and presentations  Manage multiple engagements while maintaining exceptional quality and compliance standards  Collaborate with PYA's consulting, compliance, and executive teams to deliver comprehensive...

EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workers' Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes. By partnering with clients to supercharge the reimbursement process, EnableComp removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data-rich performance management. EnableComp is a multi-year recipient the...

This is a remote based position. Applicants can be located nationwide Outpatient Coding Auditor #2972 United States Remote/Nationwide Position Description About You You are a person who enjoys ensuring coding accuracy and solving documentation and compliance challenges. We need someone who demonstrates skills in organization, prioritization, professionalism, and coaching others. In the role of Outpatient Coding Auditor, you will be responsible for quality reviews and audits and coordinating with department managers to ensure standards are met in accordance with department and organization policies. 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 knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM), Procedural Coding System (PCS), Current Procedural Terminology (CPT-4 and Healthcare Common Procedure Coding System...

***Work at Home*** Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state. There are a number of reasons why TOA is an employer of choice; here are a few of them: Stability - TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state! Impact - TOA's team members use our careers — whether in our clinics or our business office to make a positive difference in the community by building relationships and helping patients live their best life. Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. Total Rewards - TOA offers a comprehensive suite...

Become a part of our caring community Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Outpatient Behavioral Health Coding disputes and is part of the PPI Coding Disputes Team with Humana. The Outpatient Behavioral Health Coding Auditor on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient Behavioral Health coding disputes and expertise in CPT/HCPCS...

Department 10407 Enterprise Revenue Cycle - Coding Production Operations: Inpatient Coding Operations Status Full time Benefits Eligible Yes Hours Per Week 40 Schedule Details/Additional Information Will support Schedule Full-time, Monday-Friday 40hrs with a standard schedule of Monday through Friday, 8 hours per day, totaling 40 hours each week. A mix of inpatient community and academic coding. Includes service lines such as cardiology, neurology, and oncology. Certification required Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA). Remote opportunity Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY Pay Range $33.05 - $49.60 Major...

***Work at Home*** Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state. There are a number of reasons why TOA is an employer of choice; here are a few of them: Stability - TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state! Impact - TOA's team members use our careers — whether in our clinics or our business office to make a positive difference in the community by building relationships and helping patients live their best life. Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. Total Rewards - TOA offers a comprehensive suite...

Community Health Systems, Inc. is seeking a Remote Physician Pro Fee Coding Specialist-Anesthesia to review and assign CPT, HCPCS, and ICD-10 codes for professional services, ensuring proper sequencing, modifiers, and compliant billing. You will work with physicians and revenue cycle teams, conduct coding audits, resolve claim edits in Athena Collector, and support coding education to maintain accuracy and reimbursement. #J-18808-Ljbffr

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.Job Summary**If you are located outside of the state of Texas -- you must be located in KANSAS, OKLAHOMA, TENNESSEE, LOUISIANA, GEORGIA, SOUTH CAROLINA, NORTH CAROLINA, or be willing to relocate to one of the eligible states (including Texas). **Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data integrity and...

Tennessee Orthopaedic Alliance Job OpportunityWork at HomeTennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state.There are a number of reasons why TOA is an employer of choice; here are a few of them:Stability - TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state!Impact - TOA's team members use our careers — whether in our clinics or our business office to make a positive difference in the community by building relationships and helping patients live their best life.Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement.Total Rewards - TOA offers a...

Community Health Systems, Inc. seeks a Remote Physician Pro Fee Coder specializing in Cardiology to review, analyze, and assign CPT, HCPCS, and ICD-10 codes for professional services from provider documentation. You will ensure proper sequencing and modifiers, comply with NCCI edits and LCD/NCD guidelines, perform coding audits, and collaborate with physicians and revenue cycle teams to support accurate reimbursement. #J-18808-Ljbffr

Job Description Day-to-Day Responsibilities Review and code professional fee encounters using ICD-10-CM, CPT, and HCPCS guidelines. Assign accurate E/M levels, diagnoses, and procedure codes to ensure compliant reimbursement. Abstract key patient and encounter data for billing, regulatory, and reporting purposes. Audit medical records to ensure documentation supports services billed and identify documentation gaps. Communicate with physicians and providers to obtain coding and documentation clarifications. Review and resolve coding-related claim edits, including medical necessity and NCCI/CCI edits. Collaborate with billing and Accounts Receivable teams to resolve coding and reimbursement issues. Maintain quality and productivity standards while meeting a 95% coding accuracy requirement. Work within EMR, hospital information systems, and encoder software in a fully remote environment. Stay current on coding regulations, payer requirements, and continuing education requirements....

Tennessee Orthopaedic Alliance Job Opportunity Work at Home Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state. There are a number of reasons why TOA is an employer of choice; here are a few of them: Stability - TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state! Impact - TOA's team members use our careers whether in our clinics or our business office to make a positive difference in the community by building relationships and helping patients live their best life. Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. Total Rewards - TOA offers a...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in 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 role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to...

At Virtua Health, we exist for one reason – to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between – we are your partner in health devoted to building a healthier community. If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment. In addition to five hospitals, seven emergency departments, seven urgent care...

Risk Adjustment Coding Auditor II Galen Medical Group offers several medical specialties throughout the Chattanooga region. We provide quality care and patient-friendly services to adults and children of all ages. Our mission is to elevate the health of our community through multiple medical specialties providing excellent care delivered with wisdom, compassion, integrity, and a commitment to technology, education, and scientific inquiry. Galen is CHATTANOOGA'S Doctor! Summary/Objective: The Risk Adjustment Coding Auditor II is responsible for reviewing and analyzing patient medical records to ensure accurate coding and documentation of chronic conditions based on ICD-10-CM guidelines and CMS standards. This role supports accurate health status assessment to drive appropriate reimbursement and quality care. This position will interact with physicians, coding staff and other members of the health care team to ensure the accuracy and completeness of clinical...