186 inpatient coding auditor icd 10 expert jobs found

Humana Inc is seeking an Inpatient Medical Coding Auditor to join their coding disputes team. This remote position involves reviewing DRG and ICD-10-CM coding for accuracy while collaborating with coding professionals to achieve compliant outcomes. The ideal candidate holds RHIA, RHIT, or CCS certification, with experience in inpatient coding audits. Benefits include health coverage, paid time off, 401(k) match, and career development opportunities. #J-18808-Ljbffr

Cognizant is seeking an Inpatient Medical Coding Auditor to audit consultant inpatient records and mentor clients in coding, billing and compliance. This remote role is open to qualified applicants in the United States. You will review inpatient records for diagnostic and procedural coding accuracy, work with Solventum (3M), and maintain high accuracy while collaborating with stakeholders. Experience with EPIC is a plus. #J-18808-Ljbffr

Job Type Full-time Description University Health Network is seeking a Full-Time Coding Auditor. This role requires normal business hours Monday-Friday and is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region. UHN Auditor provides superior customer experience by educating internally and externally of errors and opportunities for improvement discovered during routine auditing. This individual will work closely with management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. The UHN Auditor performs duties in a professional manner while exercising good judgment and ethical standards, interacts effectively and builds respectful working relationships across the organization, and demonstrates integrity by adhering to high standards of personal and professional conduct. This...

Revenue Cycle Coder Lead-Inpatient Coding Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings. As our Lead Inpatient Coder, you will be a cornerstone of our medical coding department, providing essential leadership and strategic direction for our inpatient coding team. You will be instrumental in driving coding accuracy, ensuring regulatory compliance, and optimizing revenue cycle performance for complex medical cases, making a direct impact on our healthcare data integrity and financial health. Every day you will provide expert technical guidance, conduct comprehensive...

Coder The Coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM, ICD-10-PCS, and CPT codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Abides by the standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to all official coding guidelines. Verifies that all ICD-10-CM and CPT codes are correctly captured. Verify that physician is correctly abstracted. Keeps abreast of coding guideline changes by self-study, assigned education, coding meeting attendance or related in-services. Participates in internal and external quality review meetings. Performs other duties as assigned. Resolves billing related errors and assists with workflow changes and process improvement projects. Meets ongoing productivity and quality standard of 95% accuracy rate or better....

Inpatient Coding Auditor The Inpatient Coding Auditor is responsible for auditing inpatient coding and DRG assignment to ensure accurate ICD-10-CM/PCS coding, documentation support, and compliance with official guidelines and payer requirements. This role tracks audit outcomes, supports corrective actions, and provides education to improve coding quality and reduce audit risk. Responsibilities include, but are not limited to: Review entire medical record to confirm correct assignment of ICD-10-CM/PCS coding, sequencing and POA to ensure proper assignment of MS-DRG/APR-DRG. Review clinical documentation for guideline compliance, clinical support, and accurate capture of CC/MCC and key secondary diagnoses and procedures. Identify trends, root causes, and compliance risks; recommend corrective actions and process improvements in collaboration with coding leadership and CDI. Work closely with leadership create and prepare detailed audit reports, including findings,...

Summary The Health Information Section (HIMS) Coding Auditor is responsible for coding and provider audits. Overseeing the appropriate coding assignment of ICD-10 CM, CPT-4, and HCPCS codes and various other duties assigned. Incumbent will also complete any coding assigned. **REMOTE WORK: Position is remote work eligible and is currently on an extension for the return-to-office mandate**. Learn more about this agency Duties Help Duties of the Medical Records Technician (Coder) Auditor include but are not limited to: Performs weekly or monthly audits of outpatient encounters. Reviews results of external audits and prepares education and/or audit responses. Performs monthly audits related to VHA Directives to include in-house and contract coding audits, EPRP reviews, revenue related/CPAC audits and other coding risk areas identified by Compliance, CPAC, VISN, external auditors medical center leadership and HIMs. Researches current guidelines related to...

Job Description Job Description Description: The Facility Inpatient Coding Auditor is responsible for auditing inpatient facility coding with a focus on OB/NB, CAH, & Rehab auditing, for accuracy, compliance, and quality, while providing education and feedback to coding and QA team members. This role ensures adherence to official coding guidelines, regulatory requirements, and organizational standards, and supports continuous improvement through targeted education, data analysis, and collaboration. Coding Audit & Compliance Conduct comprehensive audits of inpatient facility coding, including MS-DRGs, ICD-10-CM/PCS, POA indicators, discharge disposition, and quality-related data elements Ensure compliance with official coding guidelines, CMS regulations, payer requirements, and internal policies Identify coding errors, trends, and root causes impacting reimbursement, quality metrics, and compliance risk Validate documentation supports coded diagnoses and...

Auditing Team Lead Under direct supervision, the Auditing Team Lead provides day to day supervision and instruction of the auditors. The Auditing Team Lead oversees the internal and external auditing function and assists Director Inpatient Coding, Coding Audits, and Education in developing reports specific to audit findings and assists with implementing action plans. The Auditing Team Lead ensures internal audits are accurate, complete and reported on a timely basis and serves in an advisory and educator role for Coding Specialists. Principal Responsibilities and Tasks The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified. 1. Provides for day to day supervision and instruction for the auditors which includes audit assignments, problem solving, monitoring productivity and...

At 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 Summary Position is responsible for leading multiple reviews / audits of healthcare coding, billing, documentation, operations, and related risk areas to support compliance with regulatory standards, internal policies and procedures, and other guidelines. Typically reports to Director, Corporate Compliance. Job Description Location : Memorial Hermann, Memorial City Status :...

Job Description Job Description Description: Full-Time, Remote Temporary Opportunity with Long-Term Potential The Facility Inpatient Coding Auditor is responsible for prebill audits for inpatient facility coders with a focus on accuracy, compliance, and quality, while providing education and feedback to coding and QA team members. This role ensures adherence to official coding guidelines, regulatory requirements, and organizational standards, and supports continuous improvement through targeted education, data analysis, and collaboration. Coding Audit & Compliance Conduct comprehensive audits of inpatient facility coding, including MS-DRGs, ICD-10-CM/PCS, POA indicators, discharge disposition, query opportunities, and quality-related data elements Ensure compliance with official coding guidelines, CMS regulations, payer requirements, and internal policies Identify coding errors, trends, and root causes impacting reimbursement, quality metrics, and...

Focusing on Coding & Clinical Chart Validation, the full-time Clinical Coding Auditor will analyze and audit inpatient claims, ensuring coding accuracy and appropriateness of treatment settings while utilizing proprietary auditing tools. Key responsibilities Analyzes and audits claims using advanced ICD-10 coding expertise and clinical guidelines Utilizes proprietary auditing systems to make determinations and generate audit letters Maintains production and accuracy standards set by the audit operations management team Required qualifications Associate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT) 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG Certification in coding/CDI (e.g., RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS) Proficiency in Word, Access, Excel, TEAMS, and other applications Expert knowledge of coding guidelines and compliance regulations

Auditing inpatient facility coding for accuracy and compliance, the full-time Facility Inpatient Coding Auditor will work remotely to ensure adherence to coding guidelines and provide education and feedback to coding and QA teams. Key responsibilities Conduct comprehensive audits of inpatient facility coding, focusing on MS-DRGs, ICD-10-CM/PCS, and quality-related data elements Ensure compliance with official coding guidelines, CMS regulations, and internal policies while identifying coding errors and trends Provide feedback and coaching to team members based on audit findings to support continuous improvement Required qualifications Active coding credential: RHIA, RHIT, or CCS (required) Minimum of 3 years of inpatient facility auditing experience Expert knowledge of ICD-10-CM/PCS, MS-DRGs, and POA indicators Strong understanding of CMS regulations and compliance standards Experience working with or supporting global or remote coding teams

To support a growing healthcare organization, the full-time remote Facility Inpatient Coding Auditor will conduct prebill audits for inpatient facility coders, ensuring accuracy, compliance, and quality while providing education and feedback to team members. Key responsibilities Conduct comprehensive audits of inpatient facility coding, focusing on MS-DRGs, ICD-10-CM/PCS, and compliance with official guidelines Identify coding errors and trends, analyzing their impact on reimbursement and compliance risk Validate documentation to ensure it supports coded diagnoses and procedures while collaborating with coding and QA teams Required qualifications Active coding credential: RHIA, RHIT, or CCS Minimum of 3 years of inpatient facility auditing experience Expert knowledge of ICD-10-CM/PCS, MS-DRGs, and POA indicators Strong understanding of CMS regulations and compliance standards Experience working with or supporting global or remote coding teams

Focusing on Coding & Clinical Chart Validation, the full-time Clinical Coding Auditor will analyze and audit inpatient claims, ensuring coding accuracy and appropriateness of treatment settings while utilizing proprietary auditing tools. Key responsibilities Analyzes and audits claims using advanced ICD-10 coding expertise and clinical guidelines Utilizes proprietary auditing systems to make determinations and generate audit letters Maintains production and accuracy standards set by the audit operations management team Required qualifications Associate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT) 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG Certification in coding/CDI (e.g., RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS) Proficiency in Word, Access, Excel, TEAMS, and other applications Expert knowledge of coding guidelines and compliance regulations

Full-Time, RemoteTemporary Opportunity with Long-Term Potential The Facility Inpatient Coding Auditor is responsible for prebill audits for inpatient facility coders with a focus on accuracy, compliance, and quality, while providing education and feedback to coding and QA team members. This role ensures adherence to official coding guidelines, regulatory requirements, and organizational standards, and supports continuous improvement through targeted education, data analysis, and collaboration. Coding Audit & Compliance Conduct comprehensive audits of inpatient facility coding, including MS-DRGs, ICD-10-CM/PCS, POA indicators, discharge disposition, query opportunities, and quality-related data elements Ensure compliance with official coding guidelines, CMS regulations, payer requirements, and internal policies Identify coding errors, trends, and root causes impacting reimbursement, quality metrics, and compliance risk Validate documentation supports coded diagnoses and...

Full-Time, Remote Temporary Opportunity with Long-Term Potential The Facility Inpatient Coding Auditor is responsible for prebill audits for inpatient facility coders with a focus on accuracy, compliance, and quality, while providing education and feedback to coding and QA team members. This role ensures adherence to official coding guidelines, regulatory requirements, and organizational standards, and supports continuous improvement through targeted education, data analysis, and collaboration. Coding Audit & Compliance Conduct comprehensive audits of inpatient facility coding, including MS-DRGs, ICD-10-CM/PCS, POA indicators, discharge disposition, query opportunities, and quality-related data elements Ensure compliance with official coding guidelines, CMS regulations, payer requirements, and internal policies Identify coding errors, trends, and root causes impacting reimbursement, quality metrics, and compliance risk Validate documentation supports...

We do Consulting Differently The Healthcare Compliance Auditor position is a staff consulting position within the Healthcare Transactions and Strategy (HTS) group. HTS is currently seeking a Healthcare Compliance Auditor at the Consultant level. HTS performs regulatory, reimbursement, data analytics, and compliance auditing for healthcare providers, healthcare payers and healthcare investors. Compliance audit deliverables include assessment of provider compliance programs and auditing of billing and coding of clinical documents and claims documents. This position requires a highly motivated problem solver with strong analytical ability, solid organizational skills, and a desire to advance within the organization. The work of a Healthcare Compliance Auditor will involve execution of engagement work streams that will primarily involve employing certified coding skills to audit provider claims and provider clinical documentation with a particular focus on government programs...

Certified Coder The Certified Coder will play a key role in converting diagnoses and treatment procedures into ICD-10, CPT and HCPCS codes. The Coder will review and accurately code office and hospital procedures for reimbursement. Essential Functions Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Reviews and verifies documentation supports diagnoses, procedures, and treatment results. Identifies diagnostic and procedural information. Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes. Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing...

DATE: July 20, 2026 POSITION: Risk Adjustment Compliance Coder DEPARTMENT: Finance-Risk Adjustment RATE: $28.86 per hour, with potential for additional compensation based on qualifications. POSITION SUMMARY: The Risk Adjustment Compliance Coder is responsible for enhancing the accuracy, quality, and integrity of coding data that supports Medicare and Medicaid reimbursement. This role conducts risk adjustment coding audits, performs compliance research, responds to coding inquiries, and serves as a subject matter expert in risk adjustment coding and compliance. The position supports Medicare and Medicaid risk adjustment programs through the development, implementation, and ongoing evaluation of program initiatives. Highly collaborative and operational in nature, this role partners closely with providers and internal stakeholders and requires strong communication, education, and relationship‑management skills. This is not a traditional production‑focused coding position. ESSENTIAL...

Outpatient Coder - Coding - 338010 US:NM:Alamogordo | Medical Coding | Full Time Summary: Responsible for maintaining current and high-quality ICD-10-CM and CPT coding for all Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. The coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM Guidelines for Coding and Reporting and CPT Guidelines. Outpatient coding is applicable towards clinical, provider office visits, therapeutic, laboratory, recurring, emergency department, outpatient observation, and ambulatory surgery patient encounters. Coder will work collaboratively with various CHRISTUS Health departments (Admitting, Charging, Patient Financial Services, HIM, etc.) to resolve charging issues,...

Description WHAT IT'S LIKE AT SGMC HEALTH Purpose . No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place. Excellence . We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service. Team Spirit. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. Award Winning Performance. We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides. WHY YOU WILL LOVE SGMC HEALTH SGMC has great benefit options, depending on the role that you are going into- including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities...

Medical Coder Individual responsible for coding all hospital records for purposes of reimbursement, research, and compliance with federal regulations. Applies correct ICD-10-CM diagnosis, ICD-10-PCS or CPT procedure codes, applies modifiers and assigns appropriate DRG, APC, and E-APG's. Coder must abstract statistical data from records into hospital abstracting system in accordance with hospital policies and procedures. Individual must have knowledge of ICD-10-CM/PCS, CPT, APC's, E-APG's, and DRGs, federal and state coding guidelines. Responsibilities Reviews patient's entire current medical record and assigns appropriate ICD-10-CM diagnosis, ICD-10-PCS or CPT procedure codes according to accepted coding guidelines and hospital's policies and procedures. Assigns accurate DRG, APC, or E-APG to patient's record utilizing hospital encoding system. Accurately abstracts statistical data from records using hospital abstracting system in accordance with hospital policies and...

Overview Individual responsible for coding all hospital ED, RCR, CLI, REF records for purposes of reimbursement, research, and compliance with federal regulations. Applies ICD-10 diagnosis and CPT procedure codes and appropriate APC or E- APG. Coder must abstract statistical data from records into hospital abstracting system in accordance with hospital policies and procedures. Individual must have knowledge of CPT, APCs, E-APG's, federal and state coding guidelines. Responsibilities Reviews patient's entire current medical record and assigns appropriate ICD-10 diagnosis and CPT procedure codes according to accepted coding guidelines and hospital's policies and procedures. Assigns accurate APC and E-APG's to patient's record utilizing hospital encoding system. Corrects any edits flagged by encoder and financial system. Understands and applies modifiers appropriately. Charge entry. Accurately abstracts statistical data from records using hospital abstracting...