• DRG Coding Auditor

    Elevance Health (Woburn, MA)
    **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ _​_ _This role enables associates to work virtually full-time, with the exception of required in-person ... to recover, eliminate and prevent unnecessary medical-expense spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records… more
    Elevance Health (07/22/25)
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  • Coding Auditor Educator

    Highmark Health (Boston, MA)
    …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality ... and accuracy of coding , billing and documentation related to DRGs, APCs, CPTs...Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician… more
    Highmark Health (05/09/25)
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  • Senior Inpatient Medical Coding…

    Humana (Boston, MA)
    …caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical records and ... evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related group (DRG) assignments.… more
    Humana (06/26/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Boston, MA)
    …years of healthcare experience in revenue cycle management (related to billing, coding , collections for Medicare and Medicaid claims) + Experience with Auditing and ... monitoring of healthcare records + Must be able to work core business hours on EST time between (9am-5pm). + Willingness to travel up to 10% to conduct audits at site locations. + Ability to manage multiple or competing priorities and meet deadlines + Must be… more
    Humana (07/29/25)
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  • Inpatient DRG Quality Auditor

    Humana (Boston, MA)
    …This is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from medical records and ... Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement,… more
    Humana (07/25/25)
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  • Remote Outpatient Facility Auditor

    TEKsystems (Boston, MA)
    Description The Outpatient Facility Auditor is integral to maintaining coding accuracy and compliance with our standards. This role involves conducting detailed ... educational sessions on code updates and rule changes. The auditor collaborates closely with the coding team,...changes. The auditor collaborates closely with the coding team, providing continuous education and feedback to enhance… more
    TEKsystems (07/29/25)
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  • Outpatient Facility Auditor

    Dana-Farber Cancer Institute (Brookline, MA)
    The Outpatient Facility Auditor is integral to maintaining coding accuracy and compliance with our standards. This role involves conducting detailed audits of ... educational sessions on code updates and rule changes. The auditor collaborates closely with the coding team,...changes. The auditor collaborates closely with the coding team, providing continuous education and feedback to enhance… more
    Dana-Farber Cancer Institute (06/25/25)
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  • Compliance Auditor -Per Diem-Day Shift

    Baystate Health (Springfield, MA)
    …more accurate billing. **2)** Validates and identifies appropriate ICD-9 (ICD-10) diagnosis coding as it pertains to specific risk adjustments and correct coding ... reports analyses for review by management. **4)** Performs Pathology and Radiology coding ; applicable use of all carrier guidelines and review of clinical… more
    Baystate Health (06/23/25)
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  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective claims auditing ... and clinical coding and reimbursement edits and necessary coding ...+ Certified Inpatient Coder (CIC) + Certified Professional Medical Auditor (CPMA) **Desired Education (nice to have):** + Masters… more
    Commonwealth Care Alliance (05/28/25)
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  • Accounts Payable Coordinator

    Robert Half Accountemps (Woods Hole, MA)
    …accurate documentation for audit purposes and internal recordkeeping. * Assist with auditor selection requests and provide necessary support during audits. * Address ... attention to detail. * Familiarity with accounts payable practices, including invoice coding and payment processing. * Knowledge of Automated Clearing House (ACH)… more
    Robert Half Accountemps (07/25/25)
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