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Medical Coding Reviewer Jobs (NOW HIRING)

Humana, Inc.

Inpatient Medical Coding Auditor

Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics ...

U.S. Career Institute

Review and manage courses and exams, including grading and using innovative ways to provide content ... Medical Coding field. * ICD-10-CM, ICD-10-PCS, CPT and HCPCS knowledge and experience.

CES, LLC

Medical Coding Auditor

Saint Augustine, FL · Remote

Maintain inter-reviewer reliability through internal QA and standardized audit methodology Required qualifications/skills: * Must have a minimum of 3-5 years medical coding experience; 2+ years in ...

Claritev

Medical Coding Specialist

Manhattan, NY · On-site

$60K - $63K/yr

Medical Coding Specialist At Claritev, we pride ourselves on being a dynamic team of innovative ... Review and analyze inpatient, outpatient, and provider billing for medical appropriateness of ...

Claritev

Medical Coding Specialist

Manhattan, NY · On-site

$60K - $63K/yr

Medical Coding Specialist At Claritev, we pride ourselves on being a dynamic team of innovative ... Review and analyze inpatient, outpatient, and provider billing for medical appropriateness of ...

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How much do medical coding reviewer jobs pay per hour?

As of Jun 11, 2026, the average hourly pay for medical coding reviewer in the United States is $42.06, according to ZipRecruiter salary data. Most workers in this role earn between $22.84 and $54.09 per hour, depending on experience, location, and employer.

Will a medical coder be replaced by AI?

Medical coding reviewers oversee the accuracy of coded medical records and ensure compliance with coding standards. While AI tools can assist with coding tasks, human oversight remains essential to handle complex cases, interpret ambiguous information, and ensure quality, so full replacement by AI is unlikely in the near future.

What is a medical coding reviewer?

A medical coding reviewer is a professional who examines medical codes assigned to patient records to ensure accuracy and compliance with coding standards such as ICD-10 and CPT. They verify that diagnoses, procedures, and services are correctly coded, often using coding software, and may work closely with healthcare providers and billing teams to improve documentation and billing accuracy.

What pays more, CCS or CPC?

In medical coding, Certified Coding Specialist (CCS) credential holders often earn higher salaries than Certified Professional Coder (CPC) holders due to the advanced training and specialization involved. However, salaries can vary based on experience, location, and work setting, with CCS generally commanding higher pay in hospital and facility environments. Both certifications are valuable, but CCS typically offers higher earning potential for medical coding reviewers and professionals working in complex healthcare settings.

What is the difference between Medical Coding Reviewer vs Medical Coding Specialist?

AspectMedical Coding ReviewerMedical Coding Specialist
CertificationsAHIMA or AAPC coding certifications, reviewer credentialsSame certifications, focus on coding accuracy
Work EnvironmentReviewing coded records, quality assuranceAssigning codes, data entry, coding documentation
Employer & IndustryHospitals, clinics, insurance companiesHospitals, physician offices, billing companies
Search & Comparison IntentUnderstanding review roles, quality controlLearning coding duties, certification info

Medical Coding Reviewers focus on auditing and ensuring the accuracy of coded medical records, while Medical Coding Specialists are responsible for assigning the appropriate codes to diagnoses and procedures. Both roles require similar certifications and often work in healthcare settings like hospitals and clinics. The main difference lies in their primary duties: reviewers verify and improve coding quality, whereas specialists perform the initial coding process.

How to get hired as a medical coder with no experience?

To become a medical coding reviewer with no experience, start by obtaining a relevant certification such as the Certified Professional Coder (CPC) or Certified Coding Associate (CCA), which demonstrates foundational knowledge. Gaining familiarity with coding software and medical terminology through online courses or training programs can also improve your chances; entry-level positions often provide on-the-job training to develop necessary skills.

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

To thrive as a Medical Coding Reviewer, you need a thorough understanding of medical terminology, ICD-10/CPT/HCPCS coding systems, and detailed knowledge of healthcare regulations, usually supported by a certification like CPC or CCS. Familiarity with electronic health records (EHRs), coding audit tools, and compliance tracking systems is also essential. Strong analytical thinking, attention to detail, and effective communication skills distinguish top performers in this role. These skills are crucial for ensuring accurate coding, maintaining regulatory compliance, and supporting proper reimbursement processes in healthcare organizations.

What are Medical Coding Reviewers?

Medical Coding Reviewers are healthcare professionals responsible for evaluating and verifying the accuracy of medical codes assigned to patient diagnoses, procedures, and treatments. They review medical records and documentation to ensure compliance with coding standards such as ICD-10, CPT, and HCPCS. Their work helps healthcare organizations maintain accurate billing, reduce claim denials, and comply with regulations. Medical Coding Reviewers also identify coding errors, provide feedback to coders, and may assist in training and quality improvement initiatives.

What are some common challenges faced by Medical Coding Reviewers, and how can they be addressed?

Medical Coding Reviewers often encounter challenges such as interpreting complex medical documentation, staying updated with frequent coding guideline changes, and ensuring coding accuracy to avoid claim denials. Overcoming these challenges requires strong attention to detail, continuous professional development, and effective communication with healthcare providers. Building collaborative relationships with clinical staff and participating in ongoing training can help reviewers stay current and maintain high-quality standards.
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What cities are hiring for Medical Coding Reviewer jobs? Cities with the most Medical Coding Reviewer job openings:
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Medical Coding Reviewer jobs near you
Infographic showing various Medical Coding Reviewer job openings in the United States as of June 2026, with employment types broken down into 17% As Needed, 17% Full Time, and 66% Contract. Highlights an 79% Physical, 4% Hybrid, and 17% Remote job distribution, with an average salary of $87,476 per year, or $42.1 per hour.
Medical Coding Analyst

Medical Coding Analyst

HealthCare Partners, MSO

Garden City, NY

$65K - $75K/yr

Full-time

Posted 9 days ago

Job description

HealthCare Partners, IPA and HealthCare Partners, MSO together comprise our health care delivery system providing enhanced quality care to our members, providers and health plan partners. Active since 1996, HealthCare Partners (HCP) is the largest physician-owned and led IPA in the Northeast, serving the five boroughs and Long Island. Our network includes over 6,000 primary care physicians and specialists delivering services to our 125,000 members enrolled in Commercial, Medicare and Medicaid products. Our MSO employs 200+ skilled professionals dedicated to ensuring members have access to the highest quality of care while efficiently utilizing healthcare resources.
HCP’s vision is to be recognized by members, providers and payers as the organization that delivers unsurpassed excellence in healthcare to the people of New York and their communities. We pride ourselves on selecting the most qualified candidates who reflect HCP’s mission of serving our members by facilitating the delivery of quality care.  Interested in joining our successful Garden City Team?  We are currently seeking a Coding Analyst!
Position Summary: The Coding Analyst will provide Risk Adjustment/HCC coding and auditing services that include the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated alphanumerical codes. The Medical Coder will summarize audit results and provide feedback and education to the field team and providers regarding documentation needs and requirements. 
Essential Position Functions/Responsibilities:
  • Review and interpret medical record documentation to identify pertinent diagnoses and procedures and assigns ICD-10 CM and CPT 4 codes accurately and timely to the highest level of specificity based upon physician documentation.
  • Verify and ensure the accuracy and completeness of medical records while extracting appropriate and specific ICD-10 CM- CPT and Category II codes.
  • Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations.
  • Review coding patterns/trends and provides ongoing consultation to the field Quality/ Network Relations team regarding coding and documentation issues.
  • Proactively identifies and communicates problems and opportunities; actively recommends and implements solutions or medical coding process improvements.
  • Interpret coding rules and general policies in addition to determining appropriate conclusions.
  • Determine valid encounters including legibility and valid signature requirements.
  • Provide information or respond to questions from medical coding quality audits.
  • Possess and maintain a current and comprehensive understanding of coding rules, changes, and guidelines as defined by the AMA.
  • Responsible for consistently meeting established quality and productivity standards.
  • Other duties relating to coding projects as assigned.

Qualification Requirements:
Skills, Knowledge, Abilities
  • Experience working in medical coding/auditing with experience in Diagnosis coding
  • Knowledge of medical terminology including anatomy and physiology...
  • HCC and risk adjustment model experience strongly preferred
  • Strong background in ICD 10 Coding
  • Knowledge and understanding of CPT and CPT II (HCSPCS) codes
  • Intermediate level of experience with Microsoft Excel (Pivot table, building chart)
  • Strong written and verbal communication and organizational skills
  • Must present active AAPC or AHIMA membership ID #
  • Proficient with Excel and MS office products
  • Demonstrates the ability to perform in a high productivity fast-paced environment.
  • Knowledge of ICD-10 CM Guidelines and CMS Risk Adjustment Guidelines
  • Knowledge of Risk Adjustment Coding

Training/Education:
  • High school diploma or general educational degree (GED), required
  • Associate or Bachelor degree in health care discipline, preferred
  • Medical coding Credentials through either AAPC or AHIMA (CCS, CCS-P, or CPC) maintained annually, required.
  • CRC or CPMA credentials, preferred
  • Proficient in navigating an electronic medical record and healthcare billing system

Experience:
  • 3+ years’ of inpatient facility coding experience with both quality and productivity requirements
  • 3+ years’ of outpatient facility coding Auditing experience is preferred
  • 1+ year of inpatient and/or outpatient facility coding experience
  • 1+ year of auditing experience preferred 
  • Knowledge of Risk Adjustment coding
  • 1 year of healthcare provider education experience

Base Compensation: $65,000 - $75,000 annual
HealthCare Partners, MSO provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, HealthCare Partners, MSO complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
The above position information is intended to describe the general nature and level of work being performed by the job incumbent(s) and is not to be considered an all-encompassing description of all responsibilities, duties, and skills required.
 

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