1747 outpatient coding compliance auditor jobs found

Working remotely from anywhere in the U.S., the full-time Outpatient Coding Compliance Auditor will perform audits of outpatient facility coding to ensure compliance with ICD-10-CM diagnoses, CPT/HCPCS codes, and billing standards while effectively communicating findings to stakeholders. Key responsibilities: Perform coding compliance and quality audits in support of the Compliance Program and client expectations Independently analyze clinical documentation from medical records and validate coding accuracy for outpatient facilities Identify audit findings and calculate billing error rates, providing follow-up validation for corrective action plans Required qualifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Outpatient Coder (COC) 5+ years of Outpatient Facility coding experience, including knowledge of NCCI/OCE billing edits 5+ years of Outpatient Facility audit experience, including familiarity with Medicare regulations and OPPS...

Working remotely from anywhere in the U.S., the full-time Outpatient Coding Compliance Auditor will perform audits of outpatient facility coding to ensure compliance with ICD-10-CM diagnoses, CPT/HCPCS codes, and billing standards while effectively communicating findings to stakeholders. Key responsibilities: Perform coding compliance and quality audits in support of the Compliance Program and client expectations Independently analyze clinical documentation from medical records and validate coding accuracy for outpatient facilities Identify audit findings and calculate billing error rates, providing follow-up validation for corrective action plans Required qualifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Outpatient Coder (COC) 5+ years of Outpatient Facility coding experience, including knowledge of NCCI/OCE billing edits 5+ years of Outpatient Facility audit experience, including familiarity with Medicare regulations and...

Optum is hiring an Outpatient Facility Coding Compliance Auditor to conduct audits and ensure compliance with coding guidelines. This role allows remote work within the U.S. and offers a salary range of $72,800 to $130,000 annually. The ideal candidate will have extensive experience in outpatient coding and auditing, certified coding credentials, and strong analytical skills. Join a diverse workplace focused on improving health outcomes nationally. #J-18808-Ljbffr

Requisition number: 2366610 Job category: Regulatory & Compliance 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,...

Improve the lives of others while Caring. Connecting. Growing together. Job Description - Outpatient Facility Coding Compliance Auditor (2366610) Outpatient Facility Coding Compliance Auditor - 2366610 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...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines.  Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties.  Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines.  Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties.  Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient...

Job Description Job Description Description: Sage Clinical RCM, LLC is seeking an experienced Outpatient Coding Auditor with a strong background in surgical coding. This role is responsible for auditing outpatient surgical encounters to ensure accurate code assignment, compliance with regulatory guidelines, and adherence to payer and client requirements. The ideal candidate has hands-on experience auditing complex outpatient surgical cases and providing clear, constructive feedback to coding staff. Key Responsibilities Perform audits of outpatient surgical encounters, including operative reports and related documentation Validate accurate assignment of CPT, ICD-10-CM, modifiers, and applicable APCs Ensure compliance with CMS, payer, and official coding guidelines Identify trends, risks, and educational opportunities based on audit findings Provide written audit feedback and coding education to support quality improvement Collaborate with coding leadership and...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines.  Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties.  Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines.  Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties.  Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines.  Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties.  Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting...

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. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines Utilize encoders and various coding resources Perform CPT Procedure reviews Maintain strict patient and physician...

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 role:...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines.  Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties.  Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines.  Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties.  Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting...

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 role:...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting...