102 provider coding auditor educator jobs found

Addison Group is partnering with a leading healthcare organization to hire a Professional Coding Auditor/Educator. This fully remote role supports coding quality, provider education, and compliance initiatives as a subject matter expert in professional fee coding and surgical auditing. The ideal candidate has 5+ years of professional fee coding experience, strong surgical coding expertise, and proven ability to educate physicians and coding staff across specialties. #J-18808-Ljbffr

Medical Coding Specialist Key Responsibilities: Analyze patient charts, physician notes and discharge summaries Ensure documentation is complete and accurate before coding Translate diagnoses and procedures into standardized codes using: ICD-10-CM (diagnoses) CPT (procedures) HCPCS (supplies/services) Make sure codes correctly represent services provided Follow healthcare laws and regulations (HIPAA, Medicare/Medicaid guidelines) Company Policies Prevent coding errors that could lead to claim denials or audits Stay updated on coding changes and updates Work with billing teams to submit coded claims to insurance companies Verify claim accuracy to ensure proper reimbursement Fix rejected or denied claims by reviewing and correcting codes Communicate with healthcare providers and insurance companies Protect sensitive patient information Follow strict privacy and data security standards Clarify documentation with physicians when needed...

Medical Coding Professional 2 Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities: Deliver coding and documentation education to providers and clinic staff within IPA clinics. Be a consultative resource and ongoing support for providers in assigned clinics. Conduct documentation audits to identify gaps, trends, and opportunities for improvement. Perform quarterly chart reviews to support coding...

Join UMC Physicians: Where Employee Satisfaction Soars at 96% UMC Physicians is seeking an experienced full-time Family/Internal Medicine Professional Coder to join our team of multi-specialty coders. Under general supervision, the coder reviews and analyzes provider documentation to ensure final diagnoses and procedures are complete, valid, and accurately documented. The Coder assigns ICD-10-CM, CPT, and HCPCS Level II codes for clinic and hospital professional services, ensuring compliance with federal regulations, payer guidelines, and organizational policies. This role is responsible for accurate coding and timely claim submission to support appropriate reimbursement while maintaining the highest standards of coding quality, compliance, and integrity. The coder collaborates with providers, clinic staff, coworkers, and revenue cycle teams to promote complete documentation, resolve coding and billing issues, and support accurate and timely insurance claim processing. The ideal...

Become a part of our caring community Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities: You will deliver coding and documentation education to providers and clinic staff within IPA clinics. You will be a consultative resource and ongoing support for providers in assigned clinics. You will conduct documentation audits to identify gaps, trends, and opportunities for improvement. You will...

Posted 2 days ago Description Summary POSITION SUMMARY The Inpatient coder reviews and analyzes documentation in the medical record for inpatient visits to ensure accuracy of diagnosis and procedure codes. Coder finalizes the coding and abstracting of the medical record according to ICD-10-CM/PCS, CPT, and HCPCS coding conventions and guidelines supported by the clinical documentation in the medical record. Coder analyzes diagnosis and procedure codes concurrently assigned by Clinical Documentation Specialists. The Inpatient Coder assumes primary responsibility for DRG validation/accuracy, primary role in assisting CDS and medical staff members with improving quality of clinical documentation. Sequence the diagnoses and procedures using official coding guidelines. Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges. Resolve Inpatient billing edits. Abide by the Standards of Ethical Coding as set forth...

Department: 10407 Enterprise Revenue Cycle - Coding Production Operations: Inpatient Coding Operations Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Will support : A mix of inpatient community and academic coding. Includes service lines such as cardiology, neurology, and oncology. Schedule : Full-time, Monday-Friday 40hrs with a standard schedule of Monday through Friday, 8 hours per day, totaling 40 hours each week. 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...

Job Code: SRMC - 114 Revision Date: October 21, 2026 Starting Salary: $21.52 hourly; $44,768 annually FLSA: Exempt Overview We are an agency committed to innovative behavioral health services in trauma-informed care that promote healing and recovery to instill a sense of empowerment and foster a lifelong sense of resilience. General Description The Medical Coder Supervisor provides day-to-day leadership, development, and accountability for assigned Billing and Coding Specialists. The position establishes work priorities and performance expectations; monitors coding quality, productivity, and turnaround time; addresses performance and conduct matters in coordination with Human Resources; and ensures coding, charge-capture, provider-query, and documentation-review activities are completed accurately, consistently, and in accordance with applicable laws, regulations, payer requirements, organizational policies, and ethical coding standards. The position also...

46665BR Position Description: Responsible for auditing medical records to ensure accurate coding and compliance with regulatory requirements. This role ensures continuous quality improvement in coding practices while maintaining compliance with healthcare laws and organizational policies. The Medical Coding Auditor collaborates with practice, providers, and other departmental leaders to provide education on medical coding and documentation based on audit findings and as required by current CMS regulations. Work directly with the Medical Coding Auditor Manager to implement best practices to maximize revenue, improve coding accuracy and assure regulatory requirements are met. Texas Tech Health El Paso (TTEP) is not considering applications from individuals who require sponsorship for an employment visa, including those with H1B visas or those currently on student or postgraduate visas. Requisition ID: 46665BR Work Location: El Paso Org Level 1: Texas...

Sports Medicine Associates of San Antonio - SMASA is seeking a motivated Certified Medical Biller and Coder (Surgical) to join our orthopedic sports medicine team. You will handle medical coding (CPT/HCPCS/ICD-10-CM) and billing workflows, ensuring compliance and accurate revenue cycle management. You will collaborate with providers and staff, conduct chart audits, and deliver education on coding and billing policies while maintaining HIPAA compliance across multiple locations. #J-18808-Ljbffr

Job Details: Job Location: Guidehouse CODER - REMOTE, TX 78223, Position Type: Full Time, Education Level: Not Specified, Job Shift: Day, Bestica is seeking Certified Medical Coder II’s to provide remote work for our government customers. Objective: The team will follow the Centers for Medicare and Medicaid Services (CMS) / Medicare Administrative Contractor (MAC) guidelines, payer policies, the 10th version of the International Classification of Diseases (ICD-10), Current Procedural Terminology (CPT), and other official source guidance to support compliant and accurate coding/billing. During the initial startup, the team will arrange daily and weekly huddle calls to support a smooth go-live; the team will then set the cadence for ongoing project implementation meetings and collaboration with the Government. The physician coding teams will coordinate with practices and/or providers, when needed, to discuss opportunities for improving coding documentation, as well as to address...

Company Overview Community Health Choice, Inc. (Community) is a non‑profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women Children's Health Insurance Program (CHIP) for the children of low‑income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions. Community Health Choice (HMO D‑SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits,...

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 audits of medical records submitted in support of services billed by providers. This process includes clinical judgment, utilization review, application of product benefits, understanding of regulatory requirements for Medicaid managed care and fraud and abuse, and verification of medical necessity utilizing nationally recognized criteria. Think you've got what it takes? Job Duties & Responsibilities • Assess the treatment plan, clinical information, and medical necessity of all requested services • Utilizes established criteria to appropriately review billed services within established timeframe required. • Consults with medical directors and clinical staff regarding patient's history and current care needs and whether services billed were appropriate. • Refers case failing...

Certified Biller/Coder Specialist Avenue360 Health and Wellness Houston, Texas, United States About this position About Avenue360 Health and Wellness Avenue 360 is a FQHC that strives to provide high quality and caring service to promote healthy people and communities. Our 360-degree approach addresses medical needs and social and environmental challenges, like housing. Our compassionate care extends to those with and without insurance. We believe income must not determine the level of access to quality health care. Providing comprehensive, high quality, and caring service is the core of what we do, whether medical, hospice care, engaging adult activities, and supportive housing programs. We strive to address the many social determinants of healthy living in Greater Houston. Our Values PACT We take PRIDE in our work. We have a positive ATTITUDE. We are CURIOUS. We are COMMITTED. We are CARING and CUSTOMER-SERVICE oriented. We are a TEAM. We LEARN,...

Senior Medical Coding Auditor The US Oncology Network is looking for a Senior Medical Coding Auditor to join our team at Texas Oncology. This full-time position will support the Revenue Cycle Department at our 3001 E. President George Bush Hwy Suite 100 location in Richardson, Texas. Typical work week is Monday through Friday 8:00a - 5:00p. This position will be a Sr level position. As a part of The US Oncology Network, Texas Oncology delivers high-quality, evidence-based care to patients close to home. Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas, our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today—at Texas Oncology, we use leading-edge technology and research to...

Signature Performance, Inc. is seeking an Outpatient Coding Auditor for a remote nationwide position. You will perform quality reviews, coordinate with managers, and deliver clear audit findings to educate staff. Strong coding credentials and experience in ICD-10-CM/PCS, CPT-4/HCPCS and reimbursement systems are required to guide improvement initiatives. You will mentor coders, identify documentation gaps, and provide continuing education on changes in coding and reimbursement. #J-18808-Ljbffr

At Suvida Healthcare, we are not just caregivers; we're compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well-being of an underserved community and their families. Our multi-disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare-eligible Hispanic seniors. Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both, our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service-centered, and more compassionate healthcare family and Employer of Choice! Will you join us Suvidanos , to help achieve our Higher Purpose? What Makes Us Unique We are an...

Coder/Biller ManagerLocation: Addison, TexasJoin Our Growing Team!We are seeking an experienced Coder/Biller Manager to lead our Billing & Coding team and support the continued growth of our healthcare practice management organization. This role is ideal for a hands-on leader who is passionate about coding accuracy, team development, operational efficiency, and revenue cycle excellence.This position reports directly to the Director of Revenue Cycle Management.What You'll DoLead & Develop the TeamSupervise, coach, and mentor billing and coding staff.Foster a collaborative, high-performing team environment.Conduct training, performance evaluations, and ongoing development initiatives.Monitor productivity and quality metrics to ensure departmental success.Oversee Billing & Coding OperationsManage daily coding and billing activities, ensuring timely and accurate claim submission.Oversee CPT, ICD-10, HCPCS, and anesthesia-specific coding accuracy.Review claim edits, denials,...

Minimum Qualifications:Bachelor's degree or equivalent and at least four years of relevant experience. Certified Coding Specialist (CCS) by the American Health Information Management Association (AHIMA) required. Job Summary:Utilize advanced skills necessary to audit documentation, coding, and reimbursement of professional, hospital/facility inpatient and outpatient billing. Ensure that documentation is complete and accurately reflects/supports the coded level of service. Audits will determine if the billed services are consistent with medical record documentation and in accordance with the appropriate third-party billing regulations and/or standards. Assist with the development and implementation of pre- and post-audit education as needed. Job Duties:Utilizes auditing software to select and conduct random or focused audits of professional and hospital/facility inpatient and outpatient billing based on determined criteria.Conducts prospective and retrospective professional and...

Medical Coder Revenue Cycle Management is looking for a full-time Medical Coder to join our team! Remote opportunity after in-person training. SUMMARY: The Medical Coder is responsible for reviewing medical documentation and accurately assigning CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS codes depending on the encounter type. The position ensures accurate billing, compliance, and optimized reimbursement across outpatient and/or facility (inpatient) settings. Essential Functions Assign accurate diagnosis and procedure codes based on medical record documentation using CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS. Review provider documentation to ensure coding is supported and complete for billing submission. Apply proper modifiers, sequencing, and coding conventions appropriate to the setting (inpatient or outpatient). Ensure compliance with coding regulations, organizational policies, and HIPAA standards. Meet coding productivity and quality benchmarks. Collaborate with...

Professional Fee Coder II Division: Ambulatory Operations Work Arrangement: Hybrid Location: Houston, TX Salary Range: $57,320 to $67,435 FLSA Status: Nonexempt Work Schedule: Monday Friday, 8 a.m. 5 p.m. Summary The Patient Business Services (PBS) Coding department is looking for an experienced mid-level coder to review and abstract CPT, ICD-10 and HCPCS coding for physician services. Our coders assist in maximizing the revenue by completely capturing and accurately documenting physician, professional, and departmental charges to ensure submission of clean insurance claims, as well as accurate patient statements. They apply correct coding guidelines to patient charge encounter, while assuring timely turnaround of charges. The PBS Coding department is responsible for accurately capturing the revenue for all physician specialties at Baylor College of Medicine as well as outpatient facility charges at McNair Cancer Center. We focus on providing accurate and compliant...

Integrative Emergency Services ("IES") LLC, is a physician founded, owned, and led company whose goal is to empower physician leaders to create the best places to give and receive care. We are a clinically integrated and outcomes-based organization with a commitment to doing the right thing for our clinicians, patients, and communities. Through our commitment to patient care and reinvestment in our physicians, IES has a proven track record of improving patient outcomes and producing results that uphold the hospitals' reputations in which we operate. We strive to create a culture of continuous improvement, community, and recognizing our Physician leaders. To learn more, visit our website IES.Healthcare and click to see a highlight of our 12th Annual Quality Summit . Integrative Emergency Services, LLC ("IES") is seeking a certified Medical Coding Specialist with emphasis on surgical services. The Medical Coding Specialist responsible for accurate professional fee coding and...

DISCOVER IES Integrative Emergency Services (“IES”) LLC, is a physician founded, owned, and led company whose goal is to empower physician leaders to create the best places to give and receive care. We are a clinically integrated and outcomes-based organization with a commitment to doing the right thing for our clinicians, patients, and communities. Through our commitment to patient care and reinvestment in our physicians, IES has a proven track record of improving patient outcomes and producing results that uphold the hospitals' reputations in which we operate. We strive to create a culture of continuous improvement, community, and recognizing our Physician leaders. To learn more, visit our website IES.Healthcare and click to see a highlight of our 12th Annual Quality Summit (https://www.youtube.com/watch?v=KFKfufqmLj4) .  POSITION SUMMARY Integrative Emergency Services, LLC (“IES”) is seeking a certified  Medical Coding Specialist  with emphasis on surgical services.  The...

Work Schedule: Monday – Friday, 8 a.m. – 5 p.m. Summary The Patient Business Services (PBS) Coding department is looking for an experienced mid-level coder to review and abstract CPT, ICD-10 and HCPCS coding for physician services. Our coders assist in maximizing the revenue by completely capturing and accurately documenting physician, professional, and departmental charges to ensure submission of clean insurance claims, as well as accurate patient statements. They apply correct coding guidelines to patient charge encounter, while assuring timely turnaround of charges. The PBS Coding department is responsible for accurately capturing the revenue for all physician specialties at Baylor College of Medicine as well as outpatient facility charges at McNair Cancer Center. We focus on providing accurate and compliant coding assistance by coders who are certified and up-to-date on coding rules and regulations. The ideal candidate will have good organizational, communication and...