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Coding Validator Jobs (NOW HIRING)

Machinify

APC Coding Validation Specialist

$85K - $100K/yr

As a Coding Validation Specialist on the Complex Payment Solutions Team, you will play a critical role in performing comprehensive outpatient payment validation reviews. Leveraging your expertise in ...

ISLAND PEER REVIEW CORP

Coding Reviewer

Jericho, NY · On-site

$65K - $70K/yr

As a Coding Reviewer, you will be responsible for the general coding validation and verification and preparation of independent dispute resolution reviews from external state and federal agencies in ...

Medix

Coding Quality Specialist

Camden, NJ · On-site

$32 - $45/hr

Perform coding validation reviews for various healthcare improvement and compliance areas. * Assist with internal and external coding audits. * Provide education and feedback as necessary.

IPRO

HIM Validator (Coder)

Jericho, NY · On-site

Technical knowledge of coding and DRG validation. * Ability to work independently with minimal supervision. Education & Experience: * Licensed Registered Health Information Administrator (RHIA ...

Lancesoft INC

Coding and Billing Auditor

Dover, DE · On-site

$53K - $81K/yr

Validate documentation supports code selection * Provide feedback and education to providers and staff * Support coding training and onboarding * Assist Revenue Cycle Manager with performance reviews ...

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Coding Validator information

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How much do coding validator jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for coding validator in the United States is $25.84, according to ZipRecruiter salary data. Most workers in this role earn between $23.32 and $28.12 per hour, depending on experience, location, and employer.

How does a Coding Validator typically collaborate with medical coders and billing teams to ensure accurate claim submissions?

As a Coding Validator, you play a crucial role in reviewing and verifying the accuracy of medical codes assigned by coders before claims are submitted to insurance providers. You frequently interact with both medical coding and billing teams to clarify documentation, resolve discrepancies, and provide feedback on coding practices. Regular communication and teamwork are essential, as your input helps prevent claim denials and ensures compliance with regulatory standards. This collaborative environment not only supports organizational accuracy but also offers opportunities for professional growth through cross-functional learning.

What are the key skills and qualifications needed to thrive as a Coding Validator, and why are they important?

To thrive as a Coding Validator, you need a strong understanding of medical coding systems (such as ICD-10, CPT, and HCPCS), healthcare regulations, and a relevant certification like CCS, CPC, or RHIT. Expertise with coding software, electronic health records (EHRs), and auditing tools is typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for ensuring coding accuracy and collaborating with healthcare teams. These competencies are vital to ensure compliance, maximize reimbursement, and reduce errors in healthcare billing processes.

What are Coding Validators?

Coding Validators are professionals who review and verify codes assigned to medical diagnoses, procedures, or treatments to ensure accuracy and compliance with regulations. They often work in healthcare settings, auditing coding performed by medical coders to confirm it aligns with clinical documentation and coding guidelines. Their work helps prevent billing errors, supports proper reimbursement, and reduces the risk of compliance issues. Coding Validators play a critical role in maintaining the integrity of medical records and supporting healthcare quality initiatives.

What is the difference between Coding Validator vs Coding Auditor?

AspectCoding ValidatorCoding Auditor
Required CredentialsCertification in medical coding (e.g., CPC, CCS)Certification in medical coding and auditing (e.g., CPC, RAC)
Work EnvironmentHealthcare facilities, coding companiesHospitals, insurance companies, healthcare organizations
Employer & Industry UsagePrimarily used for ensuring coding accuracy before billingUsed for compliance, quality assurance, and audit purposes
Common Search & ComparisonYesYes

While both Coding Validators and Coding Auditors work to ensure accurate medical coding, Validators focus on verifying code correctness during the coding process, often before billing. Auditors review completed codes for compliance and accuracy, often as part of quality assurance or regulatory requirements. Both roles require similar certifications but serve different stages in the coding and billing workflow.

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What cities are hiring for Coding Validator jobs? Cities with the most Coding Validator job openings:
What job categories do people searching Coding Validator jobs look for? The top searched job categories for Coding Validator jobs are:
What are popular job titles related to Coding Validator jobs? For Coding Validator jobs, the most frequently searched job titles are:
Coding Validator jobs near you
Infographic showing various Coding Validator job openings in the United States as of July 2026, with employment types broken down into 67% Full Time, and 33% Part Time. Highlights an 100% In-person job distribution, with an average salary of $53,749 per year, or $25.8 per hour.
APC Coding Validation Specialist

APC Coding Validation Specialist

Machinify

Remote

$85K - $100K/yr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 20 days ago

Job description

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
About the Opportunity:
As a Coding Validation Specialist on the Complex Payment Solutions Team, you will play a critical role in performing comprehensive outpatient payment validation reviews. Leveraging your expertise in coding guidelines, outpatient reimbursement methodologies, and regulatory requirements, you will ensure accurate and compliant payment determinations.
In this role, you will review medical records to validate the accuracy of coding, billing, and supporting documentation for outpatient services, including APCs, EAPGs, CPT, and HCPCS Level II codes. You will clearly document audit findings and provide well-supported rationales, citing applicable payer policies, coding guidelines, and industry-standard references.
This position requires exceptional attention to detail, expert-level proficiency in ICD-10-CM/PCS, CPT, and HCPCS coding guidelines, and a strong understanding of outpatient reimbursement methodologies.
What you'll do:
  • Conduct comprehensive reviews to validate the accuracy of billed charges against medical documentation, payer policies, coding guidelines, and industry standards to ensure appropriate reimbursement.
  • Apply coding guidelines across a broad range of outpatient services, including but not limited to Interventional Radiology, Radiation Oncology, injections and infusions, outpatient surgeries, implants, and observation services (including carve-outs).
  • Demonstrate a strong working knowledge of outpatient reimbursement methodologies, including Medicare Outpatient Prospective Payment System (OPPS), Ambulatory Payment Classification (APC), and Enhanced Ambulatory Patient Grouping (EAPG).
  • Apply expert-level knowledge of NCCI edits, including appropriate modifier usage, as well as CPT and HCPCS coding guidelines.
  • Interpret and apply Medicare Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs).
  • Produce clear, concise, and defensible audit findings that accurately articulate reimbursement impact.
  • Develop and apply well-supported rationales for coding changes impacting reimbursement, referencing appropriate sources such as AMA Official Coding Guidelines, CPT Assistant, AHA Coding Clinic, payer policies, and other industry-standard resources.
  • Work effectively both independently and collaboratively within a production-driven environment.
  • Maintain established accuracy, quality, and productivity standards, including correct code assignment and thorough documentation of review outcomes.
  • Utilize computer applications and tools, including Grouper/Pricer software, ICD-10-CM encoders, and Microsoft Office products.
  • Adhere to the Standards of Ethical Coding as established by AHIMA.
  • Perform additional duties as assigned.

What experience you bring (Role Requirements)
  • Associate's or Bachelor's degree in Health Information Management, Medical Coding, or a related field
  • At least 2 years of experience performing pre-pay and/or post-pay reimbursement audits
  • Broad outpatient facility auditing experience, including specialty areas such as Interventional Radiology, injections and infusions, Radiation Oncology, Behavioral Health, and ambulatory surgery
  • Active certification including RHIT, RHIA, CCS (AHIMA), and/or CPC
  • 5-7 years of experience in outpatient facility coding/auditing
  • Sound knowledge of ICD-10-PCS/CM, CPT, and HCPCs coding guidelines
  • Experience performing pre- and post-payment reimbursement audits
  • Expertise in Medicare regulations, including LCDs, NCDs, NCCI edits, OPPS, and APC methodologies
  • Demonstrated experience with APC payment methodologies, OPPS reimbursement logic, fee schedules, and payer contracts
  • Excellent verbal and written communication skills
  • Strong attention to detail and analytical skills
  • Experience with encoder and auditing tools (e.g., 3M, TrueBridge, Grouper/Pricer Software)

Pay range: $85,000 - $100,000, with the opportunity to earn quarterly bonuses. The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc. We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range.
What We Offer:
  • Work from anywhere in the US! Machinify is digital-first.
  • Top Medical/Dental/Vision offerings
  • FSA/HSA
  • Tuition reimbursement
  • Competitive salary, 401(k) with company match
  • Additional health and wellness benefits and perks
  • Flexible and trusting environment where you'll feel empowered to do your best work

Equal Employment Opportunity at Machinify
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/

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