547 outpatient coding compliance auditor jobs found

UnitedHealth Group is seeking an Outpatient Coding Compliance Auditor to conduct audits of OPPS coding, ensuring accurate ICD-10-CM and CPT coding, modifiers, and E/M levels. The role monitors QA processes and communicates findings to stakeholders while aligning with applicable laws and regulations. You will analyze medical records, identify root causes of non-compliance, and support education based on audit results. Remote work within the U.S. is possible. #J-18808-Ljbffr

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....

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. Summary: 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.Works closely...

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. Summary: 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.Works closely...

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,...

Outpatient Coding Compliance AuditorOptum 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,...

Emory Healthcare is seeking an Outpatient Coding Auditor to implement and maintain a compliance plan for outpatient coding and reimbursement, and to assist the Coding Manager with outpatient and emergency coding services. The role includes developing education programs, supervising HIM Compliance activities, and coordinating continual reviews and quality audits to ensure accurate APC assignment and reimbursement. Strong communication and organization are essential. #J-18808-Ljbffr

The Valley Health System in Ridgewood, NJ is seeking an Outpatient Coding Auditor to review outpatient records for compliance with coding guidelines and regulatory requirements. You will identify trends, educate staff, and collaborate with external vendors to implement industry best practices and improve overall audit results. Requires 5+ years in hospital auditing with ICD-10-CM, outpatient CPT-4, HCPCS coding experience; 3M Encoder experience and EPIC/Meditech/CERNER familiarity are preferred. #J-18808-Ljbffr

Valley Health System in Ridgewood, NJ is seeking an Outpatient Coding Auditor to review coded outpatient records for adherence to official coding guidelines, regulatory standards, and internal policies. The role drives education and process improvements through detailed case reviews and trend analyses. The incumbent will collaborate with external vendors and coding leadership to ensure accuracy and implement best practices in audit feedback and staff education. #J-18808-Ljbffr

Med-Metrix seeks a Coding Auditor to conduct inpatient and outpatient coding and auditing across specialties, preparing and presenting audit results. The role requires CPC or CCS certification, 5+ years coding and 2+ years auditing in multi-specialty settings, and strong communication skills. Responsibilities include education, HIPAA compliance, and collaboration with offsite auditors. #J-18808-Ljbffr

Overview Ardent Health is a leading provider of healthcare in growing mid-sized urban communities across the U.S. With a focus on people and investments in innovative services and technologies, Ardent is passionate about making healthcare better and easier to access. Through its subsidiaries, Ardent delivers care through a system of 30 acute care hospitals, 24,000+ team members and more than 280 sites of care with over 1,800 affiliated providers across six states. Position Summary The Hospital Auditor is responsible for reviewing hospital (inpatient and outpatient) to ensure accuracy, completeness, and compliance with regulatory guidelines and coding standards. This role supports the team’s broader mission by identifying documentation gaps, validating coding accuracy, and assessing the effectiveness of hospital practices. Through targeted feedback and education, the Hospital Auditor helps strengthen documentation quality, promote compliant billing, and safeguard reimbursement...

Sutherland is seeking a Lead - Healthcare - Coding Quality Auditor to ensure coding accuracy and compliance across inpatient, outpatient, and physician services. You will oversee retrospective, concurrent, and prospective audits and mentor coders to uphold ICD-10-CM/PCS, CPT, and HCPCS standards. This role requires 3–5 years of coding experience and 2+ years in audit/quality reviews, plus relevant certifications. #J-18808-Ljbffr

Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Days Pay Rate Type: Annual Salary Location: Remote Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $68,875.27 Mid = $86,094.08 Max = $103,312.90 Summary The Compliance Auditor performs proactive and reactive internal and external audits and investigations related to documentation, coding and billing, and regulatory guidelines for hospital and outpatient services. Responsibilities Performs proactive and reactive internal and external audits and investigations for hospital and outpatient services rendered to ensure proper documentation, medical necessity, accurate coding and billing are supported. Continually monitors regulations, standards and regulatory guidelines in coding...

Inpatient Coding Auditor Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As an Inpatient Coding Auditor with Parallon you can be a part of an organization that is devoted to giving back! Job Summary and Qualifications As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. What you will do in this...

Job Summary: HIM Coding auditor/trainer will coordinate, monitor, and audit documentation and coding of inpatient and/or outpatient services in all applicable health care settings. Audits will focus on correct assignment of CPT, ICD-10, ICD-9- CM, HCPSC codes and clinician documentation to ensure that Kaiser Permanente is compliant with all regulatory guidelines and internal controls. Audits will encompass internal practitioners, contracted practitioners, coders, internal facilities and contracted facilities. The auditor will analyze audit results, identify patterns, trends or variations in coding and documentation practices and make recommendations for improvement. When necessary, this position will initiate corrective action plan to ensure resolution of problem areas identified during auditing and monitoring activity. This position will serve as a liaison with HIM staff, Revenue Cycle, External and Internal practitioners, and other regional departments as appropriate including...

Summary This position is located in the Health Information Management (HIM) section at the Fargo VA Health Care System. MRTs (Coder) 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. Learn more about this agency Duties Help The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the...

Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Days Pay Rate Type: Annual Salary Location: Remote Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $68,875.27 Mid = $86,094.08 Max = $103,312.90 Summary The Compliance Auditor performs proactive and reactive internal and external audits and investigations related to documentation, coding and billing, and regulatory guidelines for hospital and outpatient services. Responsibilities Performs proactive and reactive internal and external audits and investigations for hospital and outpatient services rendered to ensure proper documentation, medical necessity, accurate coding and billing are supported. Continually monitors regulations, standards and regulatory guidelines in coding...

Job Opportunity At Memorial HermannAt Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Description Responsible for providing accurate, reliable and effective education to physicians and extenders regarding outpatient procedural and diagnosis coding. This position performs individual and group documentation reviews, identifies opportunities for improvement, assists with implementation of physician lead CME documentation and coding...

The U.S. Department of Veterans Affairs is seeking a Medical Records Technician (Coder) Auditor at the Erie East VA Clinic. The role requires expert knowledge of medical terminology, anatomy/physiology, coding systems, and health records management to ensure accurate code assignment and compliance across inpatient and outpatient records. Responsibilities include auditing ICD-10-CM/PCS, CPT, and HCPCS codes, researching guidelines, and guiding staff to improve documentation quality within a VA #J-18808-Ljbffr

AHIMA is seeking an experienced outpatient facility coding auditor to support the Director of Health Information Management. This remote role focuses on comprehensive claim audits, revenue integrity, and billing compliance for hospital outpatient and ProFee claims. Strong analytics and the ability to communicate complex coding concepts to clients and internal teams are essential. The ideal candidate has 5+ years in hospital outpatient coding audits, proficiency with ED, SDS, OBS, I&I, E/M, and #J-18808-Ljbffr

PYA is seeking an Inpatient/Outpatient Facility Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue and Compliance Advisory Program . RESPONSIBILITIES: Apply inpatient and outpatient facility/hospital coding and reimbursement methodologies to provide advisory services to PYA clients with a focus on the following: ICD-10-CM and PCS/CPT/HCPCS code assignment MS-DRG and other DRG validation APC validation and charge capture Clinical documentation improvement Regulatory compliance for third party payors Work in collaboration with the PYA executive team and other service lines to offer complete business solutions to clients Manage the preparation of excellent client deliverables and exhibit exceptional project management skills while balancing firm risk and compliance with appropriate professional standards QUALIFICATIONS: Professional credential required such...

Inpatient Coding Auditor Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As an Inpatient Coding Auditor with Parallon you can be a part of an organization that is devoted to giving back! Job Summary and Qualifications As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. What you will do in this...