325 certified coding auditor primary care jobs found

Join Optum Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. Positions in this function investigate Optum Waste and Error stopped claims by gathering information, researching state and federal guidelines, and following internal procedure to determine the viability of the claim for further review in a production environment. Primary Responsibilities Clinical Case Reviews - 75% Perform clinical review of professional (or facility) claims vs....

Job Type Full-time Description Job Title: Provider Coding Educator / Auditor Department: Revenue Integrity & Compliance Employer: Southeast Primary Care Partners / Southeast Medical Group, P.C. FLSA Status: Non-Exempt (Hourly) Position Summary The Provider Coding Educator/Auditor is responsible for driving accurate clinical documentation, compliant coding, and revenue integrity across Southeast Primary Care Partners' ambulatory practices. The role combines prospective and retrospective E/M, procedural and risk-adjustment auditing with in-person and virtual provider education. Up to 50 % regional travel is required to meet with physicians on flexible schedules, including early-morning huddles and occasional after-hours sessions. This is an hourly, non-exempt position governed by the Fair Labor Standards Act (FLSA) overtime provisions and subject to Occupational Safety and Health Administration (OSHA) workplace safety standards. Requirements Essential...

divh2Coding Auditor And Educator/h2pAt Anne Arundel Dermatology we give exceptional care - to our patients and to eachother./ppPatient First | Caring | Accountability | Trust | One Team | Growth/ppThe Coding Auditor and Educator role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patients health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a hands on environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience...

HCC Auditor / Coder – Job Description The HCC Auditor/Coder is responsible for improving the accuracy and quality of provider documentation and reporting of chronic health conditions. This role supports risk adjustment initiatives through medical record audits, coding review, provider education, and ongoing collaboration with internal teams and provider offices. Key Responsibilities Audit provider medical records and super bills for accurate and compliant diagnosis and procedure coding Review a wide variety of document types, including primary and specialty care, inpatient, outpatient, mental health, substance abuse, ancillary, laboratory, and pharmaceutical services for HCC values Conduct both on‑site provider office audits and remote/online audits through medical record review Interface professionally with physicians and office staff to address coding questions and discrepancies Research and resolve coding issues using internal and external error reports Provide education...

Coding Auditor And Educator At Anne Arundel Dermatology we give exceptional care - to our patients and to eachother. Patient First | Caring | Accountability | Trust | One Team | Growth The Coding Auditor and Educator role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and...

Coding Auditor And Educator At Anne Arundel Dermatology we give exceptional care - to our patients and to eachother. Patient First | Caring | Accountability | Trust | One Team | Growth The Coding Auditor and Educator role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and...

Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team! Responsibilities The Inpatient Coder Auditor Trainee reviews and analyzes documentation present in the medical record for inpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software.  The Inpatient Coder Auditor Trainee finalizes the coding and abstracting of the medical record upon ensuring the assignment of...

Medical Coding Auditor-Inpatient (OIG Focus) In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify's AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We're reshaping healthcare payment through seamless intelligence. The Medical Coding Auditor-Inpatient (OIG Focus) is responsible for ensuring the accuracy, integrity, and compliance of medical coding practices within the organization, with a primary focus on Inpatient services. This role involves auditing medical records, coding data, and billing information to verify adherence to coding guidelines and...

DEPARTMENT: Physician Practice Management FACILITY: Medical Office Building WORK TYPE: Full Time SHIFT: Daytime SUMMARY: Assess the educational needs of coding specialists and providers regarding coding and documentation and direct development of effective regularly scheduled educational programs that meet the needs of the health system. Serve as the primary resource to physicians for documentation and coding issues. Conduct ongoing coding and billing training programs for billing and coding specialists and providers. Creates presentations, develops learning material, handbook, and other training materials. Conducts coding and data quality reviews and prepares complex reports as required. Ensures all education activities comply with clinical billing standards and government regulation with concentration on hospital inpatient procedures, ambulatory, and specialty physician services. RESPONSIBILITIES: * Keeps abreast of pertinent federal, and state regulations...

Health Ministries Clinic (HMC) is seeking a Coding Auditor (with PCP auditing experience) as a trusted expert to join our integrated care team in Newton, Kansas. This is a full-time, on-site position offering the opportunity to support patient care in a collaborative, mission-driven environment. At Health Ministries Clinic, we offer more than just primary care with a full spectrum of services including behavioral health, lab, diagnostic, pharmaceutical and dental. We are seeking an experienced Coding Auditor with a multi-speciality coding background. The Coding Quality Auditor is responsible to ensure Health Ministries Clinic's compliance with national coding guidelines, FQHC coding guidelines and regulations. The Coding Auditor plays a crucial role in minimizing coding errors and preventing fraudulent activities. The Coding Auditor is responsible to ensure accurate and consistent coding which results in appropriate reimbursement and data integrity. This role requires...

Job Title: Coding Auditor Location: Reno, NV Position Overview: The Coding Auditor is tasked with coordinating the auditing schedules of the coding staff to ensure quality and proficiency, thus ensuring compliance with coding/auditing standards and documentation quality. The primary challenge is to guarantee accurate reimbursement is achieved through adherence to high-quality coding standards. This role involves auditing information coded from provider documentation and patient records within designated time frames, facilitating the billing process, ensuring accurate reimbursement, and promoting compliance. The incumbent must document and report all findings to Coding Leadership. Key Responsibilities: Coordinate coding staff auditing schedules to ensure quality and proficiency. Audit information coded from provider documentation and patient records within designated time frames. Document and report all auditing findings to Coding Leadership. Address appeals...

Job Summary and Responsibilities The Sr Coding Compliance Auditor is responsible for reviewing chart notes for proper coding with an emphasis on documentation, coding improvement, and revenue capture. Provides education to clinicians, clinic staff, and others as needed via face-to-face meetings, classroom settings, webinars, and online modules. Develops, maintains and presents coding and compliance educational materials to staff and clinicians. Collaborates with the coding team to support the needs of the organization. The position will support risk adjustment improvement efforts across the medical group. The Hierarchical Condition Category (HCC) Quality program was developed by CMS to promote quality care for Medical Advantage members. By focusing on comprehensive documentation to identify, evaluate and assess chronic conditions at the appropriate specificity, patient medical needs are met at the highest level. The Sr Coding Compliance Auditor's primary focus will be...

Job Details Compliance Auditor Job Description Compliance Auditor Under general supervision, using a unique combination of clinical expertise and billing knowledge, the Compliance Auditor monitors and improves the quality of clinical and financial documentation related to the provision of patient services. The Compliance Auditor will compare clinical and financial records to ensure that the documentation provided supports the patient charges listed. The Compliance Auditor will utilize our technology to codify and quantify findings to assist with reporting, monitoring and educating where appropriate. ESSENTIAL FUNCTIONS: • Performs audits of clinical documentation of physician, technical or specialty (e.g., Home Health, Hospice, Inpatient Rehab) billing and payment records and applicable industry standard billing codes by analyzing medical records, coding records and health system bills validating clinical documentation in conjunction with the bill; assessing the level...

Compliance Auditor Under general supervision, using a unique combination of clinical expertise and billing knowledge, the Compliance Auditor monitors and improves the quality of clinical and financial documentation related to the provision of patient services. The Compliance Auditor will compare clinical and financial records to ensure that the documentation provided supports the patient charges listed. The Compliance Auditor will utilize our technology to codify and quantify findings to assist with reporting, monitoring and educating where appropriate. Essential Functions: Performs audits of clinical documentation of physician, technical or specialty (e.g., Home Health, Hospice, Inpatient Rehab) billing and payment records and applicable industry standard billing codes by analyzing medical records, coding records and health system bills validating clinical documentation in conjunction with the bill; assessing the level and accuracy of coding, determining that governmental...

HCC Auditor / Coder - Job Description The HCC Auditor/Coder is responsible for improving the accuracy and quality of provider documentation and reporting of chronic health conditions. This role supports risk adjustment initiatives through medical record audits, coding review, provider education, and ongoing collaboration with internal teams and provider offices. The HCC Auditor/Coder reviews medical records and super bills to ensure appropriate assignment of diagnosis and procedure codes in accordance with HCC, ICD-10, CPT, and HCPCS guidelines. This position works as an integral member of the Finance Department and consistently meets established productivity and quality standards. Key Responsibilities Audit provider medical records and super bills for accurate and compliant diagnosis and procedure coding Review a wide variety of document types, including primary and specialty care, inpatient, outpatient, mental health, substance abuse, ancillary, laboratory, and...

Overview At Anne Arundel Dermatology we give exceptional care - to our patients and to eachother.  Patient First | Caring | Accountability | Trust | One Team | Growth The Coding Auditor and Educator role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing.  In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information.  An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a “hands on” environment.  The majority of time is spent in the delivery of support services or activities, typically under supervision.  An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require...

Hcc Risk Adjustment Auditor/Coder, Sr. We are looking for experienced HCC Risk Adjustment Auditors/Coders, Sr. to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities include the following: Works as an integral member of the Finance Department. Code review super bills and patient medical...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Position in this function is responsible for regulatory compliance audits, including but not limited to regulatory agencies, Quality metrics, and coding compliance. The Auditor will monitor changes to laws and regulations to ensure compliance with State and Federal laws, regulations and mandates. Establish and implement standard policies, procedures, and best practice across Optum Middle Revenue Cycle....

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients. Job Summary Our client is looking for a Coding Auditor to join their team. The primary responsibilities include developing expertise in CPT, HCPCS, and ICD-10 coding guidelines, efficiently performing policy updates or audits on medical records or claims, and drafting written communications to providers. Key Responsibilities Develop and maintain expertise on CPT, HCPCS, and ICD-10 Coding guidelines and billing requirements. Perform thorough and complex policy updates or audits on medical records or claims. Document findings clearly for both clinical and non-clinical audiences. Create reports and reference guides for team communication and efficiency. Assist in drafting provider communication about audit findings. Participate in educational calls with providers. Train new team members. Develop and document team efficiency and...

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy.AZ Blue offersa variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions. At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements: Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week Hybrid 2 (Operational Roles such as but not limited to: Customer...

Medical Record Audit / Coding Auditor Miami, Florida, United States About the Job Our client is a contracting and data management services organization dedicated to primary care physicians throughout Florida. In this role you are responsible to assist in the development, undertaking and maintenance of a long term comprehensive, clinical coding audit program for inpatient and outpatient activity. To develop and implement policies to support the clinical coding audit function Receive, review and communicate findings on patient billing coding related complaints. Identify training needs through the audit program of work and liaise with the clinical coding training manager and audit manager to provide the necessary training identified Conduct routine, risk based, proactive or reactive compliance reviews of procedural and diagnosis coding/billing and medical record documentation performed by clinical service providers Prepare reports as required relative to these...

Job Description About Us For 55 years the medical experts of Bryn Mawr Medical Specialists Association have been providing personalized care to patients in the Philadelphia region. Our patients have seamless access to 80 highly-trained physicians in 11 specialties and primary care. This integration of primary and specialty care allows our providers to improve communication by using a shared medical chart at various stages of care. Our physicians, nurses and staff work as a team to provide comprehensive, patient-centered care with a "whole person" approach. Medical Coder/Certified Professional Medical Auditor Medical Coder/Certified Professional Medical Auditor will act as an internal resource for performing routine internal compliance audits, managing internal and external chart audits, addressing coding questions, and providing education for physicians, APPs, and staff. Duties/Responsibilities: - Monitors provider coding and documentation for compliance with...