10 coder quality auditor jobs found

Overview At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. We are a leading authority in payment integrity solutions. The Outpatient Payment Integrity Coder Auditor is responsible for reviewing outpatient medical claims to ensure coding accuracy, compliance, and appropriate payment in accordance with CMS and payer-specific guidelines. This role supports the development and implementation of payment integrity initiatives by identifying coding and billing inaccuracies, trends, and potential cost savings opportunities across outpatient facility claims. The ideal candidate has advanced knowledge of outpatient coding, APC and EAPG payment methodologies, and clinical documentation requirements, with strong analytical and auditing skills. Responsibilities Perform detailed coding audits on outpatient facility claims to validate appropriate CPT/HCPCS, revenue codes, modifiers, and ICD-10 coding in accordance with CMS, NCCI, and...

Description Summary: Responsible for maintaining current and high-quality ICD-10-CM and CPT coding for all Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. The coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM Guidelines for Coding and Reporting and CPT Guidelines. Outpatient coding is applicable towards clinical, provider office visits, therapeutic, laboratory, recurring, emergency department, outpatient observation, and ambulatory surgery patient encounters. Coder will work collaboratively with various CHRISTUS Health departments (Admitting, Charging, Patient Financial Services, HIM, etc.) to resolve charging issues, denials, and physician documentation clarifications, to ensure accurate billing...

Title: Inpatient/Outpatient Coder - Certified Reporting Relationship: Health Information Manager General Summary of Responsibilities: The employee is responsible for analyzing medical records in order to code and abstract medical information for inpatient/outpatient encounters both medical and surgical using correct codes from ICD-9-CM, and/or ICD-10-CM Diagnosis AND Procedure/PCS AND CPT coding guidelines to be submitted for financial reimbursement as required for the Uniform Bill and for the DRG (Diagnosis Related Group). All Coding Guidelines are to be utilized and adhered to. Assign appropriate CPT codes and modifiers as well as CPT anesthesia codes. Assign codes using the 3M encoder with finalization/releasing of records in EMR system. Knowledge of using encoder as well as ICD-9-CM; ICD-10-CM and ICD-10-PCS and CPT coding books. Correctly sort the records after coding for doctors boxes for final signatures or refer to Electronic Medical Records Technicians for...

Description Summary: Responsible for maintaining current and high-quality ICD-10-CM and CPT coding for all Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. The coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM Guidelines for Coding and Reporting and CPT Guidelines. Outpatient coding is applicable towards clinical, provider office visits, therapeutic, laboratory, recurring, emergency department, outpatient observation, and ambulatory surgery patient encounters. Coder will work collaboratively with various CHRISTUS Health departments (Admitting, Charging, Patient Financial Services, HIM, etc.) to resolve charging issues, denials, and physician documentation clarifications, to ensure accurate billing...

Position Overview The Inpatient-Outpatient Coder is responsible for conducting coding audits and education for providers with greatest opportunity for improvement. This individual will ensure medical diagnosis and procedure codes submitted on provider claims are accurate. In addition, this person will review medical records for: physician documentation, clinical evidence that supports the diagnoses, medical necessity of procedures, appropriate setting of care and accurate use of CMS coding guidelines. Scope of Role & Responsibilities Identifies trends and inconsistencies in provider documentation and coding practices. Audits and reviews medical records to determine if the medical record is complete, accurate, and in support of individual patient risk adjustment score accuracy. Develops curriculum to improve provider coding practices. Educates providers and their practice staff in coding guidelines. Works in collaboration with other departments, develop plans...

Inpatient-Outpatient Coder Job Ref: TE0031 Category: Claims Department: CLAIMS Location: 50 Water Street, 7th Floor, New York, NY 10004 Job Type: Regular Employment Type: Full-Time Work Arrangement: Hybrid Salary Range: $76,000.00 - $86,661.00 Position Overview The Inpatient-Outpatient Coder is responsible for conducting coding audits and education for providers with greatest opportunity for improvement. This individual will ensure medical diagnosis and procedure codes submitted on provider claims are accurate. In addition, this person will review medical records for: physician documentation, clinical evidence that supports the diagnoses, medical necessity of procedures, appropriate setting of care and accurate use of CMS coding guidelines. Scope of Role & Responsibilities Identifies trends and inconsistencies in provider documentation and coding practices. Audits and reviews medical records to determine if...

Department: Health Information Management Address: 1611 NW 12 Ave, Miami, FL 33136 Shift Details: Monday to Friday, 7.30 AM to 4 PM [Remote but open to applicants who reside in the state of Florida] Jackson Health System is a nationally and internationally recognized academic medical system offering world-class care to any person who walks through our doors. For more than 100 years, Jackson has evolved into one of the world's top medical providers for all levels of care, no matter if it's for a routine patient visit or for a lifesaving procedure. With more than 2,000 licensed beds, we are also proud of our role as the primary teaching hospital for the University of Miami Miller School of Medicine. Here, the best people come together to deliver Jackson's mission for our diverse communities. Our employees are committed to providing the best CARE by demonstrating compassion, accountability, respect, and expertise in everything we do. Summary HIM Outpatient Coder 2 is...

Medix - 300 Jericho Quadrangle [Medical Records Clerk] As an Outpatient Coder at Medix, you'll: Analyze medical records to assign accurate codes for outpatient services; Ensure compliance with coding guidelines and regulations; Collaborate with healthcare providers to clarify documentation; Maintain confidentiality of patient information; Participate in coding audits and quality improvement initiatives; Stay updated with changes in coding standards and healthcare regulations...Hiring Immediately >>