35 quality coding auditor jobs found

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 thats 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 14000 colleagues including over 2850 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 weve received multiple awards for quality safety and outstanding work environment.In addition to five hospitals seven emergency departments seven urgent care centers and more than 280 other...

Valley Health System is seeking an experienced Outpatient Coding Auditor to review coded outpatient encounters for accuracy and compliance. You will support coding education, identify audit variances, and partner with leadership to drive process improvements. A collaborative role with external vendors ensures ongoing adoption of industry best practices. Requirements include a high school diploma or equivalent, 5+ years in hospital auditing or related education experience, and proficiency in #J-18808-Ljbffr

Valley Health System in Ridgewood, NJ is seeking an Outpatient Coding Auditor to review coded outpatient records for adherence to official coding guidelines, regulatory standards, and internal policies. The role drives education and process improvements through detailed case reviews and trend analyses. The incumbent will collaborate with external vendors and coding leadership to ensure accuracy and implement best practices in audit feedback and staff education. #J-18808-Ljbffr

Location: Newark, New Jersey, United StatesCompany: Integrated ResourcesPosted: 2026-09-07Coding Auditor (ICD-10) A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Position: Coding Auditor (ICD-10) Duration: Full-Time Location: Newark/Wall NJ Job Summary: This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit...

Outpatient Coding AuditorThe Outpatient Coding Auditor is responsible for auditing coded outpatient medical records to ensure compliance with official coding guidelines, regulatory agencies, and internal policies. This role supports coding accuracy, education, and process improvement through detailed review of encounters, identification of trends and variances, and communication with coding staff and leadership. This position also collaborates with external vendors to monitor performance and incorporate industry best practices into audit feedback and education.EducationHigh school diploma or equivalent required.ExperienceMinimum of 5 years of experience in hospital auditing or education experience ICD-10-CM and Outpatient CPT-4, HCPCs coding experience required. Knowledge of Medical Necessity APC, OCE, LCD, and NCD edits required. 3M Encoder experience, Meditech, EPIC, or CERNER preferred.SkillsCCS or COC, CPC, RHIT, RHIA required. Knowledge of ICD-10-CM, CPT-4 and HCPCs coding,...

Position Summary The Outpatient Coding Auditor is responsible for auditing coded outpatient medical records to ensure compliance with official coding guidelines, regulatory agencies, and internal policies. This role supports coding accuracy, education, and process improvement through detailed review of encounters, identification of trends and variances, and communication with coding staff and leadership. This position also collaborates with external vendors to monitor performance and incorporate industry best practices into audit feedback and education. Education High school diploma or equivalent required. Experience Minimum of 5 years of experience in hospital auditing or education experience ICD-10-CM and Outpatient CPT-4, HCPCs coding experience required. Knowledge of Medical Necessity APC, OCE, LCD, and NCD edits required. 3M Encoder experience, Meditech, EPIC, or CERNER preferred. Skills CCS or COC, CPC, RHIT, RHIA required. Knowledge of ICD-10-CM, CPT-4 and HCPCs coding,...

Coding Auditor (ICD-10) A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Position: Coding Auditor (ICD-10) Duration: Full-Time Location: Newark/Wall NJ Job Summary: This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on ICD9- CM,...

Overview Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Physician Billing (PB) Coding Auditor and Educator is responsible for auditing and educating healthcare providers on related applicable clinical documentation. This work supports coding and billing regulations that ensure appropriate reimbursement, public reporting, and various initiatives as directed by the Hackensack Meridian Health (HMH) Network. This is remote position. Responsibilities A day in the life of a Physician Billing (PB)...

Coding Auditor (ICD-10) A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Position: Coding Auditor (ICD-10) Duration: Full-Time Location: Newark/Wall NJ Job Summary: This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on...

Become a part of our caring community The 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 Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

Certified Professional Coder (CPC) Lead/Provider LiaisonIntegrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.This is a contract position with my direct client.Job DescriptionDirect client need- immediate interviews- we have a strong hold, with many consultants working onsite! Location could be: Newark, NJ OR West Trenton OR Ewing OR Wall, NJ. Duration: Contract to hire.Job Summary: The Provider Liaison is accountable for extracting insights specific to providers and provider groups regarding commercial risk adjustment and developing educational materials for Network Management...

Professional Coder IThis position is accountable for accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business.Responsibilities:Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction.Review medical records for completeness, accuracy and compliance with applicable coding guidelines and regulations.Identify, compile and code member/patient data, using ICD-9/ICD 10-CM and other standard classification coding systems.Support the...

Professional CoderContract: 6 MonthsLocation: 100% Remote | Can work remote from any of the following five states NY, NJ, PA, DE, CTPay rate: $42/HR on W2Summary: This position is accountable for accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business.Responsibilities:Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction.Review medical records for completeness, accuracy and compliance with applicable coding guidelines and...

Professional Coder IOur client, a health insurance company, is looking for a Professional Coder I for their remote location. Responsibilities include understanding and translating CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy, and compliance with applicable coding guidelines and regulations. Identify, compile, and code member/patient data, using ICD-9/ICD 10-CM and other standard classification coding systems. Support the collection and distribution of documentation and coding improvement tools for designated practice units as applicable. Support educational activities for internal stakeholders as necessary as subject matter expert on coding review/guidelines. Actively participate and engage in program improvement discussions and activities. Maintain department productivity and accuracy standards.Requirements include current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the...

Remote Coding SpecialistWork Mode: 100% Remote (Must live in NY, NJ, DE, PA, or CT states) Duration: 6 monthsResponsibilities:Understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction.Review medical records for completeness, accuracy, and compliance with applicable coding guidelines and regulations.Identify, compile, and code member/patient data using ICD-9/ICD-10-CM and other standard classification coding systems.Support the collection and distribution of documentation and coding improvement tools for designated practice units as applicable.Support educational activities for internal stakeholders as necessary as a subject matter expert on coding review/guidelines.Participate and engage in program improvement discussions and activities.Maintain department productivity and accuracy standards.Requirements:Current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a...

Senior Vascular Surgery Professional CoderNew Jersey's largest Vascular Surgery group dedicated solely to the diagnosis and management of diseases of the arteries and veins. The Group has been delivering care throughout New Jersey since 1963 and is home to some of the best Vascular Surgeons in the country. Consistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results.Position Summary:We are seeking an experienced Senior Vascular Surgery Professional Coder with strong expertise in complex open and endovascular procedure coding, payer authorization workflows, and revenue cycle support.This role is responsible for accurate CPT, ICD-10-CM, and modifier assignment for a high-volume vascular surgery practice with extensive cardiovascular, endovascular, catheter-based, and imaging-guided procedural work. The...

Professional Coder Contract: 6 Months Location: 100% Remote | Can work remote from any of the following five states NY, NJ, PA, DE, CT Pay rate: $42/HR on W2 Summary: This position is accountable for accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities: Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy and compliance with applicable coding...

Job Description Job Description New Jersey’s largest Vascular Surgery group dedicated solely to the diagnosis and management of diseases of the arteries and veins. The Group has been delivering care throughout New Jersey since 1963 and is home to some of the best Vascular Surgeons in the country. Consistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Position Summary: We are seeking an experienced Senior  Vascular Surgery Professional Coder with strong expertise in complex open and endovascular procedure coding, payer authorization workflows, and revenue cycle support. This role is responsible for accurate CPT, ICD-10-CM, and modifier assignment for a high-volume vascular surgery practice with extensive cardiovascular, endovascular, catheter-based, and imaging-guided procedural...

Summary This position is accountable for accurately reviewing, interpreting, auditing, coding, and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment, and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities Understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy, and compliance with applicable coding guidelines and regulations. Identify, compile, and code member/patient data using ICD-9/ICD-10-CM and other standard classification coding systems. Support the...

Coder - Physician Practice - CPC Required page is loaded## Coder - Physician Practice - CPC Requiredremote type: 100% Remotelocations: PACCT - 2000 Crawford Placetime type: Full timeposted on: Posted Todayjob requisition id: R1059742# 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...

Medical Coding Specialist Fully Remote Mount Laurel, NJ 08054 Overview Salary Range $22.00 - $30.00 Hourly Position Type Full Time Travel Percentage 10% Description Exam Works is looking for a Medical Coding Specialist to join our team remotely! *Must possess current coding certification in CPC. CPMA certification & Certified Life Care Planner certification preferred. The Medical Coding Specialist (Internally called a Coding Specialist) is responsible to create and write reports based on medical records and appropriate guideline criteria. This position utilizes the system database to determine usual and customary and/or state fee schedule allowances and this position is responsible for analyzing provider billing for proper coding and billing guidelines across all provider types and ensures reviews are completed with highest quality and integrity and that all work is in full compliance with client contractual agreements, regulatory agency standards and/or federal and...

Hcc Risk Adjustment CoderLocation:Hybrid - Verona, NJ & Remote Schedule:Monday through Friday; 40 hours/week Employment Type:Full Time; Exempt Reports To:Director, Clinical Quality & TransformationThe HCC Coder is an essential administrative member of our dynamic health care team, focused on supporting the activities of the Population Health Department through various clerical duties. Excellent time management and an ability to work as part of a team are essential skills for this role. Willing to train the right candidate.ResponsibilitiesESSENTIAL DUTIES AND RESPONSIBILITIES (included but not limited to):Accurate data management including the retrieval of hospital records and obtaining reports from specialists and health care providers.Manage data entry on multiple spreadsheets to track workflows and outcomes.Ability to review documentation and abstract all codes with specific emphasis on identifying the most accurate severity of illness according to CMS HCC (Hierarchical...

Certified Professional Coder (CPC) Lead/Provider Liaison Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. This is a contract position with my direct client. Job Description Direct client need- immediate interviews- we have a strong hold, with many consultants working onsite! Location could be: Newark, NJ OR West Trenton OR Ewing OR Wall, NJ. Duration: Contract to hire. Job Summary: The Provider Liaison is accountable for extracting insights specific to providers and provider groups regarding commercial risk adjustment and developing educational materials for...