249 senior medical coding auditor educator jobs found

Quadris Team, LLC, a Revenue Cycle Management Group, is seeking a dynamic Senior Medical Coding Auditor & Educator to join a 100% remote team serving clients across the United States. The ideal candidate is a subject matter expert in both facility and professional coding auditing and will lead audits, provide education, and manage audit projects. The role requires extensive knowledge of inpatient/outpatient/professional fee coding, audit methodologies, and strong collaboration with leadership. #J-18808-Ljbffr

Quadris Team, LLC, a Revenue Cycle Management Group, is seeking a dynamic Senior Medical Coding Auditor & Educator to join a 100% remote team serving clients across the United States. The ideal candidate is a subject matter expert in both facility and professional coding auditing and will lead audits, provide education, and manage audit projects. The role requires extensive knowledge of inpatient/outpatient/professional fee coding, audit methodologies, and strong collaboration with leadership. #J-18808-Ljbffr

Allegheny Health Network is seeking a Senior Coding Auditor to evaluate medical records for DRG, OPPS and outpatient claim accuracy. You will report findings verbally and in writing, and guide education, process changes and risk reduction across the system. The role involves mentoring staff, keeping current with CMS and ICD coding rules, and presenting clear recommendations to management and external regulators. Strong communication and MS Office skills are essential. #J-18808-Ljbffr

Favorite Healthcare Staffing partners with a Kansas City healthcare system to hire a Coding Specialist / Auditor and Educator. You will conduct coding audits, identify compliance risks, and educate physicians, APPs, and coding staff to improve documentation and reimbursement. This full-time, onsite role offers some hybrid flexibility and requires RHIT/RHIA/CCS/CPC credentials with 5+ years of coding experience; strong communication and collaboration with Compliance and Revenue Integrity teams #J-18808-Ljbffr

Laboratory Coding Auditor/EducatorThe Laboratory Coding Auditor/Educator assists with oversight of coding audits and delivers targeted education for the Laboratory Billing & Coding Representatives, Pathologists, and applicable departments. This role works closely with and supports Laboratory leadership to ensure regulatory and compliance requirements are met for appropriate code assignment, while serving as a senior coding resource for the department. The Auditor/Educator conducts billing workflow and charge integrity audits to ensure laboratory orders and charges accurately transmit to EPIC. The Auditor/Educator adheres to all duties of the Laboratory Billing & Coding Representative.Certifications: Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA); Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC)Education: Highschool Diploma or G.E.D, Work Experience: CodingResponsibilities: Must...

Coder Job Summary The Coder's primary job function is to certify accurate billing for professional services and hospital procedures. This is accomplished through review of clinical encounters, confirming correct use of diagnosis and procedural codes and application of appropriate modifiers and CCI edits. The Coder provides education to providers to ensure proper completion of the medical record. Job Specific Competencies 1. Reviews clinical encounters presented via electronic lists to ensure proper submission of services prior to billing. a. Edits and corrects diagnosis and procedural codes and applies modifiers and CCI edits as required according to coding guidelines and department policy. b. Effectively utilizes coding software and/or books to confirm coding accuracy. c. Verifies referring provider, rendering provider, department and other critical data elements are accurate prior to submission of completed coding. 2. Receives and reviews paper fee slips for hospital services...

Job Summary The Coder's primary job function is to certify accurate billing for professional services and hospital procedures. This is accomplished through review of clinical encounters, confirming correct use of diagnosis and procedural codes and application of appropriate modifiers and CCI edits. The Coder provides education to providers to ensure proper completion of the medical record. Job Specific Competencies 1. Reviews clinical encounters presented via electronic lists to ensure proper submission of services prior to billing. a. Edits and corrects diagnosis and procedural codes and applies modifiers and CCI edits as required according to coding guidelines and department policy. b. Effectively utilizes coding software and/or books to confirm coding accuracy. c. Verifies referring provider, rendering provider, department and other critical data elements are accurate prior to submission of completed coding. 2. Receives and reviews paper fee slips for hospital...

Overview The Professional Coding Compliance Specialist provides revenue cycle support to Riverside Medical Group and its coding team by regularly auditing provider documentation and corresponding coding to ensure correct, complete and compliant practices that fully support diagnoses reported and charges submitted for services rendered, meet regulatory and payor-specific requirements, and accurately describe the patient encounter; providing feedback and education to providers and coders based on audit results, regulatory changes, and industry trends; assisting with orientation of new providers, residents/fellows, and new members of the coding team. Essential Duties Completes timely audits of assigned providers and coders for accurate, complete, and compliant ICD-10-CM and CPT/HCPCS code assignment, ensuring that documentation supports the diagnoses reported, E/M level selected, and CPT/HCPCS codes submitted for services rendered during the episodes of care reviewed Reviews...

MISSION Mirum Pharmaceuticals is a biopharmaceutical company dedicated to transforming the treatment of rare diseases. We are passionate about advancing scientific discoveries to become important medicines for rare disease patients. We are collaborative, creative, and experienced professionals and we’re looking to augment our team with other individuals who embody our values: care, be real, get it done, and have fun, seriously. MISSION Mirum Pharmaceuticals is a biopharmaceutical company dedicated to transforming the treatment of rare diseases. We are passionate about advancing scientific discoveries to become important medicines for rare disease patients. We are collaborative, creative, and experienced professionals and we’re looking to augment our team with other individuals who embody our values: care, be real, get it done, and have fun, seriously. Position Summary Mirum Pharmaceutical is seeking an Associate Director of Medical Safety Science (Safety Scientist). The ideal...

Porter is hiring a Risk Adjustment Coder to join our Team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home health...

Connecticut Institute for Communities, Inc. Description: The Team Lead will oversee key components of the revenue cycle including Internal and Outsourced Billing Services and Financial & Insurance Assistance. Serves as the organizations internal lead for oversight of both outsourced billing vendor and internal patient billing activities, including self-pay and sliding fee accounts. This role ensures patients have timely access to insurance enrollment and financial assistance services while maintaining strong internal controls, accurate patient billing processes, vendor accountability, and compliance with healthcare billing and payer requirements. ESSENTIAL JOB RESPONSIBILITIES: Revenue Cycle Oversight: Serve as the primary internal liaison between CIFC Health and the outsourced billing vendor. Monitor revenue cycle performance metrics, including claim submission timeliness, denial trends, accounts receivable aging, and collections. Review billing and...

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,...

Medical Coding Professional 2 Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities Deliver coding and documentation education to providers and clinic staff within IPA clinics. Be a consultative resource and ongoing support for providers in assigned clinics. Conduct documentation audits to identify gaps, trends, and opportunities for improvement. Perform quarterly chart reviews to support...

Become a part of our caring community Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities: You will deliver coding and documentation education to providers and clinic staff within IPA clinics. You will be a consultative resource and ongoing support for providers in assigned clinics. You will conduct documentation audits to identify gaps, trends, and opportunities for improvement. You will...

Description: Join the Team at PedIM Healthcare! Delivering exceptional care, together. Who We Are PedIM Healthcare is the first private medical office of its kind in Citrus County offering top-quality care for children, adults, and seniors all under one roof. We provide pediatric, adult internal medicine, family practice, geriatrics, womens care, medical weight-loss, sleep-medicine services and more. Our dedicated, community-focused team is committed to excellence, pride in service, and making a real difference for patients and families across Citrus County. Why Work With Us? A broad, multi-discipline practice where you can grow: pediatrics, internal medicine, weight-loss & sleep medicine specialties. A values-driven environment: we listen, we help, we understandand we care. Community-oriented and recognized: voted best of the best in the region. Opportunity to make a meaningful impact by supporting patients over their full life spanfrom...

Select how often (in days) to receive an alert: Date: Aug 26, 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 contract for...

Summary: HCC Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is an onsite position with a remote option. Responsibilities: Perform Medical Record reviews and audits based on organizational priorities. These can include both prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk adjustment. Perform code...

Summary: The HCC Coding Auditor will perform code audits and abstractions using the Official Coding Guidelines for ICD-10-CM and AHA Coding Clinic Guidance, following all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor will be involved with quality assurance auditing and risk adjustment code abstraction for the following programs: Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is a hybrid role. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Performs Medical Record reviews and audits based on organizational priorities. These can include prospective and concurrent Clinical Documentation Improvement (CDI) workflows and retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk adjustment....

Connecticut Institute for Communities, Inc. Description: The Team Lead will oversee key components of the revenue cycle including Internal and Outsourced Billing Services and Financial & Insurance Assistance. Serves as the organizations internal lead for oversight of both outsourced billing vendor and internal patient billing activities, including self-pay and sliding fee accounts. This role ensures patients have timely access to insurance enrollment and financial assistance services while maintaining strong internal controls, accurate patient billing processes, vendor accountability, and compliance with healthcare billing and payer requirements. ESSENTIAL JOB RESPONSIBILITIES: Revenue Cycle Oversight: Serve as the primary internal liaison between CIFC Health and the outsourced billing vendor. Monitor revenue cycle performance metrics, including claim submission timeliness, denial trends, accounts receivable aging, and collections. Review billing and...

CHRISTUS Health is seeking a Senior HCC Coding Auditor to perform audits, abstractions, and quality reviews aligned with ICD-10-CM and CMS HCC guidelines. This onsite role offers a remote option within a hybrid structure, supporting Commercial and Medicare Advantage risk adjustment programs. The ideal candidate will have 3+ years of hospital coding/audit experience, AHIMA or AAPC certification, and strong communication skills to educate providers on documentation and coding best practices. #J-18808-Ljbffr