1425 certified coding auditor jobs found

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. Researching...

Title: Senior Certified Coding Auditor and Trainer Location: Columbia, SC Status: Full-Time Who Are We? Part of the Novant Health family based in North Carolina, Novant Health Urgent Care (formerly Doctors Care) provides exceptional healthcare through our network of more than 50 urgent care centers and 20 physical therapy facilities across South Carolina. Our Columbia-based headquarters delivers non-medical management and administrative services to support these locations. For decades, we have been committed to delivering exceptional, convenient, and affordable healthcare experiences to families and communities throughout the Palmetto State. What Do We Offer? Competitive wages Generous PTO that increases with tenure 403B Health, dental, vision insurance Flexible Spending Account Short term and Long term Disability Whole and Term Life Insurance Rewarding Careers What Are We Looking For? Novant Health Urgent Cares is currently seeking a...

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

Focused on ensuring accurate coding and compliance with regulations, the full-time Certified Coding Auditor - Oregon will perform documentation and coding reviews across various specialties while maintaining current knowledge of coding guidelines and standards in a remote work environment. Key responsibilities Perform documentation and coding reviews within assigned work queues across various specialties Utilize coding tools to assist in the accurate assignment of coding and escalate trends and issues as necessary Engage in continued development of coding knowledge and maintain certification while addressing complex coding issues and project work as assigned Required qualifications Minimum two (2) years of work experience in a healthcare setting Minimum one (1) year of professional coding experience Certification as a Certified Professional Coder, Registered Health Information Technician, or equivalent coding certification Working knowledge of Microsoft Word, Excel, and...

Providing high-level technical expertise, the full-time remote Certified Coding Auditor and Educator will conduct comprehensive audits, analyze coding patterns, and develop targeted education programs to ensure compliance and improve documentation quality within professional services. Key responsibilities: Conduct comprehensive audits of professional coders and providers to ensure accuracy and compliance with coding guidelines Analyze documentation and coding patterns to identify compliance risks and provide actionable feedback Develop and deliver training programs based on audit findings and regulatory updates Required qualifications: Associate degree in Health Information Management or a related field, or equivalent education and experience Comprehensive knowledge of ICD-10, HCPCS, CPT, and HCC guidelines Three to five years of professional coding or auditing experience Required certifications: RHIT, RHIA, CCS, or CPC

Conducting proactive audits and compliance investigations, the full-time remote Certified Coding Auditor II will identify and address billing and coding errors while ensuring adherence to healthcare regulations and coding guidelines. Key responsibilities Initiate and perform coding and billing audits to detect potential errors and ensure compliance before claims submission Analyze billing and coding data to identify patterns of non-compliance and assess the accuracy of medical service documentation Prepare detailed audit reports summarizing findings and recommendations, and collaborate with departments to implement corrective actions Required qualifications Associate's degree in a related field from an accredited institution or equivalent experience Minimum of four (4) years of progressively responsible work experience in billing and coding compliance Knowledge of coding conventions including ICD-10-CM/PCS, HCPCS, E&M, and CPT Ability to conduct detailed healthcare...

Focused on ensuring accurate coding and claim submission, the full-time Oregon Certified Coding Auditor will perform documentation and coding reviews across various specialties while maintaining compliance with regulatory guidelines and audit standards in a remote work environment. Key responsibilities Conduct documentation and coding reviews within assigned work queues across multiple specialties Maintain up-to-date knowledge of coding regulations and escalate identified trends and issues as necessary Assist with complex coding issues and participate in project work as assigned Required qualifications Minimum two (2) years of work experience in a healthcare setting Minimum one (1) year of professional coding experience Certification as a Certified Professional Coder, Registered Health Information Technician, or equivalent coding certification Working knowledge of Microsoft Word, Excel, and medical terminology Strong time management skills and ability to meet deadlines

Working remotely, the full-time Certified Coding Auditor will ensure accurate coding and support clinical documentation within health records while educating teams on compliance best practices. Key responsibilities Assist with retrospective and concurrent coding for PACE Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits and participate in provider education programs to ensure compliance with CMS coding guidelines Required qualifications Associates Degree preferred, or three (3) years of relevant experience in lieu of a degree Minimum of four (4) years of related experience in coding and auditing At least two (2) years of Risk Adjustment (HCC) coding experience in a managed care environment Current CCS, CCS-P, CPC, CPC-H, CPMA, or CRC credential Strong knowledge of ICD-10 coding standards and M.E.A.T. concepts

To support a growing healthcare organization, the full-time remote Professional Coding Auditor will review clinical documentation and coding for accuracy, provide educational feedback, and collaborate with leadership to enhance coding quality and reimbursement. Key responsibilities Perform coding audits of provider documentation and assigned CPT and ICD-10 codes Identify coding errors and documentation deficiencies while providing constructive feedback to providers and coders Collaborate with the Coding Supervisor and Regional Medical Directors to improve documentation and coding accuracy Required qualifications Active CPC or CCS coding certification through AAPC or AHIMA 2+ years of medical billing experience, preferably in Urgent Care or Occupational Health Experience with billing software and electronic medical records; Epic experience is a plus Strong understanding of medical coding and documentation requirements High school diploma or equivalent

To support laboratory operations, the full-time Laboratory Coding Auditor/Educator will conduct coding audits, provide targeted education for billing representatives and pathologists, and ensure compliance with coding regulations while working remotely. Key responsibilities Conducts coding audits and provides education on CPT, HCPCS, modifier, and place of service coding Performs billing workflow and charge integrity audits to ensure accurate transmission of laboratory orders to EPIC Tracks audit statistics and trends coding-related denials to advise leadership on resolution opportunities Required qualifications Registered Health Information Technician (RHIT) certification Certified Professional Coder (CPC) certification High school diploma or G.E.D Experience in coding and billing practices Ability to provide one-on-one and group education to team members

Universal Health Services, Inc. seeks a Coding Auditor to determine ICD-10, CPT-4, and HCPCS coding alignment with clinical documentation and to validate medical necessity per LCDs. The role requires CPC certification and experience in professional billing, auditing, and the revenue cycle. The position involves reviewing documentation, educating providers on coding requirements, and ensuring timely, accurate audits across IPM services. #J-18808-Ljbffr

Responsible for audits which are internal record reviews for compliance with coding regulations and guidelines in order to provide rebuttals to CMS or other payer denials and to assist and improve on physician correct coding/documentation education. Provides assistance with the creation of EMR templates in order to to improve capture of correct documentation to support E&M (Evaluation and Management Coding) levels. Responds to government and other payers records requests and audits. Qualifications Work requires the level of knowledge normally acquired through the completion of two to three years of occupationally specific education beyond high school OR an Associates degree in Medical Record Technology or closely related field and two to three years of previous work related experience. Certified coder with auditing experience required for ensuring accuracy of coding and documentation on hard copy charts and electronic forms and using ICD/CPT. Monitors regulatory changes on...

Job Description Responsible for audits which are internal record reviews for compliance with coding regulations and guidelines in order to provide rebuttals to CMS or other payer denials and to assist and improve on physician correct coding/documentation education. Provides assistance with the creation of EMR templates in order to improve capture of correct documentation to support E&M (Evaluation and Management Coding) levels. Responds to government and other payers records requests and audits. Qualifications Work requires the level of knowledge normally acquired through the completion of two to three years of occupationally specific education beyond high school OR an Associates degree in Medical Record Technology or closely related field and two to three years of previous work related experience. Certified coder with auditing experience required for ensuring accuracy of coding and documentation on hard copy charts and electronic forms and using ICD/CPT. Monitors regulatory...

Join to apply for the Certified Coding Auditor (2506830) role at Community Health Network Your role The Certified Coding Auditor aims to enhance documentation, specificity, and coding precision to ensure continuity of care and clean claims for appropriate reimbursement. What you’ll do Review coding accuracy Apply coding updates Adhere to coding guidelines Documentation requirements for both facility and professional coding Draft audit findings to communicate audit scope, methodologies, results, and identified trends to Coding Leadership Remember that individuals may perform additional related duties not listed here. What we’re looking for High School Diploma or GED (Required) Vocational / Technical Degree (Preferred) Associate Degree (Preferred), Bachelor’s Degree (Preferred) Certifications: Certified Coding Specialist (CCS) OR Certified Procedural Coder (CPC) (Required) AAPC CPMA certification is preferred 3+ years medical coding experience with knowledge of...

Job Title Use coding skills to review clinical documentation to accurately code for anesthesia services. Retrieve information from hospital EMR systems to resolve coding questions to support offshore vendors. To work daily tasks/edits in billing system. Primary Responsibilities Review medical record documentation to identify correct coding based on billing and payor guidelines. Research, analyze and respond to inquiries regarding compliance and inappropriate coding denials. Retrieve missing patient documentation required for accurate billing. Work task queues within various systems. Support offshore vendor coding questions. Recommend vendor education based on tasks reviewed. Required Qualifications Minimum of 2 years' professional medical coding experience. CPC or CCS-P certification. Proficient computer skills Desired/Preferred Qualifications Insurance billing knowledge Excel Knowledge of CMS guidelines Total Rewards Generous benefits package, including:...

Job Title Melville,NY - USA Position Requirements Use coding skills to review clinical documentation to accurately code for anesthesia services. Retrieve information from hospital EMR systems to resolve coding questions to support offshore vendors. To work daily tasks/edits in billing system. Primary Responsibilities Review medical record documentation to identify correct coding based on billing and payor guidelines. Research, analyze and respond to inquiries regarding compliance and inappropriate coding denials. Retrieve missing patient documentation required for accurate billing. Work task queues within various systems. Support offshore vendor coding questions. Recommend vendor education based on tasks reviewed. Required Qualifications Minimum of 2 years' professional medical coding experience. CPC or CCS-P certification. Proficient computer skills Desired/Preferred Qualifications Insurance billing knowledge Excel Knowledge of CMS...

Job DescriptionResponsible 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.QualificationsHigh 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 servicesStrong 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 OfficeMust be able to achieve and maintain appropriate coding quality and productivity as...

A healthcare services organization is seeking a Medical Record Audit / Coding Auditor to oversee the development of a clinical coding audit program. The role involves conducting compliance reviews, training coding associates, and ensuring adherence to coding regulations. Candidates must have at least five years of experience in physician coding and be a certified professional coder. This job offers an opportunity to impact billing accuracy and training processes within the organization. #J-18808-Ljbffr

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality...

Join Our Caring Community Humana, a Fortune 100 Company, is looking for an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for improvement...