601 medical coding auditor education specialist jobs found

SGMC Health is seeking a Professional Coding Auditor/Education Specialist to join our Revenue Cycle Medical Group on-site at SGMC Health Main Campus. The role focuses on auditing professional coding, educating providers, and improving documentation to support compliant billing. The ideal candidate will hold a CPC certification, prefer CPMA or CDEO, and have extensive ICD-10, HCPCS, and CPT knowledge, with strong analytical and communication skills for cross-functional collaboration. #J-18808-Ljbffr

St. Charles Health System is seeking an Ambulatory Services Auditor and Clinical Documentation Specialist I to audit outpatient, inpatient and ambulatory medical records for ICD-10-CM and CPT-4 compliance. The role provides education, feedback and guidance to physicians, clinicians and staff, ensuring accurate coding and documentation. This position supports system-wide coding quality, collaborates with the HIM team, develops procedures, tracks trends, and helps improve denials and efficiency #J-18808-Ljbffr

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...

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,...

Coding Compliance Auditor Opportunities for you! Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek Free Continuing Education and certification Tuition reimbursement, education programs and scholarships Vacation time starts building on Day 1, and builds with your seniority Free money toward retirement with a 403(b) and matching contributions Great food options with on-demand ordering Free parking and electric charging Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page. Responsibilities The Coding Compliance Auditor is a member of the Compliance Office and contributes to the Community Health System's mission to better the lives of all those we serve. As a Coding Compliance Auditor, you will be responsible for...

Summary This Medical Records Technician (Coder) Auditor position is located in the Health Information Management (HIM) section at the Southeast Louisiana Veterans Healthcare System in New Orleans, Louisiana. Learn more about this agency Duties Help Total Rewards of a Allied Health Professional 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. Reviews assigned 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). Applies guidelines specific to certain diagnoses, procedures, and other criteria used to classify patients under the Veterans...

## Medicare Risk Adjustment Compliance Auditor (CPC, CCS, or CCS-P Required) (Remote)Apply: Fully Remote: Anywhere in the U.S.: Full time: Posted Yesterday: End Date: October 16, 2026 (20 days left to apply): R2578Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.The Remote Risk Adjustment Compliance Auditor is to conduct provider and coder level reviews and audits to ensure accurate...

Summary This Medical Records Technician (Coder) Auditor position is located in the Health Information Management (HIM) section at the Southeast Louisiana Veterans Healthcare System in New Orleans - Louisiana. Summary This Medical Records Technician (Coder) Auditor position is located in the Health Information Management (HIM) section at the Southeast Louisiana Veterans Healthcare System in New Orleans - Louisiana. Qualifications Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy English Language Proficiency: MRTs (Coder) must be proficient in spoken and written English as required by 38 U.S.C. 7403(f) Experience and Education Experience One year of creditable experience that...

Essential Duties and Responsibilities These duties and responsibilities represent the general tasks performed on a daily basis; other tasks may be assigned. Coordinate, supervise, and respond to third‑party patient bill audits. Perform patient requested audits in a timely manner. Perform random quality audits as scheduled. Assist Patient Account personnel with patient questions about itemized charges. Maintain a reporting system of audit activities and identify patterns and trends of results. Act as a resource for all hospital departments with charging questions and issues. Routinely review inpatient and outpatient records for appropriate coding and charging. Provide educational sessions for revenue‑producing departments regarding appropriate charging process and procedures. Work cooperatively with the Patient Accounting staff and other health‑care professionals in obtaining correct HCPCS codes and modifiers. Assist the Health Information Department with RAC requests,...

Summary With direction from the Director, the Nurse Auditor/ Senior Revenue Integrity Specialist is responsible for auditing itemized charges versus the patient medical record and other applicable hospital documentation, assigning modifiers to appropriate claims, researching edited claims for medical necessity, and advising the billing staff of appropriate HCPCS codes and modifiers. The Nurse Auditor/ Revenue Integrity Specialist works directly with revenue producing departments regarding lost charges, billing questions, and proper coding and charging. The nurse auditor reviews documentation on all Observation accounts for carve-out observation hours, the charge coding of ED Visits and Injection and Infusion charges. Essential Duties and Responsibilities Coordinate, supervise, and respond to third party patient bill audits. Perform patient requested audits in a timely manner. Perform random quality audits as schedule permits. Work and review a high volume of accounts assigned to...

Physician Coding and Auditing Specialist Responsible for conducting independent physician coding and auditing reviews to ensure the accuracy, completeness, and compliance of medical record documentation supporting codes selected by providers and/or coders. This role ensures compliance with CMS guidelines, CPT, HCPCS, and ICD-10 code sets, while supporting providers through ongoing physician coding education, auditing feedback, compliance guidance, and training initiatives. This position plays a key role in physician documentation improvement, coding compliance, audit readiness, and provider education across the organization. Hybrid Work Expectations: To ensure collaboration, provider engagement, and training effectiveness, this position follows a hybrid work model with the following expectations: Onsite Expectations: Mandatory in-office presence at least 1 day per week (Wednesday). Additional in-office days may be required for: Training sessions Provider meetings...

Position Overview MetroPlusHealth seeks a Clinical Certified Coder to support the Special Investigations Unit in detecting, preventing, and investigating suspected fraud, waste, and abuse. The role reports to the Director of the Special Investigations Unit. Scope of Role & Responsibilities Review medical records and claims to determine accuracy and compliance with regulations. Conduct high‑risk claim audits to detect potential fraud, waste, and abuse. Collaborate with the SIU team to evaluate suspected fraudulent activities such as over‑utilization, upcoding, and non‑medically necessary services. Create detailed reports with findings, rationale, sources, and corrective action recommendations. Assist in provider calls to discuss findings and rationale. Present findings to leadership and stakeholders to facilitate FWA proceedings. Prepare documentation for audits, recoupments, compliance/legal reviews, and regulatory inquiries. Maintain thorough documentation of...

Certified Coder / Audit Specialist Summa Health Medical Group Akron, OH 44304 Full-Time Days Will work remote after training and orientation Two (2) years of work experience in a physician’s office or Out-patient/In-patient setting performing documentation review per compliance and Medicare/Medicaid Standards, diagnostic code sequencing and familiarity to Medical Terminology required. Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Certified Medical Coder (CMC), Certified Professional Coder (CPC), Certified ProfessionalMedical Auditor (CPMA) reqired. Summa Health System is recognized as one of the region’s top employers by a number of third party organizations, including NorthCoast 99. Exceptional candidates gravitate to Summa because of its culture, passion for delivering excellent service to our patients and families commitment to our philosophy of servant leadership, collegial working relationships at every level of the organization and...

Coding Auditor 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. Job Description 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....

Job Details Location: Huntington Beach Office, Huntington Beach, CA 92647. Position Type: Full Time. Salary Range: $72,800.00 – $80,000.00. This position operates on a hybrid work schedule. Candidate must reside in Los Angeles or Orange County. Job Summary The Risk Adjustment Coding Auditor is responsible for conducting retrospective and prospective coding audits, diagnosis validation reviews, provider documentation assessments, and compliance monitoring activities to support accurate Medicare Advantage risk adjustment reporting and CMS audit readiness. This role reviews medical record documentation and ICD-10-CM diagnosis coding to ensure compliance with CMS Risk Adjustment program requirements, Official Coding Guidelines, AHA Coding Clinic guidance, and organizational policies. Functions & Responsibilities Conduct retrospective, prospective, and targeted coding audits to assess the accuracy, completeness, and compliance of ICD-10-CM diagnosis coding and HCC capture....

OverviewThe Professional Coding Compliance Specialist provides revenue cycle support to Riverside Medical Group and its coding team by regularly auditing provider documentation and corresponding coding to ensure correct, complete and compliant practices that fully support diagnoses reported and charges submitted for services rendered, meet regulatory and payor-specific requirements, and accurately describe the patient encounter; providing feedback and education to providers and coders based on audit results, regulatory changes, and industry trends; assisting with orientation of new providers, residents/fellows, and new members of the coding team.Essential DutiesCompletes timely audits of assigned providers and coders for accurate, complete, and compliant ICD-10-CM and CPT/HCPCS code assignment, ensuring that documentation supports the diagnoses reported, E/M level selected, and CPT/HCPCS codes submitted for services rendered during the episodes of care reviewedReviews audit...

St. Charles Health System is seeking an Ambulatory Services Auditor and Clinical Documentation Specialist I to audit outpatient, inpatient and ambulatory medical records for ICD-10-CM and CPT-4 compliance. The role provides education, feedback and guidance to physicians, clinicians and staff, ensuring accurate coding and documentation. This position supports system-wide coding quality, collaborates with the HIM team, develops procedures, tracks trends, and helps improve denials and efficiency #J-18808-Ljbffr

Physician Coding Education SpecialistThis opportunity is a hybrid role requiring occasional on-site presence and residency in the Birmingham, AL area. Location: Hybrid, Remote 90% & On-site 10% Status: Full Time (exempt) Days: Monday through Friday Shift: Day (flextime plan with the possibility of occasional early morning/evening hours)Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. "Orlando Health Is Your Best Place to Work" is not just something we say, it's our promise to you.Performs, develops, and implements coding related efficiency processes to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Education Specialist is responsible for analyzing physician coding trends and providing educations...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Medical Coding Specialist Full Time Cloverleaf OP, KS, Overland Park, KS, US Join a Team Where Your Expertise Impacts Lives: Medical Coding Specialist Camber Mental Health, a subsidiary of KVC Health Systems, is seeking a dedicated Medical Coding Specialist to serve as our resident subject matter expert. If you are a certified professional looking to apply your skills in a high-impact behavioral health setting, we invite you to join an organization that prioritizes authenticity, compassion, and innovation. At KVC and Camber, we believe the heart of our work is helping people. Our commitment to our staff is reflected in our Indeed Work Wellbeing score of 83, demonstrating our dedication to a supportive and fulfilling professional environment. The Role As the Medical Coding Specialist, you will ensure the integrity of...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Medical Coding Specialist Full Time Cloverleaf OP, KS, Overland Park, KS, US Join a Team Where Your Expertise Impacts Lives: Medical Coding Specialist Camber Mental Health, a subsidiary of KVC Health Systems, is seeking a dedicated Medical Coding Specialist to serve as our resident subject matter expert. If you are a certified professional looking to apply your skills in a high-impact behavioral health setting, we invite you to join an organization that prioritizes authenticity, compassion, and innovation. At KVC and Camber, we believe the heart of our work is helping people. Our commitment to our staff is reflected in our Indeed Work Wellbeing score of 83, demonstrating our dedication to a supportive and fulfilling professional environment. The Role As the Medical Coding Specialist, you will ensure the integrity of patient...

1.0 FTE Full time Day - 08 Hour R2658919 Remote USA 108610021 Admin Compliance Business & Administration Day - 08 Hour (United States of America) This is a Stanford Health Care job. A Brief Overview Billing and Coding Compliance Auditors conduct audits and monitoring activities to identify and address compliance risks related to billing and coding practices. They review and evaluate healthcare regulatory compliance, focusing on the detection of documentation, coding, and billing errors. Responsibilities include assessing the adequacy and accuracy of documentation supporting billed services, including ICD, CPT, HCPCS, and other third-party payer codes, as well as adherence to Teaching Physician guidelines, Evaluation & Management criteria, DRG and APC assignments, medical necessity, and reimbursement accuracy. Auditors serve as a communication channel, partnering with Billing and Coding Compliance Educators to address compliance issues. They are responsible for conducting...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Medical Coding Specialist Full Time Cloverleaf OP, KS, Overland Park, KS, US Join a Team Where Your Expertise Impacts Lives: Medical Coding Specialist Camber Mental Health, a subsidiary of KVC Health Systems, is seeking a dedicated Medical Coding Specialist to serve as our resident subject matter expert. If you are a certified professional looking to apply your skills in a high-impact behavioral health setting, we invite you to join an organization that prioritizes authenticity, compassion, and innovation. At KVC and Camber, we believe the heart of our work is helping people. Our commitment to our staff is reflected in our Indeed Work Wellbeing score of 83, demonstrating our dedication to a supportive and fulfilling professional environment. The Role As the Medical Coding Specialist, you will ensure the integrity of...