1803 coder auditor jobs found

Back Inpatient Medical Coder/Auditor Healthcare Columbia , South Carolina Contract On-Site Aug 5, 2026 Location:Can live anywhere in SC or bordering NC as long as they are able to commute to the worksite location as needed Pay: $36 /hour + optional medical, dental, vision, 401(k) match Overview Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events for all lines of business. Coordinates rate adjustments with claims areas and provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues and coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Key Responsibilities Determines methodology to identify cases for validation review. Conducts validation reviews/coordinates rates adjustments with appropriate claims area. Creates monthly/quarterly reports to present to each line of business providing information on records review,...

Prime Healthcare, headquartered in Ontario, California, seeks a skilled Inpatient Coder Auditor to ensure accurate ICD-10-CM, CPT, and HCPCS coding for inpatient records. The role focuses on DRG validation and abstraction, supporting CDS and medical staff to improve clinical documentation. A CCS certification and acute care experience are required. Responsibilities include finalizing coding, reviewing charts, and participating in documentation quality initiatives. #J-18808-Ljbffr

Optum in Minnesota seeks an Evaluation & Management Medical Coder/Auditor to provide coding and auditing services to providers. The role emphasizes education outreach, research, and maintaining accurate procedure codes, modifiers, and units. The position is full-time with standard CST hours and potential overtime. Telecommuting from anywhere in the U.S. is supported, with virtual training and onboarding. #J-18808-Ljbffr

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 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 finalizes the coding and abstracting of the medical record upon ensuring the assignment of International Classifications...

Prime Healthcare, headquartered in Ontario, California, seeks a skilled Inpatient Coder Auditor to ensure accurate ICD-10-CM, CPT, and HCPCS coding for inpatient records. The role focuses on DRG validation and abstraction, supporting CDS and medical staff to improve clinical documentation. A CCS certification and acute care experience are required. Responsibilities include finalizing coding, reviewing charts, and participating in documentation quality initiatives. #J-18808-Ljbffr

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 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 finalizes the coding and abstracting of the medical record upon ensuring the assignment of International Classifications...

Location 1240 39th Street,Brooklyn, NY, 11218,United States Base Pay $83,000.00 - $90,000.00 / Year Employee Type Full Time Required Degree 4 Year Degree We are seeking a detail-oriented and experienced Coder Auditor to join our dynamic team. The ideal candidate will be responsible for ensuring the accuracy and completeness of clinical data used to support risk adjustment coding for our Medicare plan. You will work closely with healthcare providers and clinical teams to identify and mitigate documentation gaps, ultimately supporting our mission to provide exceptional care to our members. Responsibilities Audit and QC the coding team’s output for accuracy and compliance with HCC/ICD-10-CM guidelines Speak directly with providers — writing and following up on provider queries for insufficient or ambiguous documentation Educate providers on documentation practices that support accurate risk adjustment coding Serve as the escalation point for complex charts and coding...

To support accurate billing practices, the full-time remote Nurse Coder Auditor will review medical records and claims, validate coding accuracy, and conduct hospital bill audits while ensuring compliance with industry standards and guidelines. Key responsibilities Validate the accuracy of CPT, HCPCS, revenue codes, and billed line-item charges on facility claims Review medical records and documentation to ensure billed services are accurately represented Conduct hospital bill audits and itemized bill reviews to identify potential coding and billing issues Required qualifications Active coding certification in good standing, such as CCS, CPC, COC, RHIT, or RHIA Strong knowledge of CPT, HCPCS, ICD-10, revenue codes, and CMS coding guidelines Experience with coding validation, auditing, or claims review Ability to review and interpret complex medical documentation Knowledge of inpatient coding and billing guidelines, including hospital bill audits

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 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 finalizes the coding and abstracting of the medical record upon ensuring the assignment of International...

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 Outpatient Coder Auditor Trainee reviews and analyzes documentation present in the medical record for outpatient 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 Outpatient Coder Auditor Trainee finalizes the coding and abstracting of the medical record upon ensuring the assignment of...

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a 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 Service,...

The University of Vermont Health Network is seeking a qualified RN Clinical Coder/Auditor for a hybrid position based in Colchester, VT. This role involves auditing clinical documentation to ensure compliance with regulatory standards and enhancing clinical outcomes through accurate coding. Candidates must possess a current Vermont RN Licensure and relevant prior experience in home health or hospice. Strong skills in ICD-10 coding, attention to detail, and project management are essential for success in this position. #J-18808-Ljbffr

Coder Auditor-Professional page is loaded## Coder Auditor-Professionalremote type: Hybridlocations: Remote Office - ILtime type: Full timeposted on: Posted Todayjob requisition id: JR104062**Internal Employees: Please ensure that you are logged into Workday and applying through the Jobs Hub before proceeding.**Coder Auditor-Professional**Job Description**Coder Auditor-Professionals are responsible for auditing of coding assignment with providers and coders, training of coding professional staff, pro-fee based coding includes the assignment of Assigns ICD-CM, CPT, HCPCS codes, E&M assignment, modifiers, and charge posting. Interacts with medical staff, nursing, ancillary departments, provider offices, and outside organizations.Department: Physician codingHours: Full-Time; 40 hours requiredRequired: High School Diploma; CPC and CPMA and/or CEMAPay: based on experience, starting at $23.87**At this time, we are only able to consider applicants who reside in the following...

Coder Auditor-Professionals are responsible for auditing coding assignments with providers and coders, training coding professional staff, and pro‑fee based coding which includes the assignment of ICD‑CM, CPT, HCPCS codes, E&M assignment, modifiers, and charge posting. They interact with medical staff, nursing, ancillary departments, provider offices, and outside organizations. At this time, we are only able to consider applicants who reside in the following states: Alabama, Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, New Mexico, Ohio, Oklahoma, South Carolina, Tennessee, Texas. Responsibilities Assists coders with coding questions. Conducts the collection and reporting of provider and coder audit results and education. Works with coders and providers to ensure appropriate documentation for clinic services. Reports results to Coding Supervisor - Professional. Demonstrates ability to code all...

Overview 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. The Outpatient Payment Integrity Coder Auditor is responsible for reviewing outpatient medical claims to ensure coding accuracy, compliance, and appropriate payment in accordance with CMS and payer-specific guidelines. This role supports the development and implementation of payment integrity initiatives by identifying coding and billing inaccuracies, trends, and potential cost savings opportunities across outpatient facility claims. The ideal candidate has advanced knowledge of outpatient coding, APC and EAPG payment methodologies, and clinical documentation requirements, with strong analytical and auditing skills. Salary Range: $100,000 - $102,500 Responsibilities Perform detailed coding audits on outpatient facility claims to validate appropriate CPT/HCPCS, revenue codes, modifiers, and ICD-10 coding...

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! The Inpatient Coder Auditor 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 finalizes the coding and abstracting of the medical record upon ensuring the assignment of International Classifications of Diseases, tenth...

Blue Cross Blue Shield of Arizona is seeking a Quality Assurance Coder/Auditor to develop risk mitigation and provider education programs. On a regular basis, you will educate primary care providers and their staff on diagnoses, coding accuracy, and risk mitigation based on medical records and documentation. The role requires in-depth knowledge of HCC coding, Medicare guidelines, and the ability to perform QA audits and deliver corrective actions. #J-18808-Ljbffr

Quality Assurance Coder/Auditor The Quality Assurance Coder/Auditor will develop a risk mitigation and provider education program. On a regular basis, Coder/Auditor will educate primary care providers and their staff on their historical diagnoses/coding error trends, accurate completion of medical record documentation, and at-risk code identification and risk mitigation. This includes the review, analysis, and recommended coding based on medical and clinical diagnoses, procedures, injuries, or illnesses contained in medical records and supporting documentation. The Quality Assurance Coder/Auditor will perform risk mitigation analysis using available vendor tools to identify at-risk single occurrence of HCCs and OIG targets. Deletions will be submitted for unsupported/invalid diagnoses. This analysis combined with QA findings and EDPS claims errors will drive the content and audience for provider education. The Quality Assurance Coder/Auditor will perform medical record...

Lead Him Hospital Coder/Auditor (In-Patient - Observation) Remote The Health Information Management (HIM) Inpatient/Observation Hospital Coder Auditor/Lead responsibilities include reviewing all diagnosis and procedural coding in ICD-10-CM/PCS for accurate DRG assignment. This position will have daily interactions with internal and external customers to include physicians, hospital support services and ancillary departments. The HIM Inpatient/Observation Hospital Coder Auditor/Lead will perform inpatient/outpatient coding compliance audits and provide coder education. This position will assist in the preparation and finalization of auditing reports. Responsibilities and Essential Job Functions Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department. Note: These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and...

To ensure the accuracy and compliance of diagnosis coding in risk adjustment programs, the contract-to-hire Certified Risk Coder Auditor will conduct medical record audits, validate diagnosis codes, and provide coding guidance while working remotely. Key Responsibilities Perform prospective and retrospective medical record reviews and audits Validate diagnosis code accuracy, completeness, specificity, and appropriateness based on provider documentation Identify coding and documentation deficiencies and provide written and verbal feedback Required Qualifications 7+ years of relevant professional experience 5+ years of HCC/Risk Adjustment coding experience utilizing inpatient and outpatient coding guidelines 5+ years of Risk Adjustment auditing experience CRC (Certified Risk Coder) certification in good standing Strong knowledge of Medicare, ACA Commercial, and Medicaid risk adjustment models

Job Description Job Summary The Clinical RN Auditor is responsible for ensuring clinical documentation meets regulatory standards and procedures. This role involves reviewing potential quality of care issues, understanding workflows, and establishing patient care plans to support technical and clinical requirements. The auditor works to improve clinical outcomes by monitoring documentation accuracy and consistency, reducing risk, evaluating data, and collaborating with the manager of clinical outcomes to provide expertise in coding classifications. Initial Onboarding Initial onboarding will take place at our offices in Colchester, VT. The position will then be a hybrid work arrangement with 1-2 days per week in our offices located in Colchester, VT. In-person meetings are also required at least quarterly. Qualifications / Job Requirements Education and Licensure Current unencumbered Vermont RN Licensure Homecare Coding Specialist- Diagnosis, or ability to obtain within one year...

RN Clinical Coder/Auditor - Hybrid Colchester, VT. Initial onboarding will take place at our offices in Colchester, VT. The position will then be a hybrid work arrangement with 1–2 days per week in our offices located in Colchester, VT. In-person meetings are also required at least quarterly. Job Summary The Clinical RN Auditor is responsible for ensuring clinical documentation meets regulatory standards and procedures. This role involves reviewing potential quality of care issues, understanding workflows, and establishing patient care plans to support technical and clinical requirements. The auditor works to improve clinical outcomes by monitoring documentation accuracy and consistency, reducing risk, evaluating data, and collaborating with the manager of clinical outcomes to provide expertise in coding classifications. Qualifications / Job Requirements Education and Licensure Current unencumbered Vermont RN Licensure Homecare Coding Specialist – Diagnosis, or ability to...

Requisition number: 2372972 Job category: Medical & Clinical Operations 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. As an Evaluation & Management Medical Coder , you will provide coding and coding auditing services directly to providers. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes. The ideal candidate will possess prior...

POSITION PURPOSE Areas of emphasis will include inpatient and outpatient coding of provider charges as well as documentation reviews and audits. Secondary responsibilities will include assisting Physicians Billing staff and clinic staff with coding questions. MINIMUM EDUCATION REQUIRED High School or Equivalent (GED) MINIMUM EXPERIENCE REQUIRED 1-3 years Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician (CCS-P) MINIMUM EXPERIENCE PREFERRED LICENSES / CERTIFICATIONS REQUIRED Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician (CCS-P). KNOWLEDGE, SKILLS & ABILITIES REQUIRED Knowledge of CPT and ICD-10 codes Ability to accurately audit provider documentation to ensure all CPT codes and ICD-10 codes are accurately assigned Ability to communicate findings by way of written reports and via verbal...