97 coding auditor education advisor jobs found

We are seeking an experienced Acute Inpatient Coding Auditor with recent acute care hospital experience. This role is responsible for auditing facility-based inpatient coding, DRG assignment, ICD-10-CM/PCS coding accuracy, documentation review, and compliance. Candidates must have a strong background in acute inpatient hospital coding and auditing. This position focuses exclusively on facility (hospital) inpatient services and is not a professional fee/physician coding role. Job Summary Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and compliance with the Official Coding Guidelines for Coding and Reporting, payer regulations, and hospital policy. Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure compliant coding and billing practices....

We are seeking an experienced Acute Inpatient Coding Auditor with recent acute care hospital experience. This role is responsible for auditing facility-based inpatient coding, DRG assignment, ICD-10-CM/PCS coding accuracy, documentation review, and compliance. Candidates must have a strong background in acute inpatient hospital coding and auditing. This position focuses exclusively on facility (hospital) inpatient services and is not a professional fee/physician coding role. JOB SUMMARY Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and compliance with the Official Coding Guidelines for Coding and Reporting, payer regulations, and hospital policy. Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure compliant coding and billing practices....

Job Number: 30780 Location: Remote - Georgia Street Address: Remote Address City, State: Remote, Georgia Zip Code: 31701 Department: PPHS HEALTH INFORMATION MANAGEMENT Shift: First Shift Job Type: Full time Posted Date: 2025-01-21 Job Description Summary: Description: We are seeking an experienced Acute Inpatient Coding Auditor with recent acute care hospital experience. This role is responsible for auditing facility-based inpatient coding, DRG assignment, ICD-10-CM/PCS coding accuracy, documentation review, and compliance. Candidates must have a strong background in acute inpatient hospital coding and auditing. This position focuses exclusively on facility (hospital) inpatient services and is not a professional fee/physician coding role. JOB SUMMARY: Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and...

Job Requirements Hybrid, on site presence in MD. Functions as a trusted advisor to compliance, revenue cycle, operational, clinical, and executive leadership regarding complex regulatory, documentation, coding, billing, reimbursement, and compliance matters. Leads the development, implementation, and continuous improvement of the professional fee compliance auditing program, including risk-based audit planning, monitoring activities, and system-wide compliance initiatives. Serves as the organization's subject matter expert in professional fee documentation, coding, billing compliance, and regulatory requirements. Leads complex, high-risk audits, investigations, and special projects to evaluate compliance with applicable laws, regulations, coding guidelines, and organizational policies; identifies emerging risks, assesses organizational impact, and develops mitigation strategies. Provides advanced education, consultation, and technical guidance to providers, operational leaders,...

Job Requirements Hybrid, on site presence in MD. Functions as a trusted advisor to compliance, revenue cycle, operational, clinical, and executive leadership regarding complex regulatory, documentation, coding, billing, reimbursement, and compliance matters. Leads the development, implementation, and continuous improvement of the professional fee compliance auditing program, including risk-based audit planning, monitoring activities, and system-wide compliance initiatives. Serves as the organization's subject matter expert in professional fee documentation, coding, billing compliance, and regulatory requirements. Leads complex, high-risk audits, investigations, and special projects to evaluate compliance with applicable laws, regulations, coding guidelines, and organizational policies; identifies emerging risks, assesses organizational impact, and develops mitigation strategies. Provides advanced education, consultation, and technical guidance to providers, operational leaders,...

Medical Billing Coder I - UMC Billing Office Tuscaloosa, Alabama, United States Accounting/Bookkeeping Health Care / Social Services Closing at: Oct 26 2026 - 22:55 CDT Pay Grade/Pay Range: Minimum: $21.44 - Midpoint: $26.83 (Hourly N6) Department/Organization: 208411 - UMC Business Office Normal Work Schedule: Monday - Friday 8:00am to 5:00pm; some evenings & weekends Job Summary: The Medical Billing Coder I provides timely and accurate processing of multi-specialty physician office visits, I/P and surgical hospital visits, and procedural coding in an academic environment. Reviews and corrects charges submitted from the clinic and hospital electronic health record using CPT, HCPCS, ICD-10 and insurance payer standards. Follows-up with accounts receivable on unpaid insurance claims. Corrects denials and audit trails. Responds to patient statement inquiries. Additional Department Summary: Supports medical billing services for the College of Community Health...

Job Description Job Description Description:   Role Summary  Responsible for reviewing inpatient coding to validate accuracy, compliance, and documentation support. This role identifies risks, ensures consistency in DRG assignment, and provides actionable feedback to improve coding quality.  Core Responsibilities   Perform retrospective and/or concurrent audits of inpatient coding.  Validate ICD-10-CM/PCS code assignment and MS-DRG/APR-DRG accuracy.  Follow and adhere to AHIMA’s Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policies.   Identify trends, risks, and opportunities for coding improvement.  Provide clear, actionable audit feedback and education to client & internal coding staff.  Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards.  Requirements:   Minimum Qualifications   Credentials: CCS, RHIA, or RHIT (active).  Experience: Minimum 3+ years of...

Job Description Job Description Description:  At Sage Clinical RCM, you'll code high-acuity inpatient encounters across a national portfolio of health systems, from academic medical centers to community hospitals. No two client environments are identical, and that's the point. You'll sharpen your skills across specialties, payers, and documentation styles instead of coding the same census for years.    What You'll Do   Review inpatient encounters and assign accurate ICD-10-CM/PCS codes and DRGs that hold up to audit.  Read documentation critically. When it doesn't support the coded services, flag it and escalate the gap.  Code in full compliance with CMS requirements, payer-specific rules, and official coding guidelines.  Move confidently between client workflows, systems, and audit expectations.  Hold the line on quality (95% accuracy or better) while meeting realistic productivity standards.  Requirements:   What You Bring   Active RHIA, RHIT, and/or CCS...

Job Description Job Description Description: Role Summary   Responsible for reviewing medical records and assigning accurate CPT, HCPCS, ICD-10-CM, and appropriate modifiers for outpatient services. This role supports compliant coding and consistent performance across a variety of outpatient encounter types.  Core Responsibilities   Review medical records and assign accurate CPT/HCPCS, ICD-10-CM, and modifiers.  Ensure documentation supports coded services and identify/escalate discrepancies or gaps.  Ensure compliance with CMS, payer-specific rules, and official coding guidelines (including NCCI edits).  Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards.  Requirements:   Minimum Qualifications   Credentials: CPC, CCS, RHIA, or RHIT (active).  Experience: Minimum 3+ years outpatient coding experience across multiple outpatient service types.  Skills & Knowledge: Strong knowledge of CPT, HCPCS, ICD-10-CM,...

Job Description Job Description Description: Role Summary   Responsible for reviewing provider documentation and assigning accurate CPT, HCPCS, and ICD-10-CM codes for physician services. This role supports compliant coding, accurate charge capture, and overall revenue integrity across a variety of specialties, supporting single-specialty or multi-specialty engagements.  Core Responsibilities   Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes.  Ensure documentation supports coded services and identify/escalate discrepancies or gaps.  Ensure compliance with CMS, payer-specific rules, and official coding guidelines (including AMA and NCCI edits).  Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards.  Requirements: Minimum Qualifications   Credentials: CPC, CCS-P, RHIA, or RHIT (active and in good standing).  Experience: Minimum 2–3+ years professional fee coding experience....

Job Description Job Description Description: Role Summary Responsible for reviewing medical records and assigning accurate CPT, HCPCS, ICD-10-CM, and appropriate modifiers for outpatient services. This role supports compliant coding and consistent performance across a variety of outpatient encounter types. Requirements:   Core Responsibilities   Review medical records and assign accurate CPT/HCPCS, ICD-10-CM, and modifiers. Ensure documentation supports coded services and identify/escalate discrepancies or gaps. Ensure compliance with CMS, payer-specific rules, and official coding guidelines (including NCCI edits). Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards. Minimum Qualifications   Credentials:  CPC, CCS, RHIA, or RHIT (active).  Experience: Minimum 3+ years outpatient coding experience across multiple outpatient service types. Skills & Knowledge: Strong knowledge of?CPT, HCPCS, ICD-10-CM,...

Job Description Job Description Description: The Professional Fee (ProFee) Coder is responsible for reviewing provider documentation and assigning accurate CPT, HCPCS, and ICD-10-CM codes for physician services. This role supports compliant coding, accurate charge capture, and overall revenue integrity across a variety of specialties and client environments.   Coders may support single-specialty or multi-specialty engagements depending on client needs and experience. Requirements:   Core Responsibilities (Sage Standards)   Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes   Ensure documentation supports coded services and identify discrepancies  Apply appropriate modifiers, NCCI edits, and payer-specific coding rules   Ensure compliance with CMS, AMA, and payer guidelines   Maintain =95% coding accuracy and meet established productivity standards  Identify documentation gaps and escalate for clarification when needed   Participate in...

Overview Reporting to the Director of Healthcare Compliance, the Senior Compliance Coding Auditor is responsible for conducting independent coding, billing, documentation, and regulatory compliance audits across ambulatory and specialty care practices. The position supports the organization's compliance program through risk-based auditing, monitoring, provider education, investigation of billing concerns, identification of revenue integrity risks, and development of corrective action plans. The Senior Compliance Coding Auditor serves as a subject matter expert for professional fee coding, documentation requirements, government and commercial payer regulations, and healthcare compliance standards. This role partners closely with physicians, advanced practice providers, practice leadership, revenue cycle, coding, clinical operations, and executive leadership to promote compliant billing and documentation practices. Responsibilities Essential Functions: Auditing and Monitoring...

Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. Responsible for the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment. MINIMUM QUALIFICATIONS:EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience;OR Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience;OR High School Diploma or Equivalent AND Eight (8) years of coding experience. 2. Certification in ONE of the following: Registered Health Information Administrator (RHIA) OR...

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance. Responsibilities Using encoder, reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments. Reviews coding edits. Reviews Local Coverage Determination (LCD) edits and guidance for codes meeting medical necessity. Research electronic medical record for any additional diagnoses documented to meet medical necessity. Codes various OP service lines for all MHS specialties that include encounters with high complexity of surgical procedures and...

Overview Reporting to the Director of Healthcare Compliance, the Senior Compliance Coding Auditor is responsible for conducting independent coding, billing, documentation, and regulatory compliance audits across ambulatory and specialty care practices. The position supports the organization's compliance program through risk-based auditing, monitoring, provider education, investigation of billing concerns, identification of revenue integrity risks, and development of corrective action plans. The Senior Compliance Coding Auditor serves as a subject matter expert for professional fee coding, documentation requirements, government and commercial payer regulations, and healthcare compliance standards. This role partners closely with physicians, advanced practice providers, practice leadership, revenue cycle, coding, clinical operations, and executive leadership to promote compliant billing and documentation practices. Responsibilities Essential Functions: Auditing and Monitoring...

Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. Responsible for the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment. MINIMUM QUALIFICATIONS:EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience;OR Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience;OR High School Diploma or Equivalent AND Eight (8) years of coding experience. 2. Certification in ONE of the following: Registered Health Information Administrator (RHIA) OR...

Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. Responsible for the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment. MINIMUM QUALIFICATIONS:EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience;OR Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience;OR High School Diploma or Equivalent AND Eight (8) years of coding experience. 2. Certification in ONE of the following: Registered Health Information Administrator (RHIA) OR...

DRG Coding Auditor - MS-DRG and APR-DRG Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development . Alternate locations may be considered if candidates reside within a commuting distance from an office Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate...

OBJECTIVES / PURPOSE Provides enterprise-level governance, portfolio and operational leadership for medical grants, medical education grants and sponsorships within Global Medical. Ensures that funding decisions are transparent, objective, well documented, aligned with enterprise Medical priorities, Therapeutic Area strategies, unmet scientific or educational need, patient-centric outcomes, and compliant with Takeda standards and applicable industry requirements. Establishes and maintains clear funding frameworks, decision criteria, review pathways, committee operations, documentation expectations, budget visibility, system/repository requirements and lifecycle oversight from intake through close-out. The role partners with Global Therapeutic Areas, regions, LOC Medical, Ethics & Compliance, Legal and Finance to define areas of scientific and educational interest, prioritize funding and enable consistent decision-making across geographies. Chairs and/or facilitates Global Grant...

Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. Responsible for the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment. MINIMUM QUALIFICATIONS : EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience. 2. Certification in ONE of the following: Registered Health Information...

Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. Responsible for the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience. 2. Certification in ONE of the following: Registered Health Information Administrator (RHIA)...

Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. Responsible for the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience. 2. Certification in ONE of the following: Registered Health Information Administrator (RHIA)...

Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. Responsible for the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience. 2. Certification in ONE of the following: Registered Health Information Administrator (RHIA)...