32 quality coding auditor jobs found

A healthcare solutions company is seeking a skilled RCS Medical Coding Auditor to perform audits on professional fee medical coding. The ideal candidate should possess a CPC certification and 2+ years of ProFee auditing experience, with a strong focus on accuracy and compliance. Responsibilities include conducting daily quality assurance, validating coding against documentation, and providing training to improve coding practices. This position supports hybrid work and includes a competitive salary range of $57,728 to $80,243. #J-18808-Ljbffr

Coding Validation AuditorsTwo positions to fill:Surgical Coding Auditor: The ideal candidate will have experience auditing surgical/procedural coding and validating coding accuracy, documentation support, CPT/HCPCS and ICD-10-CM code assignment, modifier usage, and compliance with applicable coding guidelines.E/M Coding Auditor: The ideal candidate will have experience auditing Evaluation and Management (E/M) services, with a strong understanding of E/M documentation requirements, code selection, medical necessity, and applicable coding guidelines.Job Summary: The Coding Validation Auditor is responsible for performing quality reviews of medical records for coding and billing to ensure the clinical information within the medical record is accurate, complete, and compliant to support coding. Assists with evaluating and ensuring proper and complete authorization was obtained for procedures performed on the prior authorized date of service. This position is eligible for the remote...

Description Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina. Summary: Performs technical and administrative work reviewing, abstracting and assigning accepted medical CPT, HCPCS, and ICD-10 codes for professional services. Duties are performed in compliance with third party, state and federal regulations according to standardized procedures. Employees report to an administrative superior but independently handle assigned tasks. Responsibilities: Assigns International Classification of Diseases 10-CM diagnostic and ICD-10-PCS procedural codes accurately and productively, and other applicable codes such as MS-DRG on inpatient cases for all Health Care system cases excluding the academic medical center Groups codes and completed product into payment group. Assigns codes that affect Severity of Illness and Risk of Mortality and...

RCS Medical Coding AuditorThe RCS Medical Coding Auditor is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback.The ideal candidate brings strong hands-on experience with professional fee coding, deep knowledge of E/M, surgical, and modifier use, and the ability to translate audit findings into actionable insights.Key ResponsibilitiesPerform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedbackValidate ICD?10?CM, CPT®, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelinesConduct medical chart audits of professional services across multiple specialtiesIdentify coding...

RCS Medical Coding Auditor page is loaded## RCS Medical Coding Auditorremote type: Hybridlocations: Raleigh, NCtime type: Full timeposted on: Posted 7 Days Agojob requisition id: JR10360**Position Summary**The **RCS Medical Coding Auditor** is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback.The ideal candidate brings strong hands-on experience with **professional fee coding**, deep knowledge of **E/M, surgical, and modifier use**, and the ability to translate audit findings into actionable insights.**Key Responsibilities*** Perform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedback* Validate ICD‐10‐CM, CPT(R), HCPCS, and modifier assignment against clinical documentation to...

Internal Auditor The Internal Auditor is responsible for conducting regular medical record and coding compliance reviews to ensure that organizational strategies, practices and internal controls are in place and in compliance with all legal and industry regulations. Regularly reviews appropriate federal and state regulations, industry standard policies and procedures, i.e., CMS, AHIMA, AMA, etc., to ensure compliance Conducts internal audits, following established protocols, furnishing detailed reports and periodic updates of audit findings, presenting any irregularities or exceptions, as well as pertinent recommendations for improvement, to the Provider, Auditing Supervisor, executive management, the Compliance Committee, Physician Board and others as appropriate Provides feedback and instruction to the Provider regarding documentation improvements, to include EHR best practices Essential Duties/Responsibilities: Serve as a compliance resource for all coding...

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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....

Medical Coder SpecialistAt Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health.This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington.*Now offering a $10,000 sign-on...

Medical Coding Specialist Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States About Judi Health Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels. At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. Location:...

Risk Adjustment Coder Come explore career opportunities with Liberty Healthcare Management, a dynamic leader in the healthcare industry. Join us! We are currently seeking an experienced: RISK ADJUSTMENT CODER Job Summary: Perform code abstraction of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation Identify diagnosis and chart level impairments and documentation improvement opportunities for provider education Develop process for chart review Assist coding leadership and clinical team by making recommendations for process improvements to further enhance coding goals and outcomes Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations Consistently maintain a minimum 95% accuracy on coding quality audits Meet minimum productivity requirements Ability to work independently in a remote environment Handle other related duties as required or...

LOCATION: Greensboro, NC Hours: Monday - Friday, 8:30am to 5:00pm PAY: $19-$21/HOUR OPEN TO ENTRY LEVEL CODERS OR INDIVIDUALS WHO JUST OBTAINED THEIR CPC-A! MEDICAL BILLING KNOWLEDGE A PLUS! Responsibilities: Review medical records, provider documentation, and clinical notes to assign accurate ICD-10-CM, CPT, and HCPCS codes. Ensure coding aligns with official coding guidelines, payer-specific rules, and regulatory requirements (CMS, OIG, HIPAA). Query providers when documentation is unclear, incomplete, or inconsistent. Work collaboratively with billing and revenue cycle teams to resolve coding-related claim edits, denials, or rejections. Maintain productivity and accuracy benchmarks as defined by the organization. Participate in internal audits, compliance reviews, and quality improvement initiatives. Stay current with coding industry updates, regulation changes, and payer policy revisions. Protect patient confidentiality and uphold all HIPAA standards. All qualified applicants...

Medical Records Coder IIAt Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington.*Now offering a $10,000 sign-on bonus...

Select how often (in days) to receive an alert: Select how often (in days) to receive an alert: At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Virginia, South Carolina, Tennessee, Florida, and Texas. Occ Summary The Medical Records Coder II is a certified Coder. Coordinate/review...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Willing to pursue your passion for caring with the Patient Revenue Management Organization, the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Virginia, South Carolina, Tennessee, Florida, and Texas. Occ Summary The Medical Coder Specialist will have frequent and daily interactions with internal and external clients, including but not limited to physician and non‑physician surgical providers. Responsibilities include primary...

RCM Specialist / Medical Biller (Hybrid) Albany, New York, United States; Albuquerque, New Mexico, United States; Lakewood, Washington, United States Why Workit: Workit Health is an industry-leading provider of on-demand, evidence-based telemedicine care. Our programs are based in harm reduction, and bring together licensed clinicians who really listen, FDA-approved medication, online recovery groups and community, interactive therapeutic courses, and care for co-existing conditions. Workit Health's patient-centered telemedicine model is improving clinical outcomes and eliminating barriers to treatment, making long-term recovery accessible to individuals who need it, without disrupting their daily lives. We’re excited to expand our team as our impact and coverage areas continue to grow. Our team members are dedicated and passionate about our mission of making exceptional, judgment-free care for addiction more accessible. We believe everyone deserves respectful, effective...

Compensation: USD 68000 - USD 85000 - yearly Company Description *Candidate should ideally be located in Charlotte, NC* Monro’s family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach. Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company’s regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color. Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto...

Carolina Oncology Specialists has been providing compassionate, patient-centered care since 1983, delivering high-quality oncology and hematology services tailored to each individual's needs. Patients benefit from the convenience of receiving chemotherapy treatments in our clinics, along with expert diagnosis, treatment, and management of a wide range of blood disorders. Why Join Us? We are seeking talented, compassionate, and highly motivated individuals who are passionate about making a difference. At Carolina Oncology Specialists, you'll have the opportunity to support the meaningful work of community oncology while helping provide exceptional care and hope to the patients and families we serve. Join a team dedicated to clinical excellence, collaboration, and improving lives every day. Job Summary Certified Coding Specialist (Remote) Organization: Carolina Oncology Specialists Location: Fully Remote (U.S.-based candidates only, preference for NC residents) Department: Billing...

Overview Make a Difference. Grow in Your Career. Thrive with Us. About the Role At Mindpath Health , we’re on a mission to make mental health care more accessible and more human. As a national leader in mental health services, we empower our clinicians, support our teams, and prioritize care that helps people truly thrive. The Certified Professional Coder (CPC) is responsible for performing professional coding services for theRCM Team, while following AMA and CMS medical coding guidelines . The primary function of thisposition is to utilize CPT, ICD-10-CM, HCPCS and coding guidelines to ensure accurate coding asrelates to medical documentation. A Certified Professional Coder will provide research and assist inresolving rejections, denials, and any coding/carrier related inquiries. This role reviews, analyzes, andcodes diagnostic and procedural information that determines Medicare, Medicaid, and private insurancepayments. The Certified Professional Coder must work to remain up to...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Summary Join the Indian Health Service and make a meaningful impact in Native communities. In this role, you will support vital healthcare operations that ensure patients receive timely, high-quality care. If you're looking for a rewarding career where your work directly supports patient services and community well-being, we encourage you to apply. Duties Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final diagnoses accurately reflect care provided. Reviews provider documentation to ensure appropriate Evaluation and Management (E/M) levels and correct CPT code assignment. Assigns and sequences ICD, CPT, HCPCS, CDT, and DSM codes based on documented diagnoses and procedures. Ensures diagnostic and procedural terminology aligns with current medical nomenclature and...

Patient Revenue Management Organization At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington. *Now...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina,Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington....