4 jobs found in Eagan

*Description* The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. Your Responsibilities: Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy, completeness, specificity and appropriateness of...

Risk Adjustment Coding Auditor Location: Remote (U.S.) Employment Type: Contract-to-Hire About the Role The Risk Adjustment Coding Auditor is responsible for ensuring the accuracy, completeness, and compliance of diagnosis coding used in risk adjustment programs. This role conducts prospective and retrospective chart audits, validates diagnosis code capture, identifies documentation opportunities, and provides coding guidance to support regulatory compliance and appropriate reimbursement. The auditor serves as a subject matter expert in risk adjustment coding and works closely with internal teams to maintain data integrity and reduce financial and regulatory risk. Key Responsibilities Perform prospective and retrospective medical record reviews and audits. Validate diagnosis code accuracy, completeness, specificity, and appropriateness based on provider documentation. Review medical records to ensure proper capture of CMS-HCC diagnoses and risk adjustment...

*Job Description* * The Private Insurance Biller is responsible for full-cycle billing of Durable Medical Equipment (DME) claims, including claim submissions, denial resolution, appeals, accounts receivable follow-up, and payer compliance activities. * This role plays a critical part in reducing denials, improving cash flow, maintaining payer credentialing requirements, and ensuring compliance with Medicare DMEPOS and payer-specific regulations. *Skills* medical billing & coding, Customer Service *Additional Skills & Qualifications* * Medical billing experience required. * DME experience is a big plus. *Job Type & Location*This is a Contract to Hire position based out of Eagan, MN. *Pay and Benefits*The pay range for this position is $20.00 - $22.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program...

Northwest Respiratory Services in Eagan, MN is seeking a CMN (Certificate of Medical Necessity) Specialist to handle all CMNs and supporting medical documentation required for billing. This role supports the billing office and ensures accurate, timely submissions. The CMN Specialist will follow up with doctor offices, maintain files, review CMNs for accuracy, and work on multiple reports and pending CMN tasks to keep billing flowing smoothly. #J-18808-Ljbffr