1478 coder auditor professional jobs found

A healthcare provider is seeking a Coder Auditor-Professional to audit coding assignments and train staff. The ideal candidate will hold a high school diploma and relevant certifications, with a focus on coding accuracy and quality audits. Responsibilities include conducting audits, assisting coders, and ensuring compliance with coding standards. This full-time hybrid position offers compensation between $23.87 and $37.00 based on experience, along with opportunities for career development and education support. #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...

CVS Health is seeking a Certified Professional Coder to perform medical claim reviews for the Special Investigations Unit. You will audit medical records for CPT/HCPCS/ICD-10 compliance, prepare written findings, and communicate results to investigators and leadership. You will research CMS guidelines, identify billing irregularities, and maintain proper documentation. The role requires 3+ years of coding/auditing experience, CPC certification, and proficiency with Excel and Word. #J-18808-Ljbffr

Coding Auditor - Professional 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 coding Hours: Full-Time, 40 hours a week required Required: High School Diploma, CPC, CEMA within 6 months of hire, CPMA within 1 year of hire Pay: Based on experience, starting at $23.87/hour Location: Remote or onsite: At this time, you must reside in one of the following locations: 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.,...

Internal Employees: Please ensure that you are logged into Workday and applying through the Jobs Hub before proceeding. Coding 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 coding Hours: Full-Time, 40 hours a week required Required: High School Diploma, CPC, CEMA within 6 months of hire, CPMA within 1 year of hire Pay: Based one experience, starting at $23.87/hour Location: Remote or onsite: At this time, you must reside in one of the following locations: Alabama, Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi,...

CVS Health is seeking a Certified Professional Coder (CPC) to perform comprehensive medical record audits for the Special Investigations Unit (SIU). The role focuses on ensuring CPT/HCPCS compliance and proper documentation across medical and behavioral health records. The ideal candidate has 3+ years in medical coding or auditing, CPC certification, and strong analytical and communication skills. This is a full-time on-site position with a comprehensive benefits package. #J-18808-Ljbffr

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit. The role focuses on ensuring coding accuracy and compliant documentation across medical records, with emphasis on CPT/HCPCS, ICD-10, and CMS guidelines. Responsibilities include audits, detailed reporting, and presenting findings to investigators and leadership while staying current with coding changes. #J-18808-Ljbffr

PRIMARY FUNCTION The Professional Fee Coding Auditor is responsible for conducting comprehensive coding audits (prospective and retrospective), ensuring documentation and coding compliance, identifying revenue integrity opportunities, and providing feedback to providers and clinical staff. This role serves as a key partner to physicians, advanced practice providers, operational leaders, and revenue cycle teams to promote accurate coding, documentation integrity, regulatory compliance, and reimbursement optimization. This role ensures compliance with applicable coding guidelines and/or payer requirements as well as regulatory standards while supporting revenue cycle integrity through education and process improvement. In addition to audit and education responsibilities, this position maintains coding proficiency by performing production coding activities as needed to support business operations, staffing coverage, backlogs, special projects, and organizational priorities....

Coding Auditor The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals. Responsibilities Reviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment Informs manager of any activities which do not meet federal or state coding and billing requirements Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and responds...

Yeo & Yeo Medical Billing & Consulting Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future we provide...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Risk Adjustment Coding Auditor The Impact you will have The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. Your Responsibilities Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy, completeness, specificity and...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level. Job...

Coding SpecialistThis position supports Mercy's philosophy of patient centered care by the timely and accurate coding of hospital or professional services using ICD-10-CM/PCS and CPT/HCPCS classification systems for the purpose of reimbursement research and statistics in compliance with federal regulations.Job Duties:Codes the correct principal/primary diagnosis consistent with established coding guidelines (95 or greater accuracy).Identifies all significant diagnoses (complications and co-morbidities/HCCs) relevant to the type of visit and assigned appropriate codes.Codes procedures as appropriate and identifies the principal procedure consistent with established coding guidelines.Ensures all conditions coded adequately reflect the appropriate clinical severity and grouping assignment in accordance with documentation.Follows official coding guidelines and directives and uses reference materials to ensure codes assigned are in compliance with state and federal regulations.Validates...

Compliance Auditor/Educator The Compliance Auditor/Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services. Provides professional expertise and education in CPT, ICD and HCC coding. The Compliance Auditor/Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations. This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution. Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance. Develops and leads audit projects for medical record integrity, service line or issues-related audits, identifies problems and...

Conducting medical records and coding related reviews to validate the integrity of coded procedures. Work closely with clinical departments and Revenue Cycle Services within Community Health Partners to ensure compliance with coding guidelines, government, payer, and internal charge capture policies. Provide education and training to clinical providers and staff within the practices on proper documentation and coding guidelines, practices, and procedures. Requirements High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required 2 years of professional coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCS modifiers required One of the following is required: CCS - Certified Coding Specialist, CPC - Certified Professional Coder, CPMA - Certified Professional Medical Auditor, RHIT - Registered Health Information Technician, RHIA - Registered Health Information Administrator. Core...