2397 medical coding auditor jobs found

Overview Certified Medical Coder required (AHIMA, AAPC, or PMI). Hybrid-Sunrise, Florida The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through post payment medical records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines and regulatory and contract requirements. Essential Duties and Responsibilities Performs post payment medical record review audits of claims payments to identify potential fraud, waste, abuse and/or overpayment. Completes and maintains detailed documentation of audits including but not limited to coding guidelines reviewed, medical necessity documentation, decision methodology, and monetary discrepancies identified. Coordinates overpayment recoveries with the Fraud Investigative Unit Manager. Responsible for assisting the Fraud Investigative...

Location: Miami, FL (On-site preferred; Hybrid/Remote may be considered) Employment Type: Part-Time (25-35 hours per week) About the Position We are seeking an experienced Senior Medical Coding Auditor (CPC) to join our growing multi-specialty medical practice specializing in Primary Care and Gynecology. The ideal candidate will be responsible for reviewing clinical documentation before claims are submitted to ensure accurate coding, appropriate E/M level selection, documentation compliance, and optimal reimbursement while maintaining full regulatory compliance. This position works closely with providers, clinical staff, and the billing department to improve documentation quality, reduce claim denials, maximize appropriate reimbursement, and ensure coding accuracy. Primary Responsibilities Review approximately 300 provider notes per week for coding accuracy and documentation compliance prior to claim submission. Validate appropriate Evaluation & Management (E/M) level...

All inclusive preventive care in Miami, FL, is seeking a Senior Medical Coding Auditor (CPC) to join our multi-specialty practice focusing on Primary Care and Gynecology. The role reviews provider notes before submission to ensure accurate coding, proper E/M levels, and compliance while supporting optimal reimbursement. You will work with providers and the billing team to reduce denials, improve documentation quality, and maintain regulatory compliance. #J-18808-Ljbffr

ModMed is seeking a Medical Coding Auditor to join the BOOST Services team remotely in the US. You will perform coding reviews and QA audits across ICD-10-CM, HCPCS, CPT and modifiers, ensuring compliance with guidelines and payer policies. You’ll interact with global coding teams, provide training insights, and support denial management activities. Ideal candidates have at least 1 year as a CPC and CPMA preferred, with strong analytical and communication skills, and a commitment to pursue CPMA #J-18808-Ljbffr

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 Medical Coding Auditor is required to determine the accuracy of claims submitted by a provider to UnitedHealth Group by comparing it to the medical record(s) submitted for the date(s) of service being reviewed. This position supports the identification of suspected Waste & Error of health insurance claims and ensures claims are accurately documented. Candidates must be able to exercise...

UnitedHealth Group is seeking a Medical Coding Auditor to determine the accuracy of claims by comparing to medical records and to identify waste and errors in a telecommuting role across the U.S. The position requires AHIMA or AAPC certification and 2+ years in coding and medical record reviews. You will review CPT/HCPCS codes, ensure compliance, and produce clinical narratives. Strong data interpretation, communication, and collaboration skills are essential. #J-18808-Ljbffr

Xtensys, located in the Town of Ithaca, is looking for an experienced Medical Coding Auditor. The role involves auditing documentation and coding across several specialties to ensure accuracy with coding systems including CPT, ICD-10-CM, and HCPCS. The ideal candidate will have 3–5 years of experience, attention to detail, and be proficient in communication. A coding certification is required, with additional auditing certification being a plus. Join us to be part of a mission-driven organization committed to improving healthcare. #J-18808-Ljbffr

Xtensys is a rapidly growing managed service provider delivering innovative technology solutions to health systems, beginning in New York and expanding nationwide. Owned by two industry leaders with a strong focus on advancing rural and community healthcare, Xtensys is executing several major initiatives and scaling quickly. With a team of more than 500 professionals, we are building a people-centered culture rooted in collaboration, innovation, and strategic thinking. We are seeking an experienced Medical Coding Auditor to support our continued growth and commitment to deliver exceptional client outcomes. Why Join Us? Mission-Driven Work: You are the "bridge" ensuring technology serves health systems and their patients when they need it most. Autonomy & Ownership: We trust you. You’ll lead projects, define success, and manage complexities with total support. A Culture of Innovation: Have a fresh perspective? We want it. We encourage risk-taking and continuous...

Humana seeks a Medical Coding Auditor for its Outpatient Facility/APC Coding Team. The role emphasizes accuracy of CPT/HCPCS codes, review of clinical indicators, and use of encoders. The candidate works remotely with occasional travel to Humana offices for training. Required are CPC/COC/CCS/ROCC/RHIA/RHIT certifications and 3+ years post-certification experience in outpatient coding, with strong attention to detail and independent work capability. Eligible for annual pay and benefits. #J-18808-Ljbffr

Humana is seeking a Medical Coding Auditor to extract clinical information from medical records and assign ICD-10-CM and CPT codes. The role involves interpreting data, independent decision making, and ensuring accurate coding in a remote setting. Typical hours are Monday–Friday, 8 hours daily, with start between 6AM–9AM EST. Travel to Humana offices for training may be required; 40-hour work week and competitive benefits are offered. #J-18808-Ljbffr

Humana is seeking a Medical Coding Auditor for its Outpatient Facility/APC Coding Team. The role involves verifying procedure codes, reviewing documentation for clinical indicators, and ensuring coding guidelines compliance to support accurate payments. Remote position with occasional travel to Humana offices for training. Requires CPC/COC/CCS/ROCC/RHIA/RHIT certifications and 3+ years post-certification experience, plus strong CPT/HCPCS knowledge. #J-18808-Ljbffr

Become a part of our caring community and help us put health first 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. 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...

Humana, Inc. is hiring a Medical Coding Auditor to review outpatient claims and ensure CPT/HCPCS coding accuracy in a remote environment. You will verify codes, assess documentation quality, and contribute to cost containment and process improvements within a HIPAA-compliant framework. The role emphasizes independence, strong CPT/HCPCS knowledge, and post-certification experience in outpatient procedures, with occasional travel for training and meetings. #J-18808-Ljbffr

Humana is seeking a Medical Coding Auditor to review outpatient facility claims against medical records, ensuring accurate CPT/HCPCS coding and APC alignment. This remote role supports the Outpatient Facility/APC Coding Team with coding reviews and documentation. You will use encoders and coding references, perform peer reviews, maintain HIPAA confidentiality, and stay current with ICD-10 and CPT guidelines. Typical schedule is Monday–Friday with travel for training as needed. #J-18808-Ljbffr

Humana is seeking a remote Medical Coding Auditor to join the Outpatient Facility/APC Coding Team. You will verify codes, review documentation, and ensure proper CPT/HCPCS alignment while maintaining patient confidentiality. The role requires CPC/COC/CCS/ROCC/RHIA/RHIT certification with at least 3 years post-certification experience, strong CPT/HCPCS knowledge, and the ability to work independently with attention to detail and solid communication. #J-18808-Ljbffr

Humana, Inc. is seeking a Medical Coding Auditor for the Outpatient Facility/APC Coding Team to verify and code procedures accurately while maintaining patient confidentiality. This remote role requires CPC/COC/CCS/RHIA/RHIT certification with 3+ years post-cert experience and involves audits, reviews of operative reports, and adherence to CPT/HCPCS guidelines. The position offers flexible hours and the chance to contribute to cost reduction by ensuring correct claims payments and accurate #J-18808-Ljbffr

UnitedHealth Group is seeking a Medical Coding Auditor to assess the accuracy of claims by comparing medical records, with a telecommuting arrangement across the U.S. The role supports compliance, coding policy interpretation, and clinical narrative development for complex payment decisions. The position requires AHIMA or AAPC certification and 2+ years in coding and medical record review, with strong analytical and independent work abilities, in a production-driven environment. #J-18808-Ljbffr

## Medical Coding AuditorApplyremote type: Remote USlocations: Remote - USAtime type: Full timeposted on: Posted Yesterdayjob requisition id: R4766**Join the Team Modernizing Medicine**At **ModMed**, we’re not just building software—we’re reimagining the healthcare experience. Founded in 2010 by a practicing physician and a successful tech entrepreneur, we took a radically different approach: **we hired doctors and taught them how to code.** This "for doctors, by doctors" philosophy has allowed us to create an AI-enabled, specialty-specific cloud platform that places patients at the center of care.**A Culture of Excellence**When you join ModMed, you’re joining an award-winning team recognized for innovation and employee satisfaction. From our global headquarters in Boca Raton Florida, and extensive employee base in Hyderabad India, we are a team of 4,500+ passionate problem-solvers on a mission to increase medical practice success and improve patient outcomes:* **Consistently...

UnitedHealth Group is seeking a Medical Coding Auditor to verify the accuracy of claims by comparing them with medical records. The role requires in-depth coding knowledge and the ability to interpret complex policies in a remote work setup across the United States. You will analyze CPT/HCPCS coding, document detailed case outcomes, and ensure adherence to payer and government requirements while maintaining productivity and quality metrics in a production-driven environment. #J-18808-Ljbffr

Where you come in Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance...

UnitedHealth Group is seeking a Medical Coding Auditor to verify CPT/HCPCS coding accuracy and review medical records remotely from anywhere in the United States. You will analyze claims, determine service levels, and draft detailed narratives while ensuring compliance with policies and regulatory guidelines. The role requires AHIMA or AAPC credentials with 2+ years of coding and chart review experience and a track record in waste & abuse investigations. #J-18808-Ljbffr

Tegria Services Group - US, Inc. is seeking a Certified Professional Medical Coding Auditor to evaluate accuracy and quality of coded medical records, perform monthly and targeted audits, and ensure compliance with coding guidelines and payer requirements. You will provide feedback, education, and support coder development while promoting revenue integrity across the organization. The role collaborates with Coding Manager and Leads, supports process improvements, and leverages AI tools to #J-18808-Ljbffr

UnitedHealth Group is seeking a Medical Coding Auditor to verify claims accuracy by comparing to medical records, performing code reviews, and ensuring compliance across state and federal guidelines. You’ll telecommute from anywhere in the U.S. and join a team focused on waste and error reduction, detailed narratives, and high-quality documentation while meeting strict production metrics. #J-18808-Ljbffr

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for improvement...