58 coding auditor jobs found in Boston, MA

Humana is seeking a Medical Coding Auditor to extract clinical information from medical records and assign ICD-10-CM and CPT codes. This remote role supports outpatient auditing with strong attention to detail and independent judgment. You will need CPC/COC/CCS/RHIA/RHIT certification with 3+ years post-cert, 2+ years outpatient auditing, and knowledge of NCD/LCDs, CMS Manual, and coding guidelines. Proficiency in Word/Excel is required. #J-18808-Ljbffr

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Use your skills to make an impact Additional Job Description WORK STYLE: Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS:...

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

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Humana is seeking a Medical Coding Auditor to extract clinical information from medical records and assign ICD-10-CM and CPT codes with accuracy. The role supports outpatient coding audits and requires professional certification and experience. This is a remote position with occasional travel for training or meetings. Typical hours are Monday–Friday with a 40-hour work week; ability to work independently and meet deadlines is essential. #J-18808-Ljbffr

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Location: Boston, Massachusetts, United StatesSalary: $97,500.00- $141,500.00Company: Aya HealthcarePosted: 2026-09-09Location: Boston, Massachusetts, United StatesSalary: $97,500.00- $141,500.00Company: Aya HealthcarePosted: 2026-09-07Location: Boston, Massachusetts, United StatesSalary: $97,500.00- $141,500.00Company: Aya HealthcarePosted: 2026-09-04Location: Boston, Massachusetts, United StatesSalary: $97,500.00- $141,500.00Company: Aya HealthcarePosted: 2026-08-31Location: Boston, Massachusetts, United StatesSalary: $97,500.00- $141,500.00Company: Aya HealthcarePosted: 2026-08-29Senior Manager Coding IP OP Under the general supervision of the Clinical Documentation and Coding Integrity (CDCI) Director, the Senior Manager of Coding, IP/OP is responsible for guiding the inpatient (IP) and outpatient (OP) coding and reimbursement practices for BMC South and Brighton within established regulatory and organizational guidelines. This job provides direct oversight and supervision of...

Physician Practice Coder-Anesthesia The Physician Practice Coder-Anesthesia position is responsible for reviewing documentation in the outpatient/inpatient EHR. This position is responsible for assigning ICD-10-CM diagnosis codes and CPT, ASA, HCPCS II and appropriate modifiers to patient records from BMC Anesthesia Departments. The Physician Practice Coder II Anesthesia position is a resource for the physicians and other health care providers in regard to coding and to review medical documentation to insure appropriate physician coding and billing. Conducts CPT and ICD-10 coding reviews by detailed examination of each line item in the physician medical record and charge session. Performs chart audits to ensure correct coding and charge capture have been applied appropriately. Works closely with key revenue cycle stakeholders to understand reasons for denials, root cause analysis, and feedback to providers. Essential Responsibilities / Duties: Perform coding and related...

Coding Education SpecialistThe Coding Education Specialist is responsible for assisting with design, development, and delivery of all Coding Quality and Education components for all areas supported by Professional Billing. This individual is a member of a cross functional team, which includes practice leadership, business owners, IT, the professional billing office, revenue cycle teams and others as needed. This individual will work closely with these various groups to develop, implement and manage medical record review, communication, and education strategies that are needed to achieve desired results. As a highly strategic department representative, this individual consistently demonstrates solid project management skills and behaviors, in addition to continually striving to meet and exceed customer expectations.Boston Medical Center (BMC) is more than a hospital. Its a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is...

Boston Children’s Hospital is seeking a Billing Compliance Auditor III to perform audits of clinical documentation and billing records. The role is hybrid and emphasizes accuracy, compliance, and process improvement. The auditor will prepare reports, train staff, and help develop billing policies in coordination with CHB Foundations and Hospital leadership. Applicants should have a High School Diploma or GED, CPC or CCS-P certification, and at least three years of CPT/ICD-10 coding experience, #J-18808-Ljbffr

Job Description Job Description Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Auditors with strong expertise in outpatient professional fee coding and coding audits , preferably within academic medical centers. You will review coding records, identify compliance risks, and provide expert feedback to support AI-focused projects. No prior AI experience is required. Key Responsibilities Conduct detailed audits of outpatient professional fee coding records. Review coding accuracy, documentation, and compliance. Identify coding trends, gaps, risks, and improvement opportunities. Apply academic medical center standards and coding guidelines. Document audit findings and provide clear recommendations. Evaluate complex coding and documentation scenarios. Contribute to AI training through expert coding and audit feedback. Support audit program management and quality improvement initiatives. Required Qualifications...

Position Summary Billing Compliance Auditor III (hybrid). Under general supervision performs audits of clinical documentation, physician billing and payment records and applicable industry standard 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 and third party payer regulations are being complied with; and evaluating appropriateness of billing and coding procedures. Evaluates accuracy and risk level of coding and billing performance by individuals and clinical units. Prepare reports and provide individual and/or group instruction to physicians and others based on results of audit. Works collaboratively with appropriate personnel to identify and recommend strategies for process improvement and to develop and draft billing and coding policies for the CHB Foundations in coordination with the Hospital. Assists in response...

Job Description Job Description Job Title: Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Auditors to contribute their specialized expertise to an innovative healthcare AI project. In this role, you will help improve next-generation AI systems by reviewing, evaluating, and refining medical coding and audit-related content. This opportunity is ideal for professionals with strong experience in outpatient professional fee coding, auditing, and academic medical center environments. No prior AI experience is required—your healthcare expertise is what matters most. Key Responsibilities Conduct detailed reviews and audits of outpatient professional fee coding records for accuracy, compliance, and quality. Identify coding trends, gaps, risks, and opportunities for improvement. Evaluate audit findings using knowledge of academic medical center protocols and industry best practices. Document audit results and...

Position Summary: Billing Compliance Auditor III (hybrid). Under general supervision performs audits of clinical documentation, physician billing and payment records and applicable industry standard 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 and third party payer regulations are being complied with; and evaluating appropriateness of billing and coding procedures. Evaluates accuracy and risk level of coding and billing performance by individuals and clinical units. Prepare reports and provide individual and/or group instruction to physicians and others based on results of audit. Works collaboratively with appropriate personnel to identify and recommend strategies for process improvement and to develop and draft billing and coding policies for the CHB Foundations in coordination with the Hospital. Assists in response...

Boston Children's Hospital is seeking a Billing Compliance Auditor III (hybrid) to audit clinical documentation and coding for regulatory compliance. The role involves analyzing medical records and billing records, preparing reports, and advising physicians and departments on improvements. The position requires CPC/CCS-P certification and 3 years CPT/ICD-10 coding experience, including reviewing physician documentation. #J-18808-Ljbffr

Department Description:The Critical Care Auditor/ Coder position will be working directly with the Department of Anesthesia, Critical Care and Pain Medicine and will have the opportunity to work remotely following an initial onsite training period. The incumbent will be required from time-to-time to attend billing onsite staff meetings and meetings with the physicians they support. AFS, LLC is located in Needham Heights, Massachusetts. Job Location:Virtual Job Summary:Performs professional certified coding and provides administrative and project support to the department. Analyzes surgical-medical documentation, provides the individual surgeon/physician with the application of appropriate ICD-10/CPT/HCPCS descriptor codes including the appropriate use of modifiers to ensure compliance for reimbursement. Essential Responsibilities:Analyzes evaluation and management, including critical care, procedures and other notes and documents to determine the scope and complexity of the...

Location: Boston, Massachusetts, United StatesCompany: TakedaPosted: 2026-09-09Location: Boston, Massachusetts, United StatesCompany: TakedaPosted: 2026-09-07Location: Boston, Massachusetts, United StatesCompany: TakedaPosted: 2026-09-03Location: Boston, Massachusetts, United StatesCompany: TakedaPosted: 2026-08-25Location: Boston, Massachusetts, United StatesCompany: TakedaPosted: 2026-08-19LocationsZurich, Switzerland; Boston, MAJob DescriptionOBJECTIVES / PURPOSEProvides 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...

Outpatient Coder When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Under the general supervision of the Outpatient Coding Manager and OP Coding Supervisor, the OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Essential Duties & Responsibilities including but not limited to: Hospital Coding: · Review the complete electronic and...

The Elliot Health System is seeking a Hospital Inpatient Coder to accurately assign ICD-10 and DRG codes for hospital inpatient services, ensuring compliance with guidelines, payer rules, and regulatory requirements. This role supports revenue cycle integrity and timely, precise coding to minimize denials. You'll collaborate with providers and coding leadership to resolve discrepancies, participate in audits, and contribute to quality improvement in a dynamic hospital environment. #J-18808-Ljbffr

Outpatient CoderWhen you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.Under the general supervision of the Outpatient Coding Manager and OP Coding Supervisor, the OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing.Essential Duties & Responsibilities including but not limited to:Professional Coding Coding Responsibilities:· Provides review and/or...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We’re Looking For We’re looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

Title: Certified Risk Coder Reports to: Manager, Risk Coding Classification: Individual Contributor Location: Boston (Remote) Job description revision number and date: 2.0, 01.06.2025 Organization Summary: Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Quality Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary: The Certified Risk Coder will be a part of an emerging coding team and coding service that...