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10 jobs found

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Gainwell Technologies
Full Time
 
Clinical DRG Auditor – Remote
Gainwell Technologies Remote (USA)
It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary: We are seeking a talented individual for a Clinical DRG Auditor who is responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to validate the conditions that were documented in the medical record, the ICD-10-CM/PCS code assignments and determine the accuracy of DRG assignment that is clinically supported as defined by review methodologies specific to the...

Mar 10, 2026
New York Oncology Hematology
Full Time
 
Certified Billing and Coding Specialist
New York Oncology Hematology Hybrid (NY, USA)
SCOPE: Under minimal supervision performs periodic, comprehensive coding audits for all assigned regional oncologists (medical, radiation and surgical oncology).   Verifies charge documentation and charge submission processes are in compliance with Federal and State regulations, as well as payer guidelines. Coordinates efforts with manager and front office managers to ensure optimal revenue cycle processes and adherence to compliance and revenue cycle policies and procedures.  Provides effective educational feedback to physicians and staff on findings from audits and updates in Payer billing regulation . ESSENTIAL DUTIES AND RESPONSIBILITIES: Develops Audit and Education Programs Abstracts relevant clinical and demographic information from the medical record to assign current ICD and CPT codes in accordance with coding and reimbursement guidelines. Codes with an accuracy of 97% based on QA internal reviews Performs Evaluation and Management (E&M)...

Mar 02, 2026
MedReview
Full Time
 
DRG (Coding) Reviewer/Auditor
MedReview Remote
Position Summary At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare.  As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. Under the direction of the DRG Operations Department leaders, the DRG Reviewer will conduct reviews of inpatient claims for both coding accuracy as well as perform screening referrals for clinical support of coded diagnoses. Responsibilities: Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing. Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides. Collaborates with physician reviewers, as needed. Ability to prioritize and organize workload and complete tasks independently....

Feb 19, 2026
FH
Full Time
 
Corporate Compliance Specialist
Frederick Health Frederick, MD, USA
Supporting the Vice President & Chief Compliance Officer, the Compliance Specialist assists in carrying out the activities of the Frederick Health Compliance Program, including risk assessment, training & education, audits, policy development and internal investigations. Requirements: BA/BS required. MBA/MHA preferred. 5-10 years' experience in healthcare compliance and internal auditing. Certification preferred. Knowledge of laws, regulations, policies and procedures of governmental authorities and payers. Experience in developing and carrying out training and education of staff. Excellent oral and written communication skills. Strong organizational skills and ability to prioritize and manage multiple tasks. Ability to maintain a high level of confidentiality. The following experience & credentials are strongly preferred: Experience in healthcare revenue cycle or patient accounting (coding and/or billing) internal auditing and compliance....

Jan 15, 2026
MG
Full Time
 
Coding Auditor Behavioral Health
Marwood Group Hybrid (New York, NY, USA)
The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for a  Certified Coding Auditor  to work in its New York office or remotely.   Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers....

Mar 02, 2026
MG
Full Time
 
Certified Coding Auditor - Primary Care
Marwood Group Hybrid (New York, NY, USA)
The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for a Certified Coding Auditor to work in its New York office or remotely.   Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers....

Feb 27, 2026
JotPsych
Full Time Part Time
 
Behavioral Health Billing Specialist (Mid and Senior Level)
JotPsych Remote (USA)
IMPORTANT: To submit your application, please click "Apply" to view our full job description, then submit the form listed under "Application Process". We're looking forward to receiving your application! INTRODUCTION: JotPsych is hiring a Behavioral Health Billing Specialist at both the middle and senior level to own the end-to-end billing lifecycle for a dedicated set of JotBill customers—behavioral health and psychiatry practices that depend on us to get their claims submitted accurately and paid promptly. This is a high-ownership, execution-focused role. You'll run the billing independently—managing the full claim lifecycle with a high standard of accuracy and follow-through. You'll thrive here if you: Are comfortable owning multiple accounts end-to-end, without needing someone to review your work at every step Get satisfaction from resolving a denial that's been sitting open—and then identifying why it happened so it doesn't happen again Are...

Feb 24, 2026
UM
Full Time
 
INPATIENT CODING EDUCATION ANALYST
UW Medicine Remote
UW Medicine Enterprise Records and Health Information has an outstanding opportunity for an INPATIENT CODING EDUCATION ANALYSTS. WORK SCHEDULE 100% FTE Mondays - Fridays 100% Remote POSITION HIGHLIGHTS Performs daily activities related to auditing, education and training of one or more content areas ERHI has coding oversight for. Serve as an expert in Inpatient coding, respond to general coding questions (ICD, DRG, CPT and HCPCS), engage in the development and/or implementation of audit/monitoring plans, participate in the development and/or delivery of educational and outreach materials, report on unit activities, maintain unit records, monitor regulatory developments, and help develop Coding program policies and procedure. DEPARTMENT DESCRIPTION Enterprise Records and Health Information (ERHI) is a Shared Service Department that supports all aspects of the patient medical record from governance, integrity, documentation timeliness, completion, clinical...

Feb 23, 2026
University of Colorado Medicine
Full Time
 
Coding Education Specialist
University of Colorado Medicine Remote
University of Colorado Medicine (CU Medicine) is the region’s largest and most comprehensive multi-specialty physician group practice. The CU Medicine team delivers business operations, revenue cycle and administrative services to support the patients of over 4,000 University of Colorado School of Medicine physicians and advanced practice providers. These providers bring their unparalleled expertise at the forefront of medicine to deliver trusted, compassionate health care services at primary and specialty care clinics as well as facilities operated by affiliate hospitals of the University of Colorado. We are seeking 2 motivated  Coding Education Specialists  with an emphasis in Pathology/Interventional Radiology and Anesthesia/Radiation Oncology.  This job can be performed 100% remotely and out of state candidates will be considered. The Coding Education Specialist will primarily be responsible for supporting and leading ongoing education to existing coding staff,...

Feb 20, 2026
CH
Full Time
 
Coding Specialist
CHAS Health Spokane, WA, USA
Purpose of Job: Improve the overall health of the communities we serve by efficiently and accurately coding and processing claims.   Essential Duties and Responsibilities: Reviews health documentation and records to extract and ensure appropriate codes, including CPT, HCPCS, ICD-10/HCC, are captured in the electronic health records system. Codes and completes charge entry into electronic practice management systems. Researches and resolves coding related payer denials.  Serves as a documentation and coding subject matter expert to support CHAS Health teams and providers. Communicates with co-workers, providers, and third-party representatives in a professional manner while maintaining confidentiality according to HIPAA regulations. Ability to consistently adhere to established productivity standards required. Performs other duties as assigned, including supporting the CHAS Health Mission and Core Values. Qualifications: Education/Experience:...

Feb 18, 2026
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