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  • Conduct comprehensive coding reviews to ensure accuracy in code assignment and reimbursement.
  • Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications.
  • Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations.

Coding Auditing ICD-10 HCPCS CPT

12 jobs similar to Claims Auditor

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  • Perform inpatient coding audits and review services remotely.
  • Identify coding trends and recommend corrective actions.
  • Provide in-service education to clients on coding trends.

UASI helps healthcare organizations with coding and auditing services. They have been recognized as a Top Workplace by the Cincinnati Enquirer in 2022, 2023 and 2024 and pride themselves on stability and long-term success.

  • Perform coding audits and reviews on a variety of professional fee record types.
  • Perform necessary research in order to provide the client with supportive regulatory and coding guideline documentation.
  • Assist in the design and presentation of educational seminars to clients and staff.

UASI has over 40 years of experience and enduring partnerships with our valued clients, and is proud of the stability they’ve built and the long-term success of their dedicated team.

US

  • Ensure the organization's medical coding and billing practices comply with regulations and guidelines.
  • Perform independent audits and provide training for medical staff.
  • Act as a subject matter expert on coding and documentation standards.

Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care.

US

  • Conduct thorough audits of medical records and coding practices.
  • Develop and deliver educational programs on coding best practices.
  • Collaborate with billing, clinical, and revenue cycle teams.

Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching.

  • Perform auditing of claims, ensuring processing, payment, and financial accuracy.
  • Complete reporting of audits finalized with decision methodology for procedural and monetary errors.
  • Communicate corrections and adjustments to Examiners as identified on pre-payment audits.

Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their bills.

US 2000w PTO

  • Acts as the clinical coding subject matter expert and lead coding resource across the organization.
  • Acts as a resource and provides education to providers on clinical coding standards.
  • Coordinates and leads the Alliance Coding Workgroup.

Central California Alliance for Health is a regional non-profit health plan that provides accessible, quality health care. The company has over 500 employees and fosters a respectful, diverse, professional, and fun culture where employees are empowered to do their best work.

US

  • Accurately assigns and sequences ICD-10-CM and CPT-4 codes for various patient visits.
  • Interacts with physicians to clarify/verify questions and resolve coding/documentation issues.
  • Conducts internal coding studies and/or provides resource information to other departments.

Cooper University Health Care is an integrated healthcare delivery system serving residents and visitors throughout Cape May County. They are committed to providing competitive rates, compensation programs and comprehensive employee benefits.

In this role, you’ll ensure the accurate coding of medical procedures and diagnoses across our diverse range of services including inpatient, outpatient, ambulatory, and specialty care. You’ll play a key role in supporting compliance, optimizing reimbursements, and ensuring all documentation aligns with federal and state regulations.

Diana Health is a network of modern women’s health practices working in partnership with hospitals to reimagine the maternity and women’s healthcare experience.

US

  • Ensure adherence to payer requirements and internal compliance standards.
  • Support audit readiness, reduce denials, and improve claim resolution.
  • Maintain payer setup and readiness including fee schedules.

Expressable is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services, serving thousands of clients.

US

Primarily responsible for the accurate assignment of CPT, HCPCS, modifiers, and diagnosis codes. Utilizes expert knowledge and application of CPT, HCPCs, and ICD-10 coding guidelines to ensure accuracy of coding and charge capture. Communicates effectively with providers or other teams to resolve CPT, ICD-10, HCPCs, or modifier discrepancies and resolve complex coding-related denials.

Cook Children's is a not-for-profit organization comprised of a flagship medical center, a physician network, and other health-related services throughout Texas.

$60,000–$80,000/yr
US Unlimited PTO 17w maternity 9w paternity

  • Review and abstract professional medical records, including provider notes, encounters, and supporting documentation.
  • Assign ICD-10-CM, CPT, HCPCS, and applicable modifiers accurately, following national and payer-specific coding guidelines.
  • Maintain coding quality metrics (accuracy, productivity, and compliance) as defined by leadership.

Sprinter Health is reimagining how people access care by bringing it directly into their homes. They have supported more than 2 million patients across 22 states, completed over 130,000 in-home visits, and maintained a 92 NPS.

US

  • Conduct thorough reviews of medical records for accurate coding compliance.
  • Identify opportunities for documentation improvement to enhance code accuracy.
  • Educate healthcare providers on proper coding practices and HEDIS measures.

Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements. Their system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.