1381 certified coding auditor jobs found

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...

To optimize the revenue cycle, the full-time remote Certified Coding Auditor will ensure accurate and timely reimbursement by proactively resolving medical coding claim defects and providing expert guidance on corrections to prevent future issues. Key responsibilities Research and review coding-related claim denials to recover lost revenue and prevent future issues Address pre-billing resolution of coding defects to safeguard against reimbursement impacts Utilize a robust understanding of medical coding and reimbursement methodologies to enhance financial accuracy and efficiency Required qualifications High school diploma or equivalent Minimum of one year of coding experience or two years in a healthcare environment Certification from AAPC or AHIMA (e.g., CPC, CCA, CCS, CCS-P, RHIT, RHIA) Working knowledge of human anatomy, physiology, and medical terminology Ability to work under pressure to meet deadlines with minimal supervision

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 and payer...

To support coding and auditing functions, the remote CPC Certified Coding Auditor will perform inpatient and outpatient coding audits, prepare reports, and present audit findings to stakeholders. Key responsibilities Conduct coding and compliance audits for providers, preparing and presenting detailed reports Ensure accurate application of coding guidelines and provide education to physicians on audit findings Evaluate and report on the quality of physician documentation related to coding and medical necessity Required qualifications High School diploma or equivalent required CPC or CCS coding certification required from AHIMA or AAPC Minimum 5 years of coding experience with at least 2 years in auditing in a multi-specialty setting Proficiency in Microsoft Office Suite and job-related software Strong interpersonal skills with the ability to communicate effectively at all organizational levels

Focused on Coding & Clinical Chart Validation, the full-time Certified Coding Auditor will conduct audits of outpatient and specialty claims, ensuring coding accuracy and compliance with medical necessity and treatment appropriateness. Key responsibilities Audits outpatient and specialty claims using medical chart coding principles and client-specific guidelines Utilizes advanced audit tools and maintains productivity and quality standards in auditing processes Identifies new claim types and recommends improvements to enhance audit production and client satisfaction Required qualifications Associate or bachelor's degree in Health Information Management (RHIA or RHIT) or equivalent experience Coding certification (e.g., CPC, CIC, CCS, CCS-P, RHIA, or RHIT) required and maintained 5 to 7 years of experience in clinical medical record coding or auditing, with knowledge of HIPAA and CMS requirements Expert knowledge of coding guidelines, including DRG, ICD-10, CPT, and...

To support coding and auditing functions, the remote CPC Certified Coding Auditor will perform inpatient and outpatient coding audits, prepare reports, and present audit findings to stakeholders. Key responsibilities Conduct coding and compliance audits for providers, preparing and presenting detailed reports Ensure accurate application of coding guidelines and provide education to physicians on audit findings Evaluate and report on the quality of physician documentation related to coding and medical necessity Required qualifications High School diploma or equivalent required CPC or CCS coding certification required from AHIMA or AAPC Minimum 5 years of coding experience with at least 2 years in auditing in a multi-specialty setting Proficiency in Microsoft Office Suite and job-related software Strong interpersonal skills with the ability to communicate effectively at all organizational levels

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 state and payer...

Job Posting 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 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 quality and productivity...

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 quality and...

Humana Inc is seeking a Medical Coding Auditor to join the SIU clinical review team in Des Moines, Iowa. This role involves reviewing medical records for coding accuracy, applying Evaluation & Management coding principles, and communicating findings to stakeholders. Candidates must have CPC certification and acute outpatient coding experience. The position offers a remote work environment with occasional office visits for training or meetings. Benefits include medical, dental, vision, and a retirement plan. #J-18808-Ljbffr

Humana Inc is seeking a Medical Coding Auditor to join their SIU clinical review team. The role entails reviewing medical records for coding accuracy and communicating audit results to stakeholders. Required qualifications include CPC Certification and experience in acute outpatient coding. The position offers remote work with occasional travel and provides a pay range from $59,300 to $80,900 per year, along with a comprehensive benefits package including medical, dental, and 401(k). #J-18808-Ljbffr

To ensure the accuracy of HCC coded records, the full-time remote HCC Coding Quality Specialist (Auditor) will review coding compliance with Medicare and ICD-10-CM guidelines, support coder education on findings, and maintain a quality score of 95% or higher. Key responsibilities: Review HCC coded records for compliance with Medicare and ICD-10-CM guidelines Support coders by clearly identifying errors and providing educational feedback Assist in creating training materials and presentations for the HCC coding team Required qualifications: Certification through AAPC or AHIMA (CPC, CRC, CCS, or CCS-P) is mandatory At least 3 years of HCC coding experience and 2 years of auditing experience Global experience in HCC auditing is preferred Working knowledge of EMRs, billing systems, and abstraction platforms Ability to maintain compliance with privacy and security regulations

To support the Amazon One Medical Revenue Cycle team, the full-time Certified Coding Compliance Auditor will conduct detailed audits of medical coding practices, ensuring compliance with regulatory requirements and organizational policies while working remotely. Key responsibilities Conduct regular audits to verify the accuracy of ICD-10-CM, CPT, HCPCS, and modifier medical codes Review documentation to ensure appropriate code assignment and adherence to medical necessity requirements Track and report coding errors and findings, maintaining detailed records of audit results Required qualifications Associate's degree in a related field 3+ years of coding/auditing experience in professional fee and/or risk adjustment settings Knowledge of industry standard code sets and guidelines (ICD-10-CM, CPT, HCPCS) CPC certification through AAPC and/or CCS certification through AHIMA required CPMA and CRC certification through AAPC required

Sgmc-Health-1 is seeking a Professional Coding Auditor/Education Specialist to join their Revenue Cycle Medical Group. The ideal candidate will possess a Certified Professional Coder (CPC) certification, with preferred qualifications including knowledge of ICD-10, HCPCS, and CPT coding. This role requires on-site presence in Valdosta and is focused on enhancing coding practices and compliance. The selected individual will perform detailed audits, educate healthcare providers, and assist in developing training materials to promote efficiency and accuracy in coding. Strong communication, analytical, and time management skills are essential for success. #J-18808-Ljbffr

To support the Revenue Cycle team, the part-time Certified Coding Compliance Auditor will conduct audits of medical coding practices, ensuring accuracy and compliance with regulatory requirements while collaborating with clinical and revenue cycle teams in a remote setting. Key responsibilities Conduct regular audits to verify accuracy of ICD-10-CM, CPT, HCPCS, and modifier medical codes Review documentation to ensure appropriate code assignment and adherence to medical necessity requirements Track and report coding errors, maintaining detailed records of audit findings Required qualifications Associate's degree in a related field 3+ years of coding/auditing experience in professional fee and/or risk adjustment settings Knowledge of industry standard code sets and guidelines (ICD-10-CM, CPT, HCPCS) CPC certification through AAPC and/or CCS certification through AHIMA required CPMA and CRC certification through AAPC required

Datavant is seeking a Profee Auditing Specialist in Jefferson City, Missouri. This role involves conducting professional fee coding audits, providing education on coding standards, and ensuring compliance. Candidates must have over 5 years of experience in fee coding and be a Certified Professional Coder (CPC). Benefits include comprehensive training, healthcare, a 401(k), and paid time off. Join Datavant to contribute to transformative change in healthcare through accurate data solutions. #J-18808-Ljbffr

The Hispanic Alliance for Career Enhancement is seeking a Certified Professional Coder (CPC) to perform medical claim reviews to ensure compliance with coding practices. This role requires AAPC certification and at least 3 years of experience in medical coding. Responsibilities include conducting comprehensive audits of medical records and identifying billing errors. The position offers a pay range of $43,888.00 to $93,574.00 and a full-time schedule of 40 hours per week. #J-18808-Ljbffr

Providence in Spokane, United States is seeking a Coding Specialist to educate providers on coding standards and conduct chart audits. You will also answer coding questions and review financial records. A national certification is required, along with 2 years of experience in medical billing and coding. Join our team focused on whole-person care, where your contributions are valued. We empower our caregivers to provide the best patient care, especially for vulnerable communities. #J-18808-Ljbffr

Performing independent external coding audits, the full-time Medical Coding Auditor will ensure compliance with VHA Coding Guidelines and deliver evidence-based reports and education plans while working remotely. Key responsibilities Audit 80 outpatient encounters and 10 inpatient admissions monthly using VA EHR and national encoder Validate coding accuracy for ICD-10-CM/PCS, CPT, HCPCS, and E/M levels, along with DRG assignment and POA indicators Identify documentation deficiencies and provide remediation recommendations while maintaining inter-reviewer reliability through standardized audit methodology Required qualifications Minimum of 3-5 years of medical coding experience, with 2+ years in coding audit or compliance Active certification such as RHIA, RHIT, CCS, CCS-P, CPC, or equivalent Trained on VHA Coding Guidelines and applicable VHA Directives/Handbooks Prior VA/VHA coding or audit experience is strongly preferred Proficient in Microsoft Office Suite, including...

Performing independent external coding audits, the full-time Medical Coding Auditor will ensure compliance with VHA Coding Guidelines and deliver evidence-based reports and education plans while working remotely. Key responsibilities Audit 80 outpatient encounters and 10 inpatient admissions monthly using VA EHR and national encoder Validate coding accuracy for ICD-10-CM/PCS, CPT, HCPCS, and E/M levels, along with DRG assignment and POA indicators Identify documentation deficiencies and provide remediation recommendations while maintaining inter-reviewer reliability through standardized audit methodology Required qualifications Minimum of 3-5 years of medical coding experience, with 2+ years in coding audit or compliance Active certification such as RHIA, RHIT, CCS, CCS-P, CPC, or equivalent Trained on VHA Coding Guidelines and applicable VHA Directives/Handbooks Prior VA/VHA coding or audit experience is strongly preferred Proficient in Microsoft Office Suite, including Excel,...