609 coding compliance auditor outpatient jobs found

Location: Montgomery, Alabama, United StatesSalary: $72,800 to $130,000 annuallyCompany: UnitedHealth GroupPosted: 2026-09-09Outpatient Coding Compliance AuditorOptum 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.The Outpatient Coding Compliance Auditor performs audits of outpatient facility (OPPS) coding to ensure accurate assignment of ICD-10-CM diagnoses, CPT/HCPCS codes, modifiers, and facility E/M levels (ACEP or client-specific). This role reviews coding...

Outpatient Coding Compliance Auditor 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. The Outpatient Coding Compliance Auditor performs audits of outpatient facility (OPPS) coding to ensure accurate assignment of ICD-10-CM diagnoses, CPT/HCPCS codes, modifiers, and facility E/M levels (ACEP or client-specific). This role reviews coding for alignment with medical record documentation and established guidelines, ensuring compliance with applicable laws,...

The Valley Health System in Ridgewood, NJ is seeking an Outpatient Coding Auditor to review outpatient records for compliance with coding guidelines and regulatory requirements. You will identify trends, educate staff, and collaborate with external vendors to implement industry best practices and improve overall audit results. Requires 5+ years in hospital auditing with ICD-10-CM, outpatient CPT-4, HCPCS coding experience; 3M Encoder experience and EPIC/Meditech/CERNER familiarity are preferred. #J-18808-Ljbffr

Valley Health System is seeking an experienced Outpatient Coding Auditor to review coded outpatient encounters for accuracy and compliance. You will support coding education, identify audit variances, and partner with leadership to drive process improvements. A collaborative role with external vendors ensures ongoing adoption of industry best practices. Requirements include a high school diploma or equivalent, 5+ years in hospital auditing or related education experience, and proficiency in #J-18808-Ljbffr

Outpatient Coding Compliance AuditorOptum 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.The Outpatient Coding Compliance Auditor performs audits of outpatient facility (OPPS) coding to ensure accurate assignment of ICD-10-CM diagnoses, CPT/HCPCS codes, modifiers, and facility E/M levels (ACEP or client-specific). This role reviews coding for alignment with medical record documentation and established guidelines, ensuring compliance with applicable laws,...

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: Responsible for auditing coded inpatient or outpatient medical records applying ICD-10 CM/PCS and/or CPT-4. Reviews Ambulatory Payment Classification (APC), Medicare Severity Diagnosis Related Groups (MSDRG) and All Patients Refined Diagnosis Related Groups (APRDRG) assignment and queries following official coding guidelines and regulatory requirements. Provides training and education based on audit results and any regulatory changes that effect Federal, State and American Health Information Management Association (AHIMA) guidelines. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS standards and regulatory requirements.Works closely...

Emory Healthcare is seeking an Outpatient Coding Auditor to implement and maintain a compliance plan for outpatient coding and reimbursement, and to assist the Coding Manager with outpatient and emergency coding services. The role includes developing education programs, supervising HIM Compliance activities, and coordinating continual reviews and quality audits to ensure accurate APC assignment and reimbursement. Strong communication and organization are essential. #J-18808-Ljbffr

Location: Atlanta, Georgia, United StatesCompany: Emory HealthcarePosted: 2026-09-01Emory Healthcare is seeking an Outpatient Coding Auditor to implement and maintain a compliance plan for outpatient coding and reimbursement, and to assist the Coding Manager with outpatient and emergency coding services.The role includes developing education programs, supervising HIM Compliance activities, and coordinating continual reviews and quality audits to ensure accurate APC assignment and reimbursement. Strong communication and organization are essential.#J-18808-Ljbffr

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: Responsible for auditing coded inpatient or outpatient medical records applying ICD-10 CM/PCS and/or CPT-4. Reviews Ambulatory Payment Classification (APC), Medicare Severity Diagnosis Related Groups (MSDRG) and All Patients Refined Diagnosis Related Groups (APRDRG) assignment and queries following official coding guidelines and regulatory requirements. Provides training and education based on audit results and any regulatory changes that effect Federal, State and American Health Information Management Association (AHIMA) guidelines. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS standards and regulatory requirements.Works closely...

Coding AuditorLocation: Miramar, FloridaAt 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.Job DescriptionResponsible for auditing coded inpatient or outpatient medical records applying ICD-10 CM/PCS and/or CPT-4. Reviews Ambulatory Payment Classification (APC), Medicare Severity Diagnosis Related Groups (MSDRG) and All Patients Refined Diagnosis Related Groups (APRDRG) assignment and queries following official coding guidelines and regulatory requirements. Provides training and education based on audit results and any regulatory changes that effect Federal, State and American Health Information Management Association (AHIMA) guidelines.ResponsibilitiesMaintains strict adherence to patient confidentiality according to MHS standards and regulatory requirements. Works closely...

Valley Health System in Ridgewood, NJ is seeking an Outpatient Coding Auditor to review coded outpatient records for adherence to official coding guidelines, regulatory standards, and internal policies. The role drives education and process improvements through detailed case reviews and trend analyses. The incumbent will collaborate with external vendors and coding leadership to ensure accuracy and implement best practices in audit feedback and staff education. #J-18808-Ljbffr

Emory Healthcare is seeking an Outpatient Coding Auditor to support the Coding Manager with outpatient and emergency coding services, and to help develop policies and procedures. The role includes educating staff across departments on documentation and coding requirements, ICD-10-CM guidelines, and CPT/HCPCS conventions for outpatient surgery. Ideal candidates will have CCS certification, 4+ years ICD-10 coding in acute care, and at least 2 years of APC coding audits. #J-18808-Ljbffr

Location: New York, United StatesCompany: HumanaPosted: 2026-09-09Location: New York, United StatesCompany: HumanaPosted: 2026-09-07Location: New York, United StatesCompany: HumanaPosted: 2026-09-04Location: New York, United StatesCompany: HumanaPosted: 2026-09-01Humana Inc. is seeking a Senior Medical Coding Outpatient Auditor to lead coding-focused audit activities, validate coding accuracy, and ensure compliance with outpatient coding and reimbursement guidelines. You will report to the Manager, Payment Integrity.The role involves researching claims anomalies, applying CPT/HCPCS guidelines, and collaborating with clinical and analytics teams to improve audit strategies. Remote work with occasional travel is possible.#J-18808-Ljbffr

Job Description PYA is seeking an Inpatient/Outpatient Facility Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue and Compliance Advisory Program . RESPONSIBILITIES Apply inpatient and outpatient facility/hospital coding and reimbursement methodologies to provide advisory services to PYA clients with a focus on the following: ICD-10-CM and PCS/CPT/HCPCS code assignment MS-DRG and other DRG validation APC validation and charge capture Clinical documentation improvement Regulatory compliance for third party payors Work in collaboration with the PYA executive team and other service lines to offer complete business solutions to clients Manage the preparation of excellent client deliverables and exhibit exceptional project management skills while balancing firm risk and compliance with appropriate professional standards QUALIFICATIONS Professional...

PYA, a leading independent professional services firm, seeks an Inpatient/Outpatient Facility Coding Auditor to join its Revenue and Compliance Advisory Program. The role supports advisory services across inpatient and outpatient coding, DRG validation, and CDI initiatives for national clients. The ideal candidate has at least 5 years of inpatient coding auditing experience, professional credentials (CCS/RHIA/RHIT/CIC), and strong communication and project-management skills to manage multiple #J-18808-Ljbffr

NON-CLINICAL CODING AUDITOR AND TRAINER - 5525 US:NV:Carson City | Information Management | Full Time Description US:NV:Carson City Health Information Management Full Time Standard Office Hours Summary The Non-Clinical Coding Auditor and Trainer reviews services provided and compares them to EHR and billing records to determine accuracy. This position is responsible for performing quality reviews of outpatient medical records to validate the integrity of ICD-10 diagnoses and procedures as well as CPT/CPT II/PCS coded procedures. The position reviews medical records and other documentation to identify under and over coded services, prepares reports of findings and meets with management to educate on and improve coding practices. The Coding Auditor and Trainer ensures appropriate coding and maintains compliance documentation. This position ensures that billing is optimized, and errors are minimized by identifying opportunities through audit and observation; remaining abreast of...

Imagine doing meaningful work in a place where peoplevacation.That’slife at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties. If you want a career in healthcare and alifestylemost people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be Munson Material. To us, that means teammates who live by our values of excellence,teamness, positivity, creativity, and a commitment to creating exceptional experiences for our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country. Invested in You Grow: Tuition reimbursement, in-person and onlinedevelopment,and access to ourcareer hubto help you advance. Thrive: Full benefits, paid holidays, generous PTO, employee discounts, and freeindividualretirement counseling....

PYA seeks an Inpatient/Outpatient Facility Coding Auditor to support its Revenue and Compliance Advisory Program. This role focuses on ICD-10-CM/PCS coding, DRG validation, APC validation, and CDI, while ensuring regulatory compliance for payors. You will collaborate with the executive team to deliver top-tier client work. Ideal candidates have 5+ years in inpatient coding auditing, strong medical terminology knowledge, and experience with professional services firms. #J-18808-Ljbffr

Job Description PYA is seeking an Inpatient/Outpatient Facility Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue and Compliance Advisory Program . RESPONSIBILITIES Apply inpatient and outpatient facility/hospital coding and reimbursement methodologies to provide advisory services to PYA clients with a focus on the following: ICD-10-CM and PCS/CPT/HCPCS code assignment MS-DRG and other DRG validation APC validation and charge capture Clinical documentation improvement Regulatory compliance for third party payors Work in collaboration with the PYA executive team and other service lines to offer complete business solutions to clients Manage the preparation of excellent client deliverables and exhibit exceptional project management skills while balancing firm risk and compliance with appropriate professional standards QUALIFICATIONS Professional...

Compliance Coding Auditor Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year. All queries arising from the audit process are...

Job Opportunity At Memorial HermannAt Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.Job DescriptionResponsible for providing accurate, reliable and effective education to physicians and extenders regarding outpatient procedural and diagnosis coding. This position performs individual and group documentation reviews, identifies opportunities for improvement, assists with implementation of physician lead CME documentation and coding courses...

GS-09 Medical Records Technician (Coder) Auditor The GS-09 Medical Records Technician (Coder) Auditor position is above the journey level and duties include but are not limited to: Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection. Selects and assigns codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS). Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management code to ensure ethical, accurate, and complete coding. Applies codes based on guidelines...