19 (CPMA) Certified Professional Medical Auditor jobs

Day in the Life of a Medical Coding Auditor Conducting audits of claims and patient records to identify incorrect coding. Audits will be performed for both provider and coder coding accuracy with required documentation in accordance with current coding guidelines. Developing, implementing, and coordinating corrective action proposals and plans. Tracking completion of internal and external Plans of Correction. Preparing reports of findings and any compliance issues identified with audits, including monthly summary reports for the Crossroads executive team and quarterly reports for the Chief Compliance Officer. Attending and reporting at weekly team calls with Manager of Medical Coding Compliance Audits, Director of Medical Coding Compliance and Chief Compliance Officer. Attending weekly meetings with other auditors. Reporting coding patterns identified within the audit process to management and identifies corrective measures to compliance problems. Assisting the Manager of...

## **Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.**## ## ## Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder. Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted treatment (MAT) options to combat the growing opioid epidemic and helping people with opioid use disorder start their path to recovery. This comprehensive approach to treatment, the gold standard in care for opioid use disorder, has been shown to prevent more deaths from overdose and lead to long-term recovery. We are committed to bringing critical services to communities across the U.S. to improve access to treatment for over 26,500 patients. Our clinics are all outpatient and office-based, with clinics in Georgia, Kentucky, New Jersey, North and South Carolina, Pennsylvania,...

Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder. Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted treatment (MAT) options to combat the growing opioid epidemic and helping people with opioid use disorder start their path to recovery. This comprehensive approach to treatment, the gold standard in care for opioid use disorder, has been shown to prevent more deaths from overdose and lead to long-term recovery. We are committed to bringing critical services to communities across the U.S. to improve access to treatment for over 26,500 patients. Our clinics are all outpatient and office-based, with clinics in Georgia, Kentucky, New Jersey, North and South Carolina, Pennsylvania, Tennessee,...

Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Description Position Purpose : Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims...

A healthcare organization in South Carolina is seeking a Medical Coding Auditor to enhance coding accuracy and compliance within the company. The ideal candidate will have at least 5 years of coding experience and 2 years of auditing experience, preferably focused on Mental Health and Opioid Addiction. This role includes conducting audits, preparing compliance reports, and providing coding updates. Comprehensive benefits include insurance options, 401K matching, and paid leave. This position also demands strong communication and organizational skills. #J-18808-Ljbffr

Role Name: Quality Medical Auditor Location: Columbia, SC 29223 Work Environment: Remote (Preferred Onsite) Schedule: Mon - Fri, 8AM-4:30PM Contract length: 4 months assignment with possible conversion Job Summary: Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Day to Day: 75% Determines methodology to identify cases for validation review. Conducts validation reviews/coordinates rates adjustments with appropriate claims area. Creates monthly/quarterly reports to present to each line of business providing information on records review, outcomes, trends, and savings...

Medical Auditor (Billing & Coding) page is loaded## Medical Auditor (Billing & Coding)locations: Remote VAtime type: Full timeposted on: Posted 10 Days Agojob requisition id: JR100312At OrthoVirginia, you’re part of a team dedicated to delivering expert orthopedic and therapy care across the state. As Virginia’s largest provider of musculoskeletal care, we offer full-time and part-time opportunities in a collaborative, team-oriented environment.With more than 159 physicians in over 35 locations—including Lynchburg, Northern Virginia, Richmond, Southwest Virginia, and Hampton Roads—OrthoVirginia is a leader in orthopedic surgery, non-surgical care, and physical, hand, and occupational therapy. Our nationally recognized specialists treat a full range of musculoskeletal injuries and conditions, helping patients of all ages move, heal, and thrive.Join us and become part of a trusted network committed to excellence in orthopedic care.**JOB SUMMARY:**Responsible for...

A healthcare auditing firm is seeking a Quality Medical Auditor to conduct validation reviews related to medical coding and compliance. The ideal candidate will have an Associate Degree in Nursing or Health Information Management and at least 3 years of experience in medical records management. Responsibilities include managing coding issues, creating analytical reports, and ensuring HIPAA compliance. This position is primarily onsite but may offer potential for remote work. #J-18808-Ljbffr

Quality Medical Auditor - Coding Specialist Join to apply for the Quality Medical Auditor - Coding Specialist role at BlueCross BlueShield of South Carolina . Summary Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate...

Are you an experienced Medical Coder seeking a career growth? Are you a Certified Auditor interested in a new work opportunity? If so, then we want to connect with you! MAHEC is now accepting candidates for Medical Auditor. This integral role supports MAHEC's mission of educating the next generation of healthcare professionals by completing internal quality assessment reviews on Care Provider coding and effectively builds relationships with MAHEC Care Providers to educate and foster complete, accurate, timely, and consistent coding. The Auditor/Provider Educator is responsible for documentation to ensure compliance with national coding guidelines and MAHEC policies. We welcome experienced Medical Coders interested in becoming a Certified Professional Medical Auditor, and MAHEC offers an employer-sponsored pathway to CPMA certification if hired for the position! This is a hybrid work opportunity, with roughly 50-60% onsite work to support in-person collaboration and...

Hours of Work : Flexible 8 am - 4:30 pm Days Of Week : Monday through Friday Work Shift : Job Description : Remote or On-Site (Dallas, TX) Employment/Education History Requirements : Certifications : High school education or equivalent; some college credit; Bachelor's degree preferred. Certified Professional Coder ( CPC ) certification from AAPC or Certified Coding Specialist - Physician-based ( CCS-P ) certification from AHIMA with the appropriate level of experience for auditing and abstracting. Preferred : Certified Professional Medical Auditor (CPMA) certification from AAPC Experience/Knowledge : 2+ years of multispecialty auditing medical documentation experience for appropriate E&M level and CPT assignment or 4-5 years of multispecialty coding experience. Thorough knowledge of anatomy/medical terminology. Proficient with Microsoft Word and Excel. Experience with Epic preferred. Ability to communicate effectively via written and...

Director of Operations – Revenue Cycle Management (RCM) We are a newly launched Revenue Cycle Management (RCM) company seeking a Director of Operations to help build, scale, and lead our operational infrastructure from the ground up. This role is ideal for a seasoned RCM professional with broad industry experience and a proven track record of scaling operations in a growth environment. About the Company The owner operates multiple successful healthcare ventures with an established client base that already requires RCM services, providing immediate volume and growth opportunity. This new RCM company is being built with a focus on: Supporting a wide range of outpatient practice types Maintaining a strong compliance-first operating model Operating with 100% U.S.-based staff Delivering high-quality, scalable, and ethical billing services Role Overview The Director of Operations will oversee day-to-day RCM operations while helping design...