Certified coding auditor jobs | Healthcare Careers

Community Health Network Indianapolis, IN, USA

1 day ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. Join Community Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, community is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields and to better serve our patients. And above all, it means exceptional care, simply delivered and we couldnt do it without you. Make a Difference Responsibilities The Certified Coding Auditor aims to enhance documentation, specificity, and coding precision to ensure continuity of care and clean claims for appropriate reimbursement. Your responsibilities will be: Reviewing coding accuracy The...

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Certified Coding Auditor Primary Care

Marwood Weehawken Township, NJ, 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 firms private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, workers 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. Researching state...

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Certified Coding Auditor: Drive Accurate Claims & Compliance

Community Health Network Indianapolis, IN, USA

A healthcare organization is seeking a Certified Coding Auditor in Indianapolis to ensure coding precision and maintain documentation standards. The successful candidate will review coding accuracy, apply updates, and draft audit findings. Key requirements include a High School Diploma or GED, certifications like CCS or CPC, and 3+ years of medical coding experience. The role offers competitive pay and benefits, contributing to a dedicated healthcare team. #J-18808-Ljbffr

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Certified Coding Auditor

Community Health Network Indianapolis, IN, USA

Join Community Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, "community" is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields and to better serve our patients. And above all, it means exceptional care, simply delivered - and we couldn't do it without you. Make a Difference The Certified Coding Auditor conducts internal coding audits with a primary focus on diagnosis and procedure coding accuracy. This role enhances documentation, specificity, and coding precision to ensure continuity of care and clean claims for appropriate reimbursement. Responsibilities include reviewing coding accuracy, applying coding updates, ensuring...

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Certified Coding Auditor

St. Joseph’s Healthcare System Paterson, NJ, USA

Job Description Responsible for accurately abstracting data following the Official International Classification of Diseases (ICD)-10-Clinical Modification (CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Guidelines for Coding and Centers for Medicare and Medicaid Services (CMS) directives. Performs data entry of required abstracted patient information into the system. Queries physicians when appropriate. Qualifications High School diploma, general equivalency diploma (GED), and/or GED equivalent programs. Certified Professional Coder with Minimum of two to three year of coding for professional services Strong understanding of physiology, medical terms and anatomy. Proficiency in computer skills including typing speed and accuracy. Excellent written and verbal communication skills. Proficient computer skills including but not limited to Microsoft Office Must be able to achieve and maintain appropriate coding...

Full Time

Quality Analyst / Coding Auditor I

Physicians Choice LLC Remote

Physicians' Choice is currently seeking a highly proficient and seasoned Medical Coding Auditor specializing in Evaluation and Management (E/M) services, with a comprehensive understanding of Emergency Medicine, to join our esteemed team. If you possess extensive expertise in current E/M coding guidelines and have a strong background in auditing, we invite you to apply for this exceptional opportunity. Job Description: As a Medical Coding Auditor you will play a vital role in ensuring accurate and compliant coding practices within our organization. You will be responsible for conducting detailed audits of medical records, coding documentation, and related billing processes to verify compliance with established coding guidelines, regulatory requirements, and internal policies. Responsibilities: Perform comprehensive audits of medical records, coding documentation, and billing processes. Evaluate the accuracy, completeness, and appropriateness of medical...

Full Time Part Time

Fractional CoCM Billing Compliance & Audit Lead (CPMA required)

Mederva Health Remote

About the role We run a fast-growing care management program billed under partner clinic TINs across a mixed payer population. We need an expert to tighten CoCM billing yield while keeping documentation audit-proof as we scale from ~24 clinics to 100+. The right candidate will be able to convert this into a full-time role with equity, and grow with the company. Looking to hire ASAP. What you’ll own Design and audit CoCM and CCM billing workflows , including appropriate patient stratification between programs. Define clear, defensible criteria for assigning patients to CoCM vs CCM (and transitions over time). Build “gold standard” documentation templates and checklists for 99492/99493/99494, 99490, 99439 , and related codes as applicable. Design simple, audit-proof time capture and attribution workflows across care team members. Create and run a QA sampling plan with feedback loops for care teams and clinic billers. Partner with...

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Full Time

Healthcare Compliance Audit Analyst (Must have CPC, CCS-P, or CPMA)

U.S. Urology Partners Remote

General Summary: U.S. Urology Partners, LLC (USUP) and its physician groups are committed to promoting conduct that is responsible, ethically sound, and compliance with applicable law. USUP’s Compliance Department (CD) fosters a corporate culture of ethical behavior and integrity in all matters related to compliance with the laws and regulations that govern the delivery and reimbursement of health care. An integral function of USUP’s compliance program is auditing and monitoring compliance with billing, coding, and documentation requirements of its providers. An CPC, CCS-P, or CPMA is required for this position. Compliance Audit Services: Compliance audit initiatives include physician, other providers, and facility documentation audits as well as preparation of guidance documents and tools to assist physicians and staff in appropriate billing, coding, and documentation. The audit program looks at professional fee billing,...

AC

Full Time

System Professional Coding Provider Review and Education Manager

Anonymous Company Hybrid

Job Title: Manager Location: System Business Office Department Name: HIM - Professional Req #: 0000207266 Status: Salaried Shift: Day Pay Range: $110,681.00 - $156,337.00 per year Pay Transparency: The above reflects the anticipated annual salary range for this position if hired to work in New Jersey. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience. Job Overview: The System Professional Coding Provider Review and Education Manager is responsible for onboarding, educating, and reviewing medical record documentation and coding processes of the Medical Group physicians, APNs and other billing providers across all medical centers within the RWJBH enterprise. This includes onboarding education, medical record reviews, targeted education to physician groups and individual physicians, annual and quarterly...

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Full Time

Expert Witness

AccuMed Healthcare Research LLC Remote (GA, USA)

About Our Company AccuMed is the premier provider of litigation support including expert witness services for medical damages. We offer historical and future cost analysis to support quick and successful pre-litigation outcomes using our database of over 20 billion patient encounters to establish the reasonable value of healthcare costs. We provide powerful and transparent data to establish, refute, or defend the reasonable value of medical charges. Job Overview AccuMed is seeking an operationally driven and strategically minded professional to continue development and expansion of our largest business segment: Expert Witness Services . This role centers on delivering expert witness services to our clients, including the formation and defense of expert opinions related to the reasonable value of medical costs. The position will involve case-by-case analysis, deposition, and courtroom testimony. Candidates must be confident in articulating and defending their...

Full Time

Pro Fee & Pro Clinic Medical Coders

Healthcare Coding & Consulting Services (HCCS) Remote (USA)

Healthcare Coding and Consulting Services (HCCS) is hiring multiple full-time, experienced, and certified Pro Fee and Pro Clinic Coders across several outpatient specialties. These are fully remote, direct-hire W-2 positions offering long-term stability and consistent, specialty-aligned work. We currently have multiple Pro Fee and Pro Clinic openings supporting specialties such as Family Medicine, Internal Medicine, Rural Health Clinic (RHC), and other clinic-based services. We are seeking coders with strong E/M expertise who are comfortable in high-volume production environments and have recent hands-on Pro Fee and Pro Clinic coding experience. At HCCS, coders are assigned based on proven specialty expertise to ensure alignment with providers and chart types where they can perform at their highest level. Our Coding and Scheduling Managers work closely with coders to support accuracy, productivity, and workflow consistency. As a family-owned, U.S.-based company,...

Contract

Multi-Specialty Professional Coder - Contractor

AAPC Remote

AAPC is seeking a highly motivated and dedicated coding professional to join our team as a Contract Coder. This position is a fully remote contract role. The ideal candidate must have at least 5 years of coding experience for physician practices, with various surgical specialties as well as E/M. The position requires one to be resourceful, organized, and extremely driven. The ideal candidate will possess the following: Minimum 5 years of coding experience Extensive coding in multiple specialties including: all primary care specialties, anesthesia, general surgery, dermatology, and orthopedics. Excellent written and verbal communication skills Detail oriented and deadline driven attitude Sound knowledge of medical terminology Strong computer skills (Excel, Word, and internet) Ability to multitask and keep a sense of urgency Excellent customer service skills Strong time management, organization skills, and work ethic Job Duties:...

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Certified Professional Coder

InstantServe LLC DE, USA

Coding And Billing Auditor Job Coding and billing auditor job is fully onsite.

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Risk Adjustment Coding, Auditor

Cano Health Doral, FL, USA

Overview It's rewarding to be on a team of people that truly believe in making an impact! We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us. Job Summary The ACO Coding Auditor is responsible for reviewing medical records and identifying, collecting, assessing, monitoring, and documenting claims and encountering information as it pertains to Medicare Risk Adjustment. You implement ongoing quality improvement activities to assure the Medicare Risk score meets all requirements and act as a consulting MRA advisor to the practices you support. You review practices for both CMS and Commercial ACOs for quality compliance. Essential Duties & Responsibilities Performs on-site and remote clinical validation audits and interpretation of medical documentation to capture all Medicare Risk codes in coordination with the physician. Provides guidance and consultation to practice team members to drive...

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Lead Medical Coder and Auditor [PR0001D]

ProSidian Consulting Fort Stewart, GA, USA

Lead Medical Coder and Auditor ProSidian Consulting is looking for a talented professional ready to deliver real value to clients in a fast-paced, challenging environment. ProSidian Consulting is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. ProSidian seeks a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land...

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Compliance Auditor (PT- 0.5 fte, Day Shift)

Bozeman Health Bozeman, MT, USA

Position Summary: The Compliance Auditor supports an effective compliance program by planning and executing risk-based audits, monitoring adherence to federal and state regulations, and evaluating internal controls and procedures. The role partners with departments across the organization to assess billing, coding, privacy/security, and operational practices; identifies vulnerabilities; and recommends corrective actions that promote ethical, compliant operations. The position prepares clear reports for leadership and supports survey readiness, investigations, and ongoing education to sustain compliance. Qualifications: Bachelor’s degree in healthcare administration, business, accounting, or related field. Professional certification (e.g., Certified in Healthcare Compliance (CHC), Certified Professional Compliance Officer (CPCO)); or ability to obtain within twelve (12) months of hire. Three (3) years of experience in healthcare compliance, auditing, or a...

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Revenue Cycle Coding Auditor/Trainer (5032)

SIU MEDICINE Springfield, IL, USA

We recommend using the following browsers to complete the application: Desktop: Google Chrome, Edge with Chromium Mobile: Google Chrome, Safari Description The Revenue Cycle Coding Auditor will perform reviews for employees in the Coding department. Audits will include, but are not limited to; employee productivity and quality based on proper documentation, accuracy and coding guidelines. The Auditor will also provide feedback and support relating to departmental/role specific productivity and quality expectations. The incumbent for this position will utilize a high level of in-depth knowledge of the coding role to perform all audits based on specific departmental need. #IND1 Examples of Duties PBS Auditor: 100% Conduct quality and productivity reviews of coding staff using structured and consistent review programs and methods. Demonstrate in-depth knowledge and experience with SIU-HC supported applications, including but not limited to Athena IDX,...

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Medical Coder, Program Integrity

South Dakota Staffing Pierre, SD, USA

Evolent Health Care Program Integrity Coder- FWA Auditor Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in...

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Medical Coding Auditor

UNM Medical Group Augusta, GA, USA

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This is a work from home position that requires the selected candidate to have a permanent address and live in New Mexico or be willing to relocate to New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217 Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical...

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Coder Quality Auditor

Ensemble Health Partners Augusta, GA, USA

Coder Quality Auditor The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties. Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess coders'...

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DRG Validation Coding Auditor

Ensemble Health Partners Dayton, OH, USA

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

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Physician Coding Auditor

MedKoder Dayton, OH, USA

Physician Coding Auditor This is a full-time, remote position that offers a flexible schedule. Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare, Medicaid, and third-party payer guidelines to ensure receipt of accurate reimbursement. Physician Coding Auditor is expected to adhere to MedKoder's internal coding/auditing policies and expectations set forth by department management. Physician Coding Auditor must prioritize daily duties, communicate effectively, and make the decisions necessary to complete all assigned tasks and accomplish their goals. Candidates ideally have recent auditing experience specializing in some of the following profee areas: Ophthalmology, Behavioral Health, Cardiovascular/Cardiothoracic Surgery, Complex ENT Surgery, Dental, Complex Plastic Surgery, Orthopedic Surgery, Peds...

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Medical Coder, Program Integrity

Arkansas Staffing Little Rock, AR, USA

Evolent Health Care Program Integrity Coder- FWA Auditor Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in...

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Medical Coder, Program Integrity Specialist

Evolent Salt Lake City, UT, USA

Your Future Evolves Here Evolent is on a mission to transform healthcare for individuals with complex and costly conditions. By collaborating with health plans and providers, we aim to create a more integrated healthcare system that offers high-quality care and compassion, just as we would want for our loved ones. We value work/life balance, offering flexible schedules that allow you to tailor your work to your life. Our commitment to diversity and inclusion ensures that you can bring your whole self to work. Join Evolent not only for the impactful mission but also for a supportive and inclusive culture. What You'll Be Doing: As a Program Integrity Coder and FWA Auditor, you will play a crucial role in ensuring the integrity of claims by reviewing and verifying complex claim submissions for compliance with coding standards and billing guidelines. You will foster meaningful partnerships with both internal and external stakeholders while thriving in a collaborative...

962 certified coding auditor jobs found