96 profee coding auditor education expert jobs found

Datavant is seeking a Profee Auditing & Education Specialist to address coding quality, compliance assessments, payer reviews, and education programs. This fully remote role offers a flexible schedule and a chance to shape healthcare data quality from your home office. You will perform audits, develop training materials, and collaborate with clients to improve coding accuracy and compliance. Requires 5+ years in professional fee coding/auditing, 3+ years creating and presenting education, and #J-18808-Ljbffr

About Us MedKoder, LLC is a full-service medical coding management services provider based in Mandeville, Louisiana, specializing in expert medical coding for health systems, providers, and payers. MedKoder delivers accurate, efficient, and ethical coding, aiming to ensure accurate payment and financial peace for clients. With a team of certified coders throughout the United States, MedKoder emphasizes coding excellence, remote-work flexibility, and a positive workplace culture, earning high employee satisfaction ratings and awards with Best Places to Work in Modern Healthcare and City Business Best Places to Work. Position Location: 100% Remote This is a full-time, remote position that offers a flexible schedule.  Description: Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare, Medicaid, and...

Physician Coding Auditor Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare, Medicaid, and third-party payer guidelines to ensure receipt of accurate reimbursement. Physician Coding Auditor is expected to adhere to MedKoder's internal coding/auditing policies and expectations set forth by department management. The Physician Coding Auditor must prioritize daily duties, communicate effectively, and make the decisions necessary to complete all assigned tasks and accomplish their goals. Candidates should have recent auditing and education multi-specialty experience, have been client-facing, have experience presenting or educating in-person or virtually, and ideally have expert-level Epic proficiency. Responsibilities: Perform professional compliance audits of coding and documentation including...

Experience preferred. Certified Coder with 5+ years experience coding professional and facility fees for surgical cases and office visits. Specialties include Obstetrics/Women's Health, Orthopedics, Podiatry, Cardiology, Urology & General Surgery. JOB SUMMARY The Coder is responsible for reviewing discharge abstracts and patient charts in order to assign the appropriate ICD-CM/CPT codes to diagnoses and procedures. Reviews charts for potential liability risk and documents specific information as necessary. Performs studies as requested by physicians or administration. Maintains State reporting documentation for certain procedures in compliance with regulations. The Coder encounters the mission of providing quality healthcare to the patients of WhidbeyHealth to ensure medical records are charged and coded accurately and efficiently. This position may be responsible for applying the appropriate codes for ICD-10, CPT / HCPCS, evaluation and management, and/ or modifiers to...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Job: Professional Coder I Duration: 6+ Months Location: Newark, NJ [100% Remote] Job Description: This position is accountable for accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities: Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy and compliance with applicable coding guidelines and regulations. Identify, compile and code...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Medical Coder Trajectory RCS joined the MedHQ family in 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing healthcare cash flow through integration of both business office processes and clinical documentation. MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and above all excellent...

Summary This position is accountable for accurately reviewing, interpreting, auditing, coding, and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment, and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities Understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy, and compliance with applicable coding guidelines and regulations. Identify, compile, and code member/patient data using ICD-9/ICD-10-CM and other standard classification coding systems. Support the...

Select how often (in days) to receive an alert: Date: Aug 18, 2026 Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for an Inpatient Coding Auditor, Senior Associate who is responsible for performing coding reviews of inpatient medical records and/or other documentation to determine correct coding, as defined by review methodologies specific to the...

Select how often (in days) to receive an alert: Date: Aug 18, 2026 Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for an Inpatient Coding Auditor, Senior Associate who is responsible for performing coding reviews of inpatient medical records and/or other documentation to determine correct coding, as defined by review methodologies specific to the...

Professional Coder Contract: 6 Months Location: 100% Remote | Can work remote from any of the following five states NY, NJ, PA, DE, CT Pay rate: $42/HR on W2 Summary: This position is accountable for accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities: Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy and compliance with applicable...

Summary This position is located in the Health Information Management (HIM) section at the VA Eastern Kansas Health Care System. Medical Records Technicians (MRT) 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. Responsibilities Functions: Assigns codes to documented patient care encounters (inpatient and outpatient) covering the full range of health care services provided by the VAMC. Selects and assigns codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS). Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Coder II Location: Remote Organization: Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder Overview Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder, is seeking a dedicated and skilled Coder to join our team remotely. As two of the region's most respected providers of orthopedic and upper extremity care, we offer a collaborative, patient-focused environment that prioritizes clinical excellence, innovation, and ongoing professional development. Position Summary This role is responsible for accurately reviewing medical records and assigning ICD-10 and CPT codes in compliance with all applicable policies and regulations. It manages patient demographics, clinical documentation, and billing data across practice management systems and hospital records to ensure proper coding and reimbursement. The position also supports and educates clinical staff and providers on documentation and coding standards to promote compliance, accuracy, and...

Job Description Job Description Medical Billing & Coding Specialist Position Summary The Medical Billing & Coding Specialist is responsible for managing insurance billing, claims processing, coding accuracy, and collection activities. This role ensures timely reimbursement, maintains compliance with coding guidelines, identifies documentation gaps, and works collaboratively with clinical and administrative teams to support accurate billing practices. This is an on-site position and is not remote. Education, Experience, and Certification Requirements High school diploma, GED, or equivalent required. Associate degree, bachelor’s degree, or relevant experience in medical records, healthcare administration, billing, or claims processing preferred. Experience with Kentucky Medicaid, medical billing, coding, insurance claims, or revenue cycle management preferred. Certification preferred: Certified Coding Associate (CCA) through AHIMA Certified Coding Specialist...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Position Summary Responsible for the creation and maintenance of audit and education programs that will ensure success for all staff and employed providers based on their specific needs and support accurate, compliant coding practices for ECU Health Physicians in accordance with coding guidelines. Conducts internal auditing of medical coding activities using concurrent, prospective and retrospective models as appropriate and/or required. Reviews electronic health information to determine accuracy of coding, billing and documentation, including validation of ICD10CM, CPT, HCPCS and modifier assignment related to medical provider professional Part B services according to regulatory and institutional policy. Reports findings, both written and verbal, to leadership as necessary to include provision of corroborating regulatory or policy guidance. Maintains documentation of all audit activities and communicates the findings with leadership. Utilizes findings to generate topics for...

PLEASE NOTE - This position may require temporarily relocation to other TONHC Facilities: Sells Hospital, Santa Rosa Health Center, San Simon Health Center, and San Xavier Health Center. Position Summary The Lead Medical Coder serves as a certified professional coder and assists the Medical Coding Office Manager with oversight of daily coding operations. Performs the full range of coding, assigns ICD, CPT, HCPCS, and medical inpatient codes; abstracts data from the record; performs chart analysis, research coding issues; peer reviews; and serves as a medical documentation and coding technical expert to TONHC providers. Scope of Work This position is located within Tohono O'odham Nation Health Care (TONHC). The work involves performing specialized medical record tasks and resolving problems using established processes, coding conventions, and guidelines. Performance of duties reflects directly on patient care by recording services performed on the patient. The incumbent works...

Senior Coding & Billing Specialist This position will be responsible for performing on-going auditing of outpatient provider coding, and education. Individuals must be a certified coder, with experience in NY Medicaid regulations. The Senior Coding & Billing Specialist is responsible for auditing outpatient provider coding and documentation to ensure accurate code assignment, regulatory compliance, and optimal reimbursement. This position serves as a subject matter expert in CPT, ICD-10-CM, HCPCS, New York State Medicaid, CMS, and commercial payer requirements, ensuring services are coded and billed accurately in accordance with applicable federal, state, and payer guidelines. In addition to coding audits, this role is responsible for reviewing and resolving billing work queues, analyzing claim denials and reimbursement trends, identifying charge capture and documentation opportunities, and supporting timely claim resolution. The Senior Coding & Billing Specialist...

Job Title Risk Coder Location Virginia Beach, VA Work Shift First (Days) Job Description Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual risk assessments, training, monitoring, & auditing, control assessment, reporting, investigation, root cause analysis, and corrective action oversight. Performs...