973 medical coding quality compliance specialist jobs found

Primary Purpose of the Position: The Revenue Cycle Medical Coding Supervisor provides daily operational supervision of assigned coding staff and coding inventory. The Supervisor assigns work, monitors throughput and quality, performs and coordinates quality reviews, supports training and onboarding, resolves complex coding issues, and promptly escalates backlog, documentation, compliance, vendor, and system risks to the Coding Manager. The role may also perform complex coding to support operational needs while maintaining appropriate separation between production work and independent quality review. Required Knowledge and Experience: Active CPC through AAPC or CCS through AHIMA; specialty coding credentials are desirable. Minimum five years of professional medical coding experience preferred, including complex surgical or multi-specialty coding; prior lead or supervisory experience preferred. Advanced knowledge of medical terminology, anatomy and physiology,...

Primary Purpose of the Position: The Revenue Cycle Coding Manager provides strategic and operational leadership for professional coding and charge capture. The Manager is accountable for coding quality, productivity, inventory, compliance remediation, workforce planning, vendor performance, physician and division engagement, and coding-related revenue integrity. The position establishes clear standards, analyzes trends, and develops corrective action plans to support accurate, timely, and compliant claim submission.   Essential Duties of the Position May Include the Following: Leads day-to-day and long-range coding operations, including staffing, workload allocation, coverage planning, production priorities, and escalation management. Owns the coding operating model and clearly defines responsibilities among the Coding Manager, Coding Supervisor, internal coders, and external coding vendors. Establishes, monitors, and reports key performance indicators for...

About Bridge Bridge is the fastest, most compliant way to scale insurance billing nationwide. We enable virtual care companies to go in-network nationally in as little as 30 days, without the operational lift. Our platform handles payer contracting, credentialing, real-time benefit verification, medical coding, claim submission, denial management, and compliance in a single integrated solution. Backed by leading investors including General Catalyst, Andreessen Horowitz, Thrive Capital, Khosla Ventures, Greenoaks, and Mischief, we're scaling rapidly. The Role We are seeking a detail-oriented and experienced RCM Coding Specialist with CPC (Certified Professional Coder) certification to join our Revenue Cycle Management team. This role is responsible for accurate and timely medical coding in accordance with current coding guidelines, payer requirements, and company standards. The ideal candidate has strong analytical skills, in-depth knowledge of CPT, ICD-10, and...

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. Risk Adjustment Coding Specialists are an important part of the Team at Virtix Health. The HCC Coding Team Member will review medical records to abstract ICD-10 codes, specifically those that map to HCCs, RxHCCs, and ESRD models. Coders will follow Medicare guidelines, ICD-10-CM guidelines as well as client specific requirements. Equipment provided along with Encoder software with access to AHA Coding Clinic This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES:...

Risk Adjustment Auditor and Physician Educator Health Information Management | Full-Time | Renton, Washington Help Improve Clinical Documentation and Support Better Patient Care Valley Medical Center is seeking an experienced Risk Adjustment Auditor and Physician Educator to join our Health Information Management team. This role combines clinical documentation expertise, risk adjustment auditing, coding knowledge, data analysis, and physician education to help ensure the accurate and complete capture of patient conditions and the clinical complexity of the care we provide. The ideal candidate brings strong experience in Medicare risk adjustment, medical record auditing, ICD-10-CM coding, and physician education , along with the ability to translate complex coding and documentation requirements into practical guidance for providers. This is an opportunity to play a meaningful role in improving documentation quality, supporting value-based care initiatives, and...

Overview As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA   This position is responsible for abstracting, coding, and interpreting of outpatient clinic and provider services for professional and/or facility billing. This position uses coding knowledge to abstract and record data from medical records and provides support to areas related to documentation and coding. This position codes and charges complex or specialty services and may serve as a resource for other coders. This position is not responsible for providing care to patients.   Corporate Overview: The...

Billing Compliance Curriculum Development Specialist Dana-Farber Cancer Institute  Boston, MA  Full Time, Remote (Occasional Onsite)  Overview Reporting to the Manager of Billing Compliance, the Billing Compliance Curriculum Development Specialist is responsible for designing, implementing, and maintaining a comprehensive billing compliance education and awareness program that supports adherence to federal and state regulations and aligns with industry standards. This role develops and delivers training for billing providers, including physicians and advanced practice providers, and provides post-review education and feedback in collaboration with Billing Compliance Reviewers and Senior Billing Compliance Reviewers, as needed. The Specialist creates, updates, and manages instructional materials such as presentations, tip sheets, slide decks, and other training resources, and tracks training completion and effectiveness. The position also supports the...

Your Role The Risk Adjustment Compliance Specialist, Principal is responsible for ensuring organizational compliance with laws related to Risk Adjustment across our Marketplace (ACA), Medicaid and Medicare Advantage lines of business. This role involves auditing, monitoring, and evaluating risk adjustment processes, identifying areas of non-compliance, and recommending corrective actions. The Principal collaborates with internal teams and external partners to maintain the integrity of risk adjustment data and supports the development and implementation of compliance programs. Responsibilities Your Work In this role, you will:  Conduct regular audits and reviews of risk adjustment data submissions to ensure compliance with regulatory requirements (e.g., CMS, OIG, HHS). Monitor changes in risk adjustment guidelines, policies, and regulations, and communicate updates to relevant stakeholders. Analyze risk adjustment...

About Med USA Med USA is a Utah-based medical billing/provider services company with a nationwide presence. We have been in business for over 45+ years and provide practice management, payer credentialing and contracting, and full-cycle management (RCM) services, including coding, billing, follow-up, and denial resolution. Join our fast-paced, high-energy team as a medical billing specialist, with great company benefits and opportunity for growth. The ideal candidate is motivated, professional, and detail-oriented, with a strong commitment to producing high-quality work and making a positive impact on the team. If you enjoy helping others, solving problems, and working in an open, collaborative, fast-paced environment, this is a great opportunity for you. Medical billing or insurance experience is preferred, but we’re happy to train the right candidate. Position Summary The Certified Medical Coder is responsible for reviewing clinical documentation and...

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. Risk Adjustment Coding Specialists are an important part of the Team at Virtix Health. The HCC Coding Team Member will review medical records to abstract ICD-10 codes, specifically those that map to HCCs, RxHCCs, and ESRD models. Coders will follow Medicare guidelines, ICD-10-CM guidelines as well as client specific requirements. Equipment provided along with Encoder software with access to AHA Coding Clinic ESSENTIAL DUTIES AND RESPONSIBILITIES:  Note: The essential duties and...

We are expanding our outpatient coding and clinical documentation capabilities and are looking for an experienced outpatient coding or CDI professional to support this work on a contract basis. - Location:   Remote - Type:   1099 Contractor About Ambience Healthcare Ambience Healthcare is a clinical documentation AI company building tools that improve the accuracy and efficiency of medical documentation. Role Overview We are seeking a meticulous outpatient coding or CDI specialist to review outpatient encounters, analyze clinical documentation, and determine accurate ICD-10-CM diagnosis codes.  Your work will directly inform how we evaluate and improve the accuracy of clinical coding at scale. This is not a traditional role embedded in a health system — you will be reviewing outpatient data and making determinations about ICD-10-CM codes, identifying gaps, and providing expert-level feedback. What we value most:   We are looking for someone with...