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Preferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.

YEAR

Elevance Health

DRG Clinical Validation Auditor - RN (Cdi, Ms-Drg, Ap-Drg & Apr-Drg)

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Must have one of the following: • RHIT - Certified Health Information Technician (AHIMA) • RHIA - Registered Health Information Administrator (AHIMA) • CCS - Certified Coding Specialist (AHIMA) • CCA - Certified Coding Associate (AHIMA) • CCS-P - Certified Coding Specialist Physician-Based (AHIMA) • CPC - Certified Professional Coder (AAPC) • CPC-H - Certified Professional Coder - Hospital (AAPC) • CPC-I - Certified Professional Coder Instructor (AAPC) • CPC-A - Certified Professional Coder Associate (AAPC) • CCC - Certified Cardiology Coder (AAPC) • COC - Certified Outpatient Coder (AAPC). Must have one of the following: •RHIT - Certified Health Information Technician (AHIMA) •RHIA - Registered Health Information Administrator (AHIMA) •CCS - Certified Coding Specialist (AHIMA) •CCA - Certified Coding Associate (AHIMA) •CCS-P - Certified Coding Specialist Physician-Based (AHIMA) •CPC - Certified Professional Coder (AAPC) •CPC-H - Certified Professional Coder - Hospital (AAPC) •CPC-I - Certified Professional Coder Instructor (AAPC) •CPC-A - Certified Professional Coder Associate (AAPC) •CCC - Certified Cardiology Coder (AAPC) •COC - Certified Outpatient Coder (AAPC).

Houston Methodist Hospital

Ambulatory Payment Classification Coordinator

Required Minimum Experience: Minimum 2 years working in an acute care setting as a Clinical Documentation Specialist (CDS) Required and Minimum 5 years healthcare experience Required and Prior experience of working as a CDI/Coding auditor is preferred Preferred and Prior experience of working in inpatient case management or utilization review is preferred Preferred and. a) Initiates audits and prepares findings to assist CDI Education Lead in preparing and providing regular CDI education to stakeholders based on findings, trends, industry events and based on management needs b) Audits medical records to determine opportunities as they relate to clinical documentation improvement, PSI, HACs, mortality, etc.

As the largest healthcare system in the suburbs of Atlanta, WellStar serves more than a million patients a year within our hospitals, health parks, urgent care centers, and medical practices in NW Atlanta. We are a leading not-for-profit health system with state-of-the-art medical technology and a world-class employee family. Onsite concierge services, pension plans and job sharing are just the start of our innovative vision of a ‘Work Life Well Lived!’

WellStar Health System Inc

Clinical Documentation Auditor

Houston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities. The health system consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the Texas Medical Center, seven community hospitals and one long-term acute care hospital throughout the Greater Houston metropolitan area.

Coding Quality Auditor

Preferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.

DRG Clinical Validation Lead

Elevance Health Inc

Position Overview: Responsible for activities which improve the accuracy of facility outpatient clinical documentation coding and charging, including education with the clinical departments and coding staff and root cause correction to support accurate charging and coding in compliance with policies. Demonstrated ability to utilize official coding/billing resources including CPT/HCPCS references, OPPS Manual, NCCI Manual, NUBC Manual, etc. to determine applicable charges/codes as documented in the health record.

HOUR

Sutter Health has a long history in California. Some of our facilities have been providing care in the communities we serve for more than 100 years. Today, we’re proud to partner with more than 12,000 doctors to care for more than 3 million people.
We’re inspired by our Northern California community and work tirelessly to deliver top-rated, affordable healthcare. Doctors, hospitals, care teams and employees in the Sutter Health network are always looking for new, meaningful ways to care for you and your loved ones. We believe that every moment matters when it comes to helping you live a longer, healthier and happier life.
Our not-for-profit network delivers top-rated, personalized care in more than 100 Northern California communities. Recently ranked among the Top 15 Health Systems in the nation by Truven Health Analytics™, our team of more than 50,000 doctors, employees and volunteers partner to spread innovation, improve access to healthcare services and put our patients’ needs first—all to achieve the highest levels of quality, access and affordability.

Sutter Health

Charge Audit Analyst

Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and compliance with the Official Coding Guidelines for Coding and Reporting, payer regulations, and Clinic/hospital policy. Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure compliant coding and billing practices.

Phoebe Putney Health System

PPG Auditor/Educator

For ambulatory surgery centers (ASCs), SIS provides comprehensive software and services, including ASC management, electronic health records (EHRs), patient engagement capabilities, compliance technology, and revenue cycle management and transcription services, all built specifically for ASCs. Recognized as the No. 1 ASC EHR vendor by Black Book for 11 consecutive years and honored with the Best in KLAS Award for ASC Solutions in 2026, 2025, 2023, and 2022, SIS remains the trusted choice for surgical providers seeking to enhance their performance.

Surgical Information Systems LLC

Team Lead, Coding

PART_TIME

The Coding Provider Liaison (Professional Coding Auditor & Educator) works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges.

Four Winds Health

Coding Provider Liaison

Responsibilities: Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts. Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar''s unlimited vacation program and annual performance bonuses.

Oscar Health Inc

Risk Adjustment Auditor

Well Street Urgent Care

Required Minimum Education: Associate''s Degree from an accredited college required or in lieu of associates degree candidate must meet the minimum experience Required Bachelor''s Degree from an accredited college in a healthcare related field. Required Minimum Experience: Minimum 5 years auditing or coding compliance experience in a physician practice Required or Minimum 7 years coding or billing (Revenue Cycle) experience in a physician or outpatient coding environment.

Coding Compliance Auditor & Educator

Job Summary: The Clinical Documentation Integrity (CDI) Education Lead collaborates with key stakeholders such as the CDI Leadership team, coding team members, providers, facility and service-line operational leadership, CDI & Coding auditors, and others to train providers on documentation best practices aimed at improving clinical documentation and coding accuracy. It is expected that all non-clinical (coding) background candidates have at least one of the following active/current certifications: (1) Certified Coding Specialist (CCS) from AHIMA, (2) Certified Professional Coder (CPC) from AAPC, (3) Registered Health Information Administrator (RHIA) from AHIMA, or (4) Registered Health Information Technician (RHIT) from AHIMA Upon Hire Required.

Clinical Documentation Education Lead

Lead coding and documentation integrity strategies, including pre- and post-bill review, provider queries, addendums, signatures/co-signatures, identification of inappropriate documentation practices or cloning, and proactive provider education to address documentation gaps and support accurate coding. This leader will serve as a subject matter expert in professional billing and coding and will partner closely with clinical, operations, finance, compliance, credentialing, product, to identify revenue cycle risks and opportunities and translate them into actionable operational strategies.

Oscar Health Insurance

Senior Manager, Revenue Cycle Management, Provider Operations

Associates degree from an accredited college or university in healthcare or business-related field with four years of clinical or administrative experience in dental or medical healthcare environment as a certified coder with certification form the American Academy of Professional Coders (AAPC), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Dental Assisting National Board (DANB) or American Health Information Management Association (AHIMA). Bachelors degree from an accredited college or university in healthcare or business-related field with two years of clinical or administrative experience in dental or medical healthcare environment as a certified coder with certification form the American Academy of Professional Coders (AAPC), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Dental Assisting National Board (DANB) or American Health Information Management Association (AHIMA).

Augusta University

DCG Billing Compliance Analyst

OTHER

Oscar Health

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Requires at least one of the following certifications: RHIA certification as a Registered Health Information Administrator and/or RHIT certification as a Registered Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder. Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred.

Inpatient DRG Validator (Acute Care)

FULL_TIME

This position is remote; however, applicants must be physically located and authorized to work in one of the following states: Alabama, Arkansas, Florida, Georgia, Illinois, Louisiana, Michigan, New Hamsphire, North Carolina, Ohio, Pennsylavnia, South Caroline, Tennessee, Texas, Virginia, Wisconsin Description: This position ensures the accuracy, completeness, and compliance of medical coding and clinical documentation for professional coding services. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be .

Medical Coder Jobs in Georgia

DRG Clinical Validation Auditor - RN (Cdi, Ms-Drg, Ap-Drg & Apr-Drg) Elevance Health

Ambulatory Payment Classification Coordinator Houston Methodist Hospital

Clinical Documentation Auditor WellStar Health System Inc

Coding Quality Auditor Houston Methodist Hospital

DRG Clinical Validation Lead Elevance Health

DRG Clinical Validation Lead Elevance Health Inc

Charge Audit Analyst Sutter Health

PPG Auditor/Educator Phoebe Putney Health System

Team Lead, Coding Surgical Information Systems LLC

Coding Provider Liaison Four Winds Health

Risk Adjustment Auditor Oscar Health Inc

Coding Provider Liaison Well Street Urgent Care

Coding Compliance Auditor & Educator WellStar Health System Inc

Clinical Documentation Education Lead WellStar Health System Inc

Senior Manager, Revenue Cycle Management, Provider Operations Oscar Health Insurance

DCG Billing Compliance Analyst Augusta University

Senior Manager, Revenue Cycle Management, Provider Operations Oscar Health Inc

Senior Manager, Revenue Cycle Management, Provider Operations Oscar Health

Inpatient DRG Validator (Acute Care) Elevance Health

Remote - Professional Coding Auditor Emory Healthcare

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