10 senior coding auditor jobs found

ARMA International in Brookline, Massachusetts, is seeking a Billing Compliance Reviewer. This role entails planning and executing audits, analyzing medical documentation, and ensuring compliance with regulations. The ideal candidate will have a strong background in healthcare coding and auditing. The position offers a salary range of $93,800.00 - $106,000.00 based on experience and skills. Qualified candidates must have at least 5 years of relevant experience and appropriate certifications. #J-18808-Ljbffr

South Shore Health System is seeking a Coding & Compliance Auditor to ensure medical coding accuracy and compliance. The role involves establishing audit processes, conducting training for clinical staff, and monitoring regulatory changes. Applicants should have at least 5 years of coding experience in an acute care setting, extensive knowledge in coding standards, and relevant certifications. Join a team committed to quality healthcare standards. #J-18808-Ljbffr

South Shore Health seeks a Coding & Compliance Auditor to evaluate medical record documentation and coding accuracy. The role designs and delivers training for clinical staff and coders while monitoring regulatory changes to ensure adherence to Federal, State, and local requirements. The incumbent will support multiple departments, maintain training tools, and report program effectiveness. Requires AHIMA/AAPC certifications and ongoing licensure. #J-18808-Ljbffr

Coding & Compliance Auditor The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. This is a hybrid position: 2 days onsite; 3 days remote option. Compensation Pay Range: $73,000.00 - $104,400.00 Job Responsibilities Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process. Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC's, PCS and ICD-10-CM codes. Perform prospective and retrospective audits to validate medical necessity and documentation...

Optum is seeking a qualified medical coder to join our telecommute team. This full-time role requires identifying appropriate medical codes across diagnosis and procedures, applying guidelines, and using medical coding software from your home. Normal hours are 8:00 am–5:00 pm CST, Monday–Friday, with occasional overtime or weekend work as needed. You will contribute to the revenue cycle by accurate coding, participate in audits, mentor others, and stay current with continuing education. #J-18808-Ljbffr

Job Requirements If you are an existing employee of South Shore Health then please apply through the internal career site. Requisition Number R-22463 Facility LOC0006 - 780 Main Street 780 Main Street Weymouth, MA 02190 Department Name SHS Compliance Status Full time Budgeted Hours 40 Shift Day (United States of America) Hybrid Position 2 days onsite; 3 days remote option. Description The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Compensation Pay Range $73,000.00 - $104,400.00 Job Responsibilities Establishes, implements, and maintains a formalized review process for coding...

Senior Medical Coding Analyst 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. 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 meetsand exceedsour 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 externally. They will play a pivotal role in improving the quality and efficiency of coding...

Locations Zurich, Switzerland; Boston, MA Job Description OBJECTIVES / PURPOSE Provides 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 educational interest, prioritize funding and enable consistent...

Job Description OBJECTIVES / PURPOSE Provides 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 educational interest, prioritize funding and enable consistent decision-making across geographies. Chairs and/or...

Job Description Job Description Key Responsibilities Authorization Management Obtain and verify prior authorizations for services, treatments, and procedures. Review patient insurance eligibility and benefits to ensure coverage requirements are met. Submit authorization requests accurately and timely through payer portals, fax, or phone. Track authorization status and follow up with insurance companies as needed. Maintain accurate documentation of authorization approvals, denials, and expiration dates. Communicate authorization updates to clinical and scheduling teams. Denial Management Review denied or rejected claims to identify root causes and trends. Research payer policies and determine appropriate corrective actions. Prepare and submit appeals with supporting documentation within payer deadlines. Work collaboratively with billing, coding, and clinical departments to resolve claim issues. Monitor denial reports and maintain denial logs for...