39 medical coding auditor jobs found in Dallas, TX

Medical Coding Auditor (CPC) at McDermott Will & Schulte Farragut Square Group provides clients with research and policy advisory services on a range of healthcare topics, including Billing and Coding. This description reflects the Medical Coding Auditor role with CPC certification; reporting line to the VP of Billing & Coding within the group. Overview We are looking for a CPC-certified Medical Coding Auditor who thrives in a fast-paced, collaborative environment. The role involves performing accurate auditing reviews of medical records and physician services to identify and report audit outcomes and education needs, ensuring compliance with ICD-10-CM, ICD-10-PCS, CPT, CDT, HCPCS coding and modifier guidelines. Responsibilities Perform accurate and compliant auditing reviews of medical records and physician services to identify and report audit outcomes and coding education needs. Conduct coding reviews for practice and ASC-based services, ensuring compliance with coding...

Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: • Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to...

Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: · Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to Standards...

Title: Physician Compliance Auditor Length of Assignment:3 months Work Location: Dallas, TX - 75246 Work Schedule: Mon-Fri, 8 am - 5 pm Interview Type: 2 rounds of interviews Certification/Degree Requirements: CPC, CCS, RHIT - must have one and Please attach in resume Top Skills: Provider education/audit required, 5 years exp minimum, epic is preferred Additional Notes: Consulting exp is highly preferred Restricted States: California, Hawaii, New Jersey, New York, North Dakota, Oregon, Puerto Rico, Rhode Island, US Virigin Islands, Washington, Wyoming JOB SUMMARY: Currently, there is only one level of Physician Compliance Auditor. Even though there are some more advanced and knowledgeable Physician Compliance Auditors, they all have the same designation. Risk Management and Revenue Cycle Management both have several levels of coders/auditors. This would help to give Physician Compliance Auditors an additional position to aspire to. Information highlighted in red...

We are a professional staffing firm, working with organizations across the country to place exceptional candidates. Currently, we have a Physician Compliance Auditor opportunity with a nationally recognized healthcare system that combines cutting-edge medical innovation with compassionate, patient-centred care, offering rewarding career growth in a supportive environment. This position is Fully Remote. Length of assignment: 90 days (Temp-to-Perm with possible extension) Physician Compliance Auditor responsible for the specific duties listed below. Your specific duties will include: Conducting annual specialty-based chart audits, developing recommendations, and communicating findings to the appropriate personnel. Implementing annual coding reviews to identify compliance concerns and areas of risk. Designing and delivering educational curriculum for providers and staff on medical record documentation, coding guidelines, and methodologies. Supporting...

Details Client Name Baylor Scott & White Health Job Type Travel Offering Non-Clinical Profession Non-Clinical Specialty Credentialing Coordinator Job ID 34564399 Job Title Physician Compliance Auditor 2 Weekly Pay $863.28 Shift Details Shift Day - 8x5 - 09AM Scheduled Hours 40 Job Order Details Start Date 11/24/2025 End Date 02/23/2026 Duration 13 Week(s) Job Description Job Title: Physician Compliance Auditor 2 Profession: Physician Compliance Auditor 2 Specialty: Physician Compliance Auditor 2 Duration: Temp Only Shift: Mon-Fri Hours per Shift: 8 Experience: Minimum 5 years required License: N/A Certifications: CPC, CCS, RHIT - must have one Must-Have: Provider education/audit experience required, Epic preferred Description: Perform annual chart audits and formulate recommendations based upon the audit findings. Implement annual coding reviews and ensure compliance issues and areas of risk are...

We're seeking an experienced Physician Compliance Auditor to join our team. In this role, you'll support compliance efforts by performing chart audits, providing provider education, and ensuring adherence to coding and documentation standards. This role is ideal for someone who enjoys problem-solving, educating providers, and ensuring compliance standards are met with accuracy and integrity. Must hold one of the following certifications: CPC, CCS, or RHIT salary: $25.99 - $26 per hour shift: First work hours: 8 AM - 5 PM education: High School Responsibilities 1. Perform annual chart audits (mostly in their areas of expertise) and formulate recommendations based upon the audit findings and communicate them to the appropriate personnel. 2. Implement annual coding reviews and ensure that compliance issues and areas of risk are identified and addressed. 3. Develop curriculum to be used in orienting and educating providers and staff in the specialty clinics to medical...

Job Title: Physician Compliance Auditor 2 Job Location: Fully Remote Job Duration: Dallas, TX Shift: Mon-Fri, 8am - 5pm Job Summary: Currently, there is only one level of Physician Compliance Auditor. Even though there are some more advanced and knowledgeable Physician Compliance Auditors, they all have the same designation. A great dissatisfier repeatedly in the People Survey has been the lack of opportunities for advancement in Compliance. Risk Management and Revenue Cycle Management both have several levels of coders/auditors. This would help to give Physician Compliance Auditors an additional position to aspire to. Information highlighted in red highlights the differences between Physician Compliance Auditors I and II. Duties and Responsibilities: Perform annual chart audits (mostly in their areas of expertise) and formulate recommendations based upon the audit findings and communicate them to the appropriate personnel. Implement annual coding...

Hours of Work : Flexible 8 am - 4:30 pm Days Of Week : Monday through Friday Work Shift : Job Description : Remote or On-Site (Dallas, TX) Employment/Education History Requirements : Certifications : High school education or equivalent; some college credit; Bachelor's degree preferred. Certified Professional Coder ( CPC ) certification from AAPC or Certified Coding Specialist - Physician-based ( CCS-P ) certification from AHIMA with the appropriate level of experience for auditing and abstracting. Preferred : Certified Professional Medical Auditor (CPMA) certification from AAPC Experience/Knowledge : 2+ years of multispecialty auditing medical documentation experience for appropriate E&M level and CPT assignment or 4-5 years of multispecialty coding experience. Thorough knowledge of anatomy/medical terminology. Proficient with Microsoft Word and Excel. Experience with Epic preferred. Ability to communicate effectively via written and...

GI Alliance is seeking an experienced Coding Auditor & Provider Educator. Duties of this position include, but are not limited to, the following: Position Purpose The Compliance Auditor I will be responsible for researching and analyzing the medical record where there is a discrepancy in coding, validating the coding and preparing reports that summarize audit findings and provide recommendations for corrective actions, if warranted. Responsibilities/Duties/Functions/Tasks: * Conducts physician chart audits to identify incorrect coding and prepares reports of findings and issues. * Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. * Reports coding patterns identified within the audit process to the Coding Auditor & Provider Education Manager and identifies corrective measures to problems. * Provides second-level review of organization's billing performance to ensure...

2 days ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here, each employee has the chance to make a real difference by carrying out our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right Time, in the Right Place. Job Description The Billing Compliance Auditor performs comprehensive audits within the Skilled Home Health, Hospice, Behavioral Health, and Personal Care Services (PCS) agencies at Elara Caring to ensure compliance with Medicare and Medicaid regulations and billing rules. Areas of focus for audits will include, but are not limited to eligibility, billing, coding, and clinical documentation. Duties of the Billing Compliance Auditor include but are not limited to: Conducting audits in accordance with internal policies and procedures and the annual...

Healthcare Coding Auditor, Ambulatory Surgery Centers - Remote based in the US Join to apply for the Healthcare Coding Auditor, Ambulatory Surgery Centers - Remote based in the US role at United Surgical Partners International, Inc Location: Remote Based in the US Responsibilities Serve as support to ASC coders, hospital coders, and coding compliance teams by assisting with pre‑bill internal coder monitoring, auditing and training of new hires, and coders with low audit scores. Assist in analyzing enterprise audit results, identifying risk areas, and focusing coder education. Field coding questions from coding teams and facilities via research of all available authoritative coding references. Manage field requests from managed care and revenue cycle departments. Other duties as assigned. Requirements RHIA, RHIT, CPC, or CCS certification required. Must have knowledge of AMA, CMS, and CPT coding guidelines. Knowledge of ICD‑10‑CM, medical terminology, anatomy &...

Coding Auditor & Provider Educator – GI Alliance GI Alliance is seeking an experienced Coding Auditor & Provider Educator. The role focuses on researching and analyzing medical records with coding discrepancies, validating coding, and preparing audit reports that summarize findings and recommend corrective actions. Responsibilities Conduct physician chart audits to identify incorrect coding and prepare findings reports. Examine claims for compliance with billing and processing guidelines and identify fraud and abuse opportunities. Report coding patterns to the Coding Auditor & Provider Education Manager and recommend corrective measures. Provide second‑level review of billing performance to ensure legal and procedural compliance. Give feedback to providers on billing and documentation policies and educate on ambiguous or non‑specific documentation. Perform quality assessment of records, including verification of electronic and handwritten documentation....

Innova Solutions has a client that is immediately hiring for a Physician Compliance Auditor 2. Position type: Full-time Contract Duration: 3+ months (Contract to Hire) Location: Remote As a Physician Compliance Auditor 2, you will: Perform annual chart audits (mostly in their areas of expertise) and formulate recommendations based upon the audit findings and communicate them to the appropriate personnel. Implement annual coding reviews and ensure that compliance issues and areas of risk are identified and addressed. Develop curriculum to be used in orienting and educating providers and staff in the specialty clinics to medical record documentation guidelines and standards and to diagnostic and procedural coding conventions and methodologies. Assist in specialty coding educational sessions with Revenue Cycle Management (RCM) and Risk Based Coding. Coding compliance resource and consultant for all physicians and advance practice providers, company...

Physician Compliance Auditor 2 - Healthcare & Research Job ID: 1008401 Dallas , Texas Job Type: Contract Added - 21 hours ago Job Description A client of Innova Solutions is immediately hiring for a Physician Compliance Auditor . Position type: Full‑Time, Contract Duration: 9 Month Location: Remote As a Physician Compliance Auditor , you will: Perform annual chart audits (mostly in their areas of expertise) and formulate recommendations based upon the audit findings and communicate them to the appropriate personnel. Implement annual coding reviews and ensure that compliance issues and areas of risk are identified and addressed. Develop curriculum to be used in orienting and educating providers and staff in the specialty clinics to medical record documentation guidelines and standards and to diagnostic and procedural coding conventions and methodologies. Assist in specialty coding educational sessions with Revenue Cycle Management (RCM) and Risk Based Coding. Coding...

Description Summary: The HCC Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is an onsite position with a remote option. Responsibilities: Perform Medical Record reviews and audits based on organizational priorities. These can include both prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk adjustment....

Job Description Job Description We are hiring a part-time Medical Coder to to assign procedure,diagnosis codes for insurance billing, review claims data, research and corresponds with insurance companies in an effort to obtain accurate reimbursement for healthcare claims. . Duties include but are not limited to: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims Adhere to coding policies and procedures consistent with the industry standard guidelines for CPT, ICD-9 and ICD-10. Answer coding questions Review clinical documentation to ensure it meets level of CPT codes and ICD-10 codes...

Job Description Job Description THIS IS NOT A REMOTE POSITION We are hiring a Medical Records Clerk/Coder to assign procedure, and diagnosis codes for insurance billing, review claims data, research, and correspond with insurance companies to obtain accurate reimbursement for healthcare claims. This person will also be responsible for analyzing, abstracting, compiling data, and generating reports. This position must provide customer service excellence when dealing with internal and external contacts. Duties include but are not limited to: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place before submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims...

Manager Compliance Coding Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for qualified candidates like you to join our Texas Health family. Work location: Texas Health Resources Core work hours: Monday - Friday; 8:00a-5:00p; Position Summary The Coding Compliance Manager oversees and manages auditing and monitoring activities related to billing and coding compliance. This role is responsible for developing policies, procedures, and risk-based educational materials to ensure adherence to federal and state regulations, as well as THR policies. Key responsibilities include analyzing audit data to identify areas of concern, collaborating with auditees, providers, and leadership to guide rebuttals, and establishing management correction plans when necessary. Additionally, the Compliance Auditor Manager effectively communicates audit findings through reports, presentations, and educational materials...

JOB SUMMARY The CRC Auditor, conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims, were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and / or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends...

RN CRC Coding Auditor - REMOTE - $10K Sign On Bonus The CRC Auditor conducts coding and documentation quality reviews and generates responses for cases denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims are coded and billed in accordance with nationally recognized coding guidelines, standards, regulations, and regulatory requirements, as well as payor and billing guidelines. Responses may include system documentation of findings and/or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidence-based criteria application outcomes, physician documentation, and physician advisor input, and will complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends and...

Overview DRG Coding Auditor - CDI Remote - $10K Sign On Bonus at Conifer Health Solutions. Job Summary The CRC Auditor conducts coding and documentation quality reviews and generates responses for cases denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims are coded and billed in accordance with nationally recognized coding guidelines, standards, regulations, and regulatory requirements, as well as payor and billing guidelines. The responses may include system documentation of findings and/or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership, and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidence-based criteria, physician documentation, physician advisor input, and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates...

JOB SUMMARY The CRC Auditor, conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims, were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and / or a formal appeal letter. The Auditor will elevate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends and...

Senior Clinical Coding Auditor & Trainer You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for developing, conducting, administering, and analyzing clinical coding training and auditing programs. The Senior Clinical Coding Auditor & Trainer will conduct audits of inpatient coding processes for Fidelis Care and assist in development of training and audit tools. ***The Senior Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. *** Responsibilities: Develop and maintain complex audit processes and audit tools related to inpatient coding Develop...