30 quality coding auditor jobs found

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Use your skills to make an impact Additional Job Description WORK STYLE: Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS:...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality...

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare...

Location: Boston, Massachusetts, United StatesCompany: TakedaPosted: 2026-09-01LocationsZurich, Switzerland; Boston, MAJob DescriptionOBJECTIVES / PURPOSEProvides enterprise-level governance, portfolio and operational leadership for medical grants, medical education grants and sponsorships within Global Medical.Ensures that funding decisions are transparent, objective, well documented, aligned with enterprise Medical priorities, Therapeutic Area strategies, unmet scientific or educational need, patient-centric outcomes, and compliant with Takeda standards and applicable industry requirements.Establishes and maintains clear funding frameworks, decision criteria, review pathways, committee operations, documentation expectations, budget visibility, system/repository requirements and lifecycle oversight from intake through close-out. The role partners with Global Therapeutic Areas, regions, LOC Medical, Ethics & Compliance, Legal and Finance to define areas of scientific and...

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together. As a Medical Coder, you will be responsible for procedure and diagnostic coding of professional charges. Works closely with clinical department physicians and staff to ensure accurate and compliant coding and maximization of revenue through initial coding. Schedule (38.75 hours): Following training, hours will be 7.75 hours Monday-Friday between the hours of 6am-6pm EST. Candidates residing in EST or CST...

Everyone Is a CaregiverAt UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.Interprets a wide variety of clinical and diagnostic documentation in order to process hospital and / or pro-fee charges for episodes of outpatient care. Assigns appropriate ICD-CM (current edition) and CPT codes as well as modifiers. Based on account type, may assign ICD-PCS codes, as appropriate adhering to official coding guidelines.I. Major Responsibilities:Upon review of the medical record, performs analysis on documentation, which...

Are you a current UMass Memorial Health caregiver? Exemption Status: Non-Exempt Hiring Range: $23.81 - $35.08 Please note that the final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations. Schedule Details: Monday through Friday Scheduled Hours: 7-3:30 Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5458 Coding Services Union: SHARE (State Healthcare and Research Employees) This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees,...

Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? Exemption Status: Non-Exempt Hiring Range: $0.00 - $0.00 Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations. Schedule Details: Monday through Friday Scheduled Hours: 7a-3:30p Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5470 ED Coding and Revenue Capture This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are...

Join Our Team at OptumOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:Codes a variety of medical records using CPT, HCPCS and ICD-10 codes for office, outpatient, inpatient, surgical, hospital ancillary, nursing facility, urgent care, ambulatory surgery center and other charges for physicians and other providers of...

Join Our Team at Optum Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Codes a variety of medical records using CPT, HCPCS and ICD-10 codes for office, outpatient, inpatient, surgical, hospital ancillary, nursing facility, urgent care, ambulatory surgery center and other charges for physicians and other...

Outpatient Coder When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Under the general supervision of the Outpatient Coding Manager and OP Coding Supervisor, the OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Essential Duties & Responsibilities including but not limited to: Hospital Coding: Review the complete electronic and scanned...

UnitedHealth Group's Optum division seeks a full-time Medical Coder to join our team. This role offers telecommuting from anywhere in the U.S. and a training period 8:00am–5:00pm CST, Monday–Friday, with occasional overtime as needed. Responsibilities include assigning medical codes using CPT guidelines, interpreting clinical documentation, maintaining productivity, and supporting quality audits. Certification requirements include CPC or CCS/RHIT/RHIA, with 3+ years of CPT coding experience. #J-18808-Ljbffr

Location Remote - US; Boston Hybrid Employment Type Full time Location Type Remote Department Customer Operations CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix’s autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. Overview Reporting to the Senior Manager, Medical Coding & Audit, as a Senior Medical Coding Analyst, this role will be a key member of the team responsible for ensuring that CodaMetrix meets—and exceeds—our customers’ coding quality expectations. They will leverage their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and...

Medical Coder/Biller – Full Time Child Health Associates is looking for an experienced Medical Coder/Biller to join our Billing team! We're looking for someone with strong Evaluation & Management (E/M) coding experience who is detail-oriented, organized, and enjoys working collaboratively to support accurate coding, timely billing, and quality patient care. This is a full-time, on-site position based in our Auburn office. What You'll Do Review provider documentation and assign accurate ICD-10-CM, CPT, HCPCS, and E/M codes. Ensure coding is compliant with CMS guidelines, payer requirements, and current coding regulations. Submit and monitor insurance claims for timely reimbursement. Review documentation to ensure it supports the appropriate level of E/M services and identify opportunities for improvement. Research and resolve claim denials, coding edits, and payment discrepancies. Work closely with providers and staff to improve documentation and coding accuracy. Perform...

Overview: We are seeking a detail-oriented and experienced Billing & Certified Medical Coder to join our Allergy & Asthma practice. This role is responsible for accurate medical coding, timely claim submission, payment posting, denial management, and ensuring compliance with payer and regulatory requirements. Experience in allergy, immunology, and asthma-related billing is strongly preferred. This is a Hybrid position located in Leominster, Massachusetts and requires weekly in-office duties. Responsibilities: Medical Coding Accurately assign CPT, ICD-10-CM, and HCPCS codes for allergy and asthma services Code office visits, diagnostic testing, procedures, and treatments including: Allergy skin testing (e.g., 95004–95075) Immunotherapy injections (e.g., 95115, 95117) Allergy serum preparation (e.g., 95165) Pulmonary function testing (e.g., spirometry) Asthma and allergy-related E/M services Biologic medications and injections (e.g., Xolair, Dupixent,...

Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Non-Exempt Hiring Range: $0.00 - $0.00 Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations . Schedule Details: Monday through Friday Scheduled Hours: 7a-3:30p Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5470 ED Coding and Revenue Capture This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a...

Medical Coder/Biller – Full Time Child Health Associates is looking for an experienced Medical Coder/Biller to join our Billing team! We're looking for someone with strong Evaluation & Management (E/M) coding experience who is detail-oriented, organized, and enjoys working collaboratively to support accurate coding, timely billing, and quality patient care. This is a full-time, on-site position based in our Auburn office. What You'll Do Review provider documentation and assign accurate ICD-10-CM, CPT, HCPCS, and E/M codes. Ensure coding is compliant with CMS guidelines, payer requirements, and current coding regulations. Submit and monitor insurance claims for timely reimbursement. Review documentation to ensure it supports the appropriate level of E/M services and identify opportunities for improvement. Research and resolve claim denials, coding edits, and payment discrepancies. Work closely with providers and staff to improve documentation and coding...

Overview: We are seeking a detail-oriented and experienced Billing & Certified Medical Coder to join our Allergy & Asthma practice. This role is responsible for accurate medical coding, timely claim submission, payment posting, denial management, and ensuring compliance with payer and regulatory requirements. Experience in allergy, immunology, and asthma-related billing is strongly preferred. This is a Hybrid position located in Leominster, Massachusetts and requires weekly in-office duties. Responsibilities: Medical Coding Accurately assign CPT, ICD-10-CM, and HCPCS codes for allergy and asthma services Code office visits, diagnostic testing, procedures, and treatments including: Allergy skin testing (e.g., 95004–95075) Immunotherapy injections (e.g., 95115, 95117) Allergy serum preparation (e.g., 95165) Pulmonary function testing (e.g., spirometry) Asthma and allergy-related E/M services Biologic medications and injections (e.g., Xolair, Dupixent, Nucala,...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Under the general supervision of the Facility Outpatient (OP) Coding Manager and OP Coding Supervisor, the Facility OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The facility OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Job Description: Essential Duties & Responsibilities including but not limited to: Hospital Coding: •...

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...

Title: Certified Risk Coder Reports to: Manager, Risk Coding Classification: Individual Contributor Location: Boston (Remote) Job description revision number and date: 2.0, 01.06.2025 Organization Summary: Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Quality Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary: The Certified Risk Coder will be a part of an emerging coding team and coding service that...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Under the general supervision of the Facility Outpatient (OP) Coding Manager and OP Coding Supervisor, the Facility OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The facility OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Job Description: Essential Duties & Responsibilities including but not limited to: Hospital Coding: ·...

Medical Coder/Biller – Full Time Child Health Associates is looking for an experienced Medical Coder/Biller to join our Billing team! We're looking for someone with strong Evaluation & Management (E/M) coding experience who is detail-oriented, organized, and enjoys working collaboratively to support accurate coding, timely billing, and quality patient care. This is a full-time, on-site position based in our Auburn office. What You'll Do Review provider documentation and assign accurate ICD-10-CM, CPT, HCPCS, and E/M codes. Ensure coding is compliant with CMS guidelines, payer requirements, and current coding regulations. Submit and monitor insurance claims for timely reimbursement. Review documentation to ensure it supports the appropriate level of E/M services and identify opportunities for improvement. Research and resolve claim denials, coding edits, and payment discrepancies. Work closely with providers and staff to improve documentation and coding accuracy. Perform charge...