39 mra coding auditor jobs found

Alignment Health is a remote company focused on senior care. The Medical Risk Adjustment (MRA) Coding Auditor role supports departmental quality assessment audits of internal coding analysts and vendors to ensure accurate and complete data submission to CMS. General Duties / Responsibilities Supports regular quality assurance audits of the internal Coding Analyst Team to validate and confirm coding & abstracting quality (95% HCC accuracy), ensuring coding quality and performance improvement standards are maintained. Tracks and reports progress of QA audits performed on coding vendors to verify coding accuracy and quality of data submitted to AHP for CMS submission. Works with Risk Adjustment Management on any MRA data validation or coding audit to ensure completeness and coding accuracy of all CMS submissions; this may include data reconciliation, data flow integrity, UAT testing, review of high‑cost/low‑risk score members, retrospective chart reviews, or other related data...

Alignment 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. This is a remote position. The MRA Coding Auditor supports departmental Quality Assessment audits of internal Coding Analyst team and vendors to ensure accurate and complete data is submitted to CMS. Assists in Risk Adjustment related data audits (RAF, prevalence, clinical documentation improvement, P360, process) audits to identify areas of...

MRA Coding Auditor Alignment 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. This is a remote position. General Duties/Responsibilities Supports regular quality assurance (QA) audits of internal Coding Analyst Team to validate and confirm coding & abstracting quality (95% HCC accuracy). These ongoing audits ensure coding quality & performance improvement standards are maintained,...

Job Description Job Description Description: Come and join our growing organization as a Medical Biller! Roswell Park Care Network is a recognized leader in oncology and specialty care, supporting community physician practices across New York State. We are committed to delivering exceptional patient care while advancing innovative treatment options in a collaborative and patient-focused environment. Comprehensive Benefits: Monday-Friday schedule Medical, dental, and vision coverage Employer funded Health Reimbursement Account (HRA) 401(k) with company match Generous vacation and sick time Company-paid life insurance 11 paid Holidays Position is Sign-On Bonus ELIGIBLE! The Medical Biller position offers a hybrid schedule. After successfully completing on-site training, the schedule transitions to just one on-site day per week Responsibilities: Prepares, reviews, and transmits claims, both electronic and paper. Follows up on unpaid claims...

Hours Shift Start Time: 6 AM Shift End Time: 2:30 PM AWS Hours Requirement: 8/80 - 8 Hour Shift Additional Shift Information: 0600-0900 Start, 1430-1730 End Weekend Requirements: No Weekends On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $30.370 - $37.950 - $42.510 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do Ensure that all charges are submitted accurately, timely and meets department guidelines. Provides administrative and coding support to management, site support, staff and physicians. Identifies and reports documentation and coding opportunities and makes...

Job Description Job Description Inpatient Medical Coding Auditor/Trainer- Lead (ON-SITE) Walter Reed National Military Medical Center ABOUT US: Laredo Technical Services, Inc. provides staffing services to federal Government agencies all over the world.   LTSi connects the right opportunities to the right people.  With our experience in placing our Team Members throughout the United States and overseas, we excel at providing experienced, professional personnel for a wide range of Professional and Office Administration as well as Medical Services. Our goal is to provide the highest quality professionals in the industry. LTSi’s culture delivers a strong work ethic while going above and beyond with a sense of urgency.  We are an employee-driven company.  We strive for excellence every day, which is what sets us apart from all the other government contractors. As a Certified Service-Disabled Veteran Owned Small Business (SDVOSB) Minority Business...

Why Join First Choice Community Health Centers Nestled in the heart of North Carolina, Harnett County offers a unique blend of small-town charm and convenient access to big‑city amenities. Located less than an hour from both Raleigh and Fayetteville, residents enjoy the tranquility of rural living with the benefit of nearby urban excitement. At First Choice, we’re proud to offer employment opportunities in this beautiful area, giving you the chance to work in a close‑knit community while staying connected to the vibrant Triangle region. With a perfect balance of peaceful and affordable living and easy access to cultural and career opportunities, Harnett County is an ideal place to call home. Position Summary The Medical Billing Specialist will be responsible for billing and collections for Medicare, Medicaid, Insurance, and Self Pay patients for all Medical and Dental clinics. Responsibilities vary depending on assignment from Billing Supervisor. This role is on‑site at our...

Summary The Medical Record Technician (Coder) Auditor position is located in the Health Information Management (HIM) section at the Thomas H. Corey VA Medical Center. Medical Record Technician (Coder) Auditors hold a mastery level certification, able to perform all duties of a MRT (Coder), and serve as experts of medical coding conventions and guidelines related to professional and facility coding. Responsibilities PLEASE NOTE: This Medical Records Technician (Coder) Auditor position is not remote and requires physical presence on-site. The Medical Records Technician (Coder) Auditor is responsible for abstracting medical record data and assigning codes using current clinical classification systems appropriate for the type of care provided. Auditors serve as experts of current coding conventions and regulations related to professional and facility coding; perform audits of encounters to identify areas of non-compliance in coding; provide recommendation son appropriate coding; and...

Summary This position is located in the Health Information Management (HIM) section at the Kansas City VA Medical Center. MRTs (Coder) Auditors are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. These coding practitioners analyze and abstract patients' health records, and assign alpha-numeric codes for each diagnosis and procedure. Learn more about this agency Duties Help Duties consist of significant scope, complexity (difficulty), range of variety, and be performed by the incumbent at least 25% of the time. Auditors must be able to perform all duties of a MRT (Coder). Auditors serve as experts of current coding conventions and guidelines related to professional and facility coding. Auditors perform audits of encounters to identify areas of non-compliance in coding. They facilitate improved overall quality,...

Description This is a flexible CMS HCC/Risk Validation Audit role for a seasonal project. Other opportunities for continued work may be available at the conclusion of the project. Full time opportunities are available at either 30 or 40 hours weekly. Flexible work hours - nights and weekends are acceptable. Responsibilities Coders will review member and claim data validation aspects, which include: Member name, Member DOB, Gender, Dates of service, claim type, and provider signature Coders will be presented with all risk-adjusting diagnoses billed on a claim for a particular date of service or inpatient stay Must be able to identify acceptable provider specialty Coder must have knowledge of ICD-10-CM IP and OP coding Coders will confirm or not confirm each diagnosis Coders will add risk-adjusting diagnoses that are valid but not reported Requirements Active certification through AAPC or AHIMA is required Minimum 5 years verifiable risk adjustment coding experience post...

MRA Coder The MRA Coder will be responsible for coordinating/supporting retrospective and concurrent chart reviews using knowledge of Hierarchical Condition Categories (HCC) coding to translate, input, extract and validate medical record data. Review patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries in order to verify whether the diagnosis codes are supported by the documentation to ensure they are within Guidelines for Coding and Reporting Schedule chart reviews with Physician practices Assist in obtaining medical records from Physicians to support audits requested by Health Plans Ensure compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment. Educate Physicians regarding proper billing and documentation policies, procedures, and conflicting/ambiguous...

Position Summary Responsible for reviewing medical records for compliance with coding and documentation requirements. Job Responsibilities Performs ongoing prospective coding and documentation chart reviews for physician services to ensure that the coding supports the services billed. Identifies issues and patterns related to coding. Selects and assigns the appropriate ICD-10, CPT and HCPCS codes, based on chart review documentation. Identifies issues and patterns related to coding. Enters charges into the practice management billing system, ensuring to meet productivity and quality-based departmental benchmarks. Performs charge entry batch quality assurance. Reviews and resolves charge router and charge review edits, as needed. Submits queries to physicians, as appropriate, for documentation clarification. Participates in internal and external audits of billing operations and activities. Participates in annual and on-going mandatory compliance training. Fulfills Continuing...

Summary/Objective:  The Revenue Cycle Manager is responsible for all duties listed below. The position requires coordination with clients, executive staff and RCM staff for the revenue cycle management performance reporting. Essential Functions: Core duties and responsibilities include the following. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.  1.  LEAD AND SUPERVISE REVENUE CYCLE STAFF Provide day‑to‑day leadership, coaching, and performance oversight for billing, coding, collections, and reimbursement teams. Ensure staff adhere to organizational policies, regulatory requirements, and best practices across the full revenue cycle. 2.   Monitor and Report Staff Productivity Develop, track, and analyze productivity metrics for all revenue cycle functions. Prepare regular performance dashboards and present findings AND SUGGESTIONS for...

Under general supervision of the Director, the Coder II provides consistency and efficiency in outpatient claims processing and data collection to optimize APC reimbursement and facilitate data quality in outpatient services. Reviews, audits, and reports on charge capture. Maintains patient confidentiality at all times. ESSENTIAL JOB FUNCTIONS Analyzes IP, OP, Recurring, & SDC records and appropriately codes per coding guidelines, ICD-10-CM and CPT rules and updates, creating APC or DRG group assignments. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Concurrently codes Recurring records for interim billing. Processes records for deficiencies and return for completion. Enters codes into the Abstracting Module as needed, including use of the 3M encoder. Performs data quality reviews on outpatient encounters to validate the ICD-10-CM, CPT, and HCPCS Level II code and...

Benefits: 401(k) 401(k) matching Competitive salary Dental insurance Free food & snacks Health insurance Paid time off Tuition assistance Vision insurance POSITION SUMMARY: The Revenue Cycle Manager is responsible for the end-to-end revenue cycle for the multi-specialty internal medicine practice, including patient access, charge capture, coding oversight, billing, denials management, and collections across internal medicine, behavioral health, diabetic center, pulmonary, and sports medicine service lines. This role provides strategic and hands‑on leadership to optimize reimbursement, reduce denials, ensure compliance with payer and regulatory requirements, and support the financial health of the provider‑owned practice. ESSENTIAL FUNCTIONS: Oversee the full revenue cycle from scheduling/registration and insurance verification through coding, billing, payment posting, denials, and patient collections for all specialties and locations. Develop, implement, and...

Insurance Billing And Coding Specialist Education, Experience, and Licensing Requirements: High school diploma, GED, or equivalent University/college degree, or experience in medical records, claims or billing areas is an asset. CCA (AHIMA) CCS (AAPC) or greater Expectations of Role: Manages the insurance billing and collections processes. Excellent organizational skills and attention to detail. Processes, tracks claims, and ensures accuracy and timeliness in the billing process. Provides excellent customer service to our clients. Inputs patient information into the practice's billing software. Submits claims to insurance companies and follows up on unpaid claims. Posts ERA payments, resolves any issues that arise with claims or payments. Maintains accurate records of billing and collection activities. Generates monthly reports to track billing and collection performance. Accounts for coding and abstracting of patient encounters, including procedural information, significant...

Under general supervision of the Director, the Coder II provides consistency and efficiency in outpatient claims processing and data collection to optimize APC reimbursement and facilitate data quality in outpatient services. Reviews, audits, and reports on charge capture. Maintains patient confidentiality at all times. ESSENTIAL JOB FUNCTIONS Analyzes IP, OP, Recurring, & SDC records and appropriately codes per coding guidelines, ICD-10-CM and CPT rules and updates, creating APC or DRG group assignments. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Concurrently codes Recurring records for interim billing. Processes records for deficiencies and return for completion. Enters codes into the Abstracting Module as needed, including use of the 3M encoder. Performs data quality reviews on outpatient encounters to validate the ICD-10-CM, CPT, and HCPCS Level II code and...

It's rewarding to be on a team of people that truly believe in making an impact!We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.Job SummaryThe Risk Adjustment coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations.Duties & ResponsibilitiesEssential Duties & ResponsibilitiesReview medical record information to identify all appropriate coding based on CMS HCC categoriesPrepare the medical charts and track patient information via Excel spreadsheets.Complete appropriate paperwork/documentation/system...

Supervisor, Medical Audit - Medical Bill Audit Job Description - (260002D8) Supervises and monitors daily activities of non‑licensed and licensed staff to successfully complete the daily work, maintains contact with the clinical departments to ensure accurate charge capture and works with the CDM analyst to maintain a compliant Charge Master. Works with MBA staff to meet the daily DNB goals and contributes to meeting the Revenue Integrity Department’s and the hospital’s fiscal goals. Supports the efforts of Coding, HIM, Denials, and Utilization Management by ensuring timely, accurate, and complete data entry in multiple information systems/databases. Assists Patient Accounts by reviewing, correcting and submitting billing information to enable timely filing of bills and maintaining a low AR. Brings issues with legal, risk management, or compliance implication to the attention of Manager or Director in an expedient manner. Functions as key contact point for the Hospital and...

Medical Billing Specialist I/II - Behavioral Health Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5369990) Apply  Medical Billing Specialist I/II - Behavioral Health Salary $47,840.00 - $69,546.52 Annually Location Oxnard, CA Job Type Full-Time Regular Job Number 0838HCA-26AA (VM) Department Health Care Agency Division Behavioral/Mental Health Opening Date 06/15/2026 Description Benefits Questions Description How to Submit a Successful Application video: https://hr.venturacounty.gov/how-to-apply/application THE DEPARTMENT: As a vital department of Ventura County Health Care Agency (HCA), Ventura County Behavioral Health (VCBH) provides comprehensive mental health and substance use treatment services tailored to meet the needs of our community. From mobile crisis response to outpatient treatment, our array of programs ensures individuals receive the support they need at every stage of their...

Medical Billing Specialist I/II The Department: As a vital department of Ventura County Health Care Agency (HCA), Ventura County Behavioral Health (VCBH) provides comprehensive mental health and substance use treatment services tailored to meet the needs of our community. From mobile crisis response to outpatient treatment, our array of programs ensures individuals receive the support they need at every stage of their journey. The Position: Under general supervision at the (I) level, or direction at the (II) level, the incumbent is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance reimbursement requirements. What We Offer: The County of Ventura offers an attractive compensation and benefits package. Aside from our base salary range, an employee within this position will also be eligible for the following: Educational Incentive - An educational incentive of...

Job Description Job Description Mb Staffing Services is seeking a detail-oriented Medicaid Coding & Reimbursement Analyst with direct experience in Medicaid billing, coding, claims review, and financial reconciliation. This role is ideal for professionals who understand the financial side of healthcare operations and are passionate about accuracy, compliance, and reporting. Key Responsibilities Review and analyze Medicaid claims, billing, and reimbursement data. Perform data entry and validate coding information for accuracy. Utilize ICD-10, CPT, HCPCS, and Medicaid-specific codes. Reconcile reports, payments, and billing discrepancies. Research and resolve claim denials and coding issues. Conduct audits and support compliance initiatives. Generate reports and analyze trends to improve billing accuracy. Review financial and operational data to identify variances and opportunities for improvement. Collaborate with providers and internal teams to ensure timely...

Date Posted: 2026-06-29 Country: United States of America Location: US-CA-REMOTE Position Role Type: Remote U.S. Citizen, U.S. Person, or Immigration Status Requirements: U.S. citizenship is required, as only U.S. citizens are authorized to access information under this program/contract. Security Clearance Type: DoD Clearance: Secret Security Clearance Status: Active and existing security clearance required after day 1 RTX Corporation is an Aerospace and Defense company that provides advanced systems and services for commercial, military and government customers worldwide. It comprises three industry-leading businesses - Collins Aerospace Systems, Pratt & Whitney, and Raytheon. Its 185,000 employees enable the company to operate at the edge of known science as they imagine and deliver solutions that push the boundaries in quantum physics, electric propulsion, directed energy, hypersonics, avionics and cybersecurity. The company, formed in 2020...

Location: 700 West Main Street, Leesburg, FL, 34748, United States Employee Type: FT Non-Exempt Required Degree: High school Manages Others: No Contact information Name: HR Phone: 352-600-5017 Welcome to Pathways Health Partners, the Accountable Care Organization (ACO) that's leading the charge in helping independent providers transition to Value-Based Care. What We Do: Medicare REACH ACO: We're at the forefront of Medicare innovation. Medicare Advantage MSO: Providing top-notch services to our Medicare Advantage patients. Commercial MSO: Managing care for approximately 16,000 patients across North-West/Central Florida. Where We Operate: From The Villages to St. Petersburg, and across to Mount Dora, we've got you covered! Our Services: Hospital Medicine Group: Delivering exceptional care in hospitals. Affiliated Medical Practices: Managing several top-tier medical practices. Insurance Agency: Offering comprehensive insurance solutions. Join us on our journey to...