62 outpatient payment integrity production coder jobs found

Position Summary:  MedReview is looking for a Outpatient Payment Integrity Production Coder . The Outpatient Payment Integrity Production Coder is responsible for completing claim-level outpatient coding reviews to identify inaccurate coding, unsupported billing, documentation gaps, and potential overpayments. This role supports payment integrity operations by applying outpatient coding expertise, client payer policy, CMS guidance, CPT/HCPCS requirements, modifier rules, NCCI edits, and medical record documentation standards to ensure audit findings are accurate, defensible, and client savings consistently recovered.  Key Responsibilities  Perform outpatient coding reviews using medical records, itemized bills, claim lines, payer requirements, CPT/HCPCS guidance, ICD-10-CM guidelines, revenue codes, modifier rules, NCCI edits, APC/EAPG logic, and supporting documentation.  Validate whether billed outpatient services are supported by documentation and...

Outpatient Payment Integrity Production CoderMedReview is looking for an Outpatient Payment Integrity Production Coder. The Outpatient Payment Integrity Production Coder is responsible for completing claim-level outpatient coding reviews to identify inaccurate coding, unsupported billing, documentation gaps, and potential overpayments. This role supports payment integrity operations by applying outpatient coding expertise, client payer policy, CMS guidance, CPT/HCPCS requirements, modifier rules, NCCI edits, and medical record documentation standards to ensure audit findings are accurate, defensible, and client savings consistently recovered.Key ResponsibilitiesPerform outpatient coding reviews using medical records, itemized bills, claim lines, payer requirements, CPT/HCPCS guidance, ICD-10-CM guidelines, revenue codes, modifier rules, NCCI edits, APC/EAPG logic, and supporting documentation.Validate whether billed outpatient services are supported by documentation and whether the...

Outpatient Coder (Remote) Full-time Work From Home Must have Surgical/OBS coding experience and documented billing edit experience Ob Summary As part of our hospital outpatient coding team, you will work outpatient coding quality and/or billing alerts/edits for hospital outpatient encounters (e.g., same day surgery, observation, wound care, emergency department, and/or diagnostic) to ensure complete and accurate code assignment. This is a great starting position for those wanting to move from production coding toward an outpatient coding quality review position. Job Responsibilities Verifying accuracy of assigned CPT codes for complex and/or error prone procedures Verifying the diagnosis coding accuracy for complex and/or error prone encounters Validating certain discharge dispositions Reviewing charge and procedure mismatches Reviewing codes with revenue integrity for NCD/LCD coverage Reviewing invalid codes, code conflicts, and missing modifiers Working with other...

Outpatient Coder (Remote)Full-time • Work From HomeMust have Surgical/OBS coding experience and documented billing edit experienceOb SummaryAs part of our hospital outpatient coding team, you will work outpatient coding quality and/or billing alerts/edits for hospital outpatient encounters (e.g., same day surgery, observation, wound care, emergency department, and/or diagnostic) to ensure complete and accurate code assignment. This is a great starting position for those wanting to move from production coding toward an outpatient coding quality review position.Job ResponsibilitiesVerifying accuracy of assigned CPT codes for complex and/or error prone procedures,Verifying the diagnosis coding accuracy for complex and/or error prone encounters,Validating certain discharge dispositions,Reviewing charge and procedure mismatches,Reviewing codes with revenue integrity for NCD/LCD coverage,Reviewing invalid codes, code conflicts, and missing modifiers,Working with other team members in...

Outpatient Coder (Remote)Full-time • Work From HomeMust have Surgical/OBS coding experience and documented billing edit experienceOb SummaryAs part of our hospital outpatient coding team, you will work outpatient coding quality and/or billing alerts/edits for hospital outpatient encounters (e.g., same day surgery, observation, wound care, emergency department, and/or diagnostic) to ensure complete and accurate code assignment. This is a great starting position for those wanting to move from production coding toward an outpatient coding quality review position.Job ResponsibilitiesVerifying accuracy of assigned CPT codes for complex and/or error prone procedures,Verifying the diagnosis coding accuracy for complex and/or error prone encounters,Validating certain discharge dispositions,Reviewing charge and procedure mismatches,Reviewing codes with revenue integrity for NCD/LCD coverage,Reviewing invalid codes, code conflicts, and missing modifiers,Working with other team members in...

Outpatient Coder (Remote)Full-time • Work From HomeMust have Surgical/OBS coding experience and documented billing edit experienceOb SummaryAs part of our hospital outpatient coding team, you will work outpatient coding quality and/or billing alerts/edits for hospital outpatient encounters (e.g., same day surgery, observation, wound care, emergency department, and/or diagnostic) to ensure complete and accurate code assignment. This is a great starting position for those wanting to move from production coding toward an outpatient coding quality review position.Job ResponsibilitiesVerifying accuracy of assigned CPT codes for complex and/or error prone proceduresVerifying the diagnosis coding accuracy for complex and/or error prone encountersValidating certain discharge dispositionsReviewing charge and procedure mismatchesReviewing codes with revenue integrity for NCD/LCD coverageReviewing invalid codes, code conflicts, and missing modifiersWorking with other team members in billing,...

Medical Coder IIMeduit is a national leader in healthcare revenue cycle management, supporting hospitals and physician practices in 48 states. We focus on optimizing payments, allowing clients to focus on patient care, and pride ourselves on our core values: Integrity, Teamwork, Continuous Improvement, Client-Focused, and Results-Oriented.The Medical Coding Specialist II is responsible for correctly coding healthcare claims and analyzing denials to obtain proper reimbursement. The Medical Coder accurately and efficiently codes hospital outpatient and professional service using official code sets and classifications systems to obtain the most accurate data based on documentation.Title: Medical Coder II Location: Remote Schedule: 8am – 5pm in Eastern, Central, Mountain, or Pacific time zones Department: Insurance Reports To: Coding Supervisor Compensation: $26-$30 per hour, depending on qualifications Key Responsibilities: Read and analyze patient records Accurately and...

Outpatient Coder (Remote) Full-time • Work From Home Must have Surgical/OBS coding experience and documented billing edit experience Ob Summary As part of our hospital outpatient coding team, you will work outpatient coding quality and/or billing alerts/edits for hospital outpatient encounters (e.g., same day surgery, observation, wound care, emergency department, and/or diagnostic) to ensure complete and accurate code assignment. This is a great starting position for those wanting to move from production coding toward an outpatient coding quality review position. Job Responsibilities Verifying accuracy of assigned CPT codes for complex and/or error prone procedures Verifying the diagnosis coding accuracy for complex and/or error prone encounters Validating certain discharge dispositions Reviewing charge and procedure mismatches Reviewing codes with revenue integrity for NCD/LCD coverage Reviewing invalid codes, code conflicts, and missing modifiers...

Title: Risk Adjustment Coding Auditor Location: Remote Job Type: Contract (6 months) Compensation: $35.00 – $38.00 per hour Industry: Health Insurance About the Role Our firm is partnering with a leading nonprofit health insurance organization that serves members across commercial, Medicare, and Medicaid health plans. We are seeking an experienced Risk Adjustment Coding Auditor to help ensure the accuracy, integrity, and compliance of clinical coding and documentation used in risk adjustment programs. In this role, you will support accurate reimbursement and regulatory compliance by conducting detailed coding audits, identifying documentation gaps, and providing expert guidance on risk adjustment coding practices. This position is ideal for a coding professional with strong HCC auditing experience who is passionate about data accuracy, compliance, and continuous improvement. Job Description As a Risk Adjustment Coding Auditor, you will evaluate coded clinical data to ensure...

Exceptional care starts with exceptional people. For us, this is more than a job- it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you to discover your passion, reach your potential, and Pursue Your Purpose. Exceptional care starts with exceptional people and teams. Together we are leading the way. This job is responsible for reviewing and accurately coding either most professional services, including evaluation and management, and Procedures or hospital outpatient surgeries/procedures and observation patients. Remains in conformance with applicable Medicare, Medicaid and third-party payer guidelines to ensure receipt of accurate reimbursement. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made...

Pursue Your Purpose Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you to discover your passion, reach your potential, and Pursue Your Purpose. Exceptional care starts with exceptional people and teams. Together we are leading the way. This job is responsible for reviewing and accurately coding either most professional services, including evaluation and management, and procedures or hospital outpatient surgeries/procedures and observation patients. Remains in conformance with applicable Medicare, Medicaid and third-party payer guidelines to ensure receipt of accurate reimbursement. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable...

The University of Texas MD Anderson Cancer Center is seeking a Senior Clinical Coding Specialist to join its Revenue Operations and Coding team. The Senior Clinical Coding Specialist plays a critical role in ensuring accurate and compliant coding of patient encounters, supporting timely billing and reimbursement processes, and maintaining the integrity of clinical data across systems. This position works remotely and collaborates closely with coding professionals, leadership, and clinical partners. The Senior Clinical Coding Specialist at UT MD Anderson is responsible for reviewing medical records, assigning appropriate clinical codes, and supporting departmental goals for accuracy, compliance, and operational efficiency. UT MD Anderson Cancer Center is a leading institution focused on cancer care, research, education, and prevention. The ideal candidate brings strong expertise in clinical coding practices, including CPT, ICD-10, and regulatory guidelines, along with experience...

Exceptional care starts with exceptional people. For us, this is more than a job– it’s a calling. It’s waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you to discover your passion, reach your potential, and Pursue Your Purpose. Exceptional care starts with exceptional people and teams. Together we are leading the way. This job is responsible for reviewing and accurately coding either most professional services, including evaluation and management, and Procedures or hospital outpatient surgeries/procedures and observation patients. Remains in conformance with applicable Medicare, Medicaid and third-party payer guidelines to ensure receipt of accurate reimbursement. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be...

Coder II Cabinet Peaks Medical Center is looking for a Coder II to join our Health Information Management (HIM) team! The Coder abstracts clinical documentation and codes diagnoses and procedures for inpatient and outpatient encounters, including surgeries, urgent care, emergency department, observation, swing bed, laboratory, imaging, orthopedics, OB, cancer registry, sleep, and rehabilitative services. Compilation of statistical reports as needed for healthcare operations. Major Job Duties & Responsibilities Accurately assigns diagnosis and procedure codes for assigned patient encounters using appropriate coding guidelines and regulations. Compiles and distributes statistical reports as requested. Adjusts/enters charges in Meditech. Educates providers for correct coding, documentation specificity, and ethical reimbursement methodology. Queries providers for documentation clarification. Completes educational requirements for certification maintenance. Participates...

Coding Specialist Wage Range: $27.45 - $43.92 per hour Remote in state of Washington only - Kirkland, WA Campus Posted wage ranges represent the entire range from minimum to maximum. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. Some positions also offer additional premiums based on shift, certifications or degrees. Job offers are determined based on a candidate's years of relevant experience, level of education and internal equity. Job Summary: Abstracts, analyzes, and assigns ICD-10-CM, CPT, HCPCS codes and appropriate modifiers for evaluation and management (E/M), minor procedures, and diagnostic tests by using either computerized or manual systems. Researches and resolves coding and reimbursement issues to ensure the accuracy, quality, and integrity of coding and billing practices. Effectively communicates with clinicians and billing/coding teams regarding code changes and denials....

Pursue Your Purpose Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Together we are leading the way. This job is responsible for reviewing and accurately coding either most professional services, including evaluation and management, and procedures or hospital outpatient surgeries/procedures and observation patients. Remains in conformance with applicable Medicare, Medicaid and third-party payer guidelines to ensure receipt of accurate reimbursement. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties. This job description is a summary of the...

Job Summary and Responsibilities As our Outpatient Coder Lead, you will code and abstract outpatient records for data retrieval, analysis, reimbursement, and research, ensuring complete charge capture, and providing expert guidance to coding and hospital staff. Every day you will direct Outpatient Coding Service Center operations including personnel management, training, education, productivity, work assignments, and quality reviews. You will assist with coding education, audits, denials, claim edits, and CHA data submissions, promoting standardization and managing DNB and coding compliance to achieve financial goals and improve the accuracy and integrity of patient data. To be successful in this role, you will possess expert-level outpatient coding proficiency, strong leadership and management skills, a deep understanding of coding regulations and reimbursement methodologies, and the ability to drive accuracy, quality, and standardization across coding operations, while...

Job Description Job Description Description: Riverland Community Health is a Federally Qualified Health Center in St. Paul, where patients receive community-based Family Practice medical care in addition to mental health, dentistry, social work and other integrated services. When joining RCH, you become part of a diverse, inclusive, and welcoming team who are dedicated to serving our patients and pursuing our mission to deliver excellent healthcare for all and training for the providers of tomorrow.  JOB SUMMARY: The Medical Coding Specialist / Provider Educator is responsible for the review of medical records, notes, dictation and other related documentation to ensure the accurate and timely submission of charges for professional services provided by physicians and other providers as well as diagnoses for clinic services. The Medical Coding Specialist / Provider Educator is also responsible for conducting coding audits, providing education and communication of process...

Medical Device Coder In Some Jobs You Take Orders. In This One, You Write History. Join the healthcare information technology team that's turning drug and medical device data into knowledge used by thousands of hospitals; the majority of U.S. health plans, retail pharmacies, and pharmacy benefit managers; and millions of healthcare decision makers throughout the world. Partnering with our information system developer and healthcare institution customers, you'll help evolve leading-edge thinking into reality and make a measurable difference in improving human health. We're looking for people who are: Intelligent. Productive. Committed. Willing and able to go above and beyond. Passionate about making a difference. Innovative. Energized. And want to play an essential role in a successful company's continued growth. Are you ready for this exciting challenge? First Databank (FDB) is currently seeking a Medical Device Coder in the Quality department. This position is...

Hourly Wage Estimate: $34.59 - $51.89 / hour Learn More About The Benefits Offered For This Job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Schedule: Monday-Friday Day Shift Hours Candidate must have Inpatient Facility Coding and DRG Validation experience 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...

Schedule: Monday-Friday Day Shift Hours Candidate must have Inpatient Facility Coding and DRG Validation experience 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: Leads, coordinates and performs all functions of quality reviews (routine, pre-bill, policy driven and incentive plan...

Position OverviewWe are seeking an experienced Risk Adjustment Coding Auditor to join our team. This role is responsible for ensuring the accuracy, completeness, and compliance of risk adjustment coding and clinical documentation across Medicare, Medicaid, and ACA Commercial populations. The ideal candidate will bring deep expertise in HCC coding, risk adjustment auditing, and regulatory compliance while serving as a trusted resource for coding guidance and best practices.The Risk Adjustment Coding Auditor plays a critical role in supporting accurate reimbursement, reducing compliance risk, improving data integrity, and driving organizational success through high-quality coding audits and reporting.Key ResponsibilitiesConduct retrospective and prospective chart reviews to validate risk adjustment diagnoses and reporting accuracy.Audit provider-reported diagnosis codes for accuracy, specificity, completeness, and documentation support.Review medical records to identify complete and...

Risk Adjustment Coding Auditor5+ month ContractMinimum Qualifications High school diploma, GED, or equivalent practical experience. 7+ years of professional experience in risk adjustment, medical coding, auditing, or a related healthcare field. 5+ years of Hierarchical Condition Category (HCC) coding experience utilizing inpatient and outpatient coding guidelines. 5+ years of experience auditing Risk Adjustment records. 1+ year of experience working in a production-based environment. Certified Risk Coder (CRC) certification in good standing and an additional coding certification, or ability to obtain certification within six months of hire. Experience with Medicare, ACA Commercial, and Medicaid risk adjustment models. Experience interpreting and applying coding policies, regulations, and documentation standards. Experience providing written and verbal feedback on coding errors and trends. Intermediate proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and...

Hourly Wage Estimate: 34.59 - 51.89 / hour. Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Schedule: Monday-Friday Day Shift Hours Candidate must have Inpatient Facility Coding and DRG Validation experience 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...