17 drg coding auditor jobs found

EnableComp is seeking a DRG Auditor to review post-billed inpatient claims, validate missed reimbursement opportunities, and optimize hospital reimbursement using ICD-10 coding and DRG guidelines. You will analyze records in a specialized DRG database, identify coding errors, and recommend improvements while maintaining PHI privacy and security. This role supports nationwide hospital systems. #J-18808-Ljbffr

Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to medical coding and...

Coding Auditor (ICD-10)A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas:Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.Job DescriptionPosition:Coding Auditor (ICD-10)Duration:Full-TimeLocation:Newark/Wall NJJob Summary:This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on ICD9-...

PeaceHealth is seeking a remote Coding Auditor Educator for Hospital Coding, with a remote-friendly setup but residency within WA, OR, or AK. The role emphasizes audits, education, and regulatory compliance for accurate ICD-10/CPT coding and DRG validation. The position requires acute care coding experience, relevant credentials, and the ability to work independently in a remote environment. PeaceHealth offers a comprehensive rewards package and professional growth opportunities. #J-18808-Ljbffr

Clinical Coding Auditor & TrainerLocation:Remote (U.S.) Must be willing to travel to New York twice annuallyPosition Type:Full TimeThe Clinical Coding Auditor & Trainer is responsible for conducting clinical documentation and coding audits to ensure compliance with federal regulations, payer requirements, and company policies. This position focuses on DRG validation, inpatient prospective payment system (IPPS) compliance, and ICD-10-CM/PCS coding accuracy.

Location :RemoteSalary :$85,000depending on experienceSkills :Auditing, Inpatient Coding, DRG Validation, Quality ReviewAbout the Company / Opportunity :Are you passionate about upholding quality standards in health information management and coding practices? Our client, an industry leader in the hospitals and health care sector, provides nationwide revenue cycle services to a vast network of hospitals and physician practices.This remote opportunity allows you to leverage your expertise in coding quality review, ensuring compliance with national guidelines and maintaining data integrity.Join a mission-driven organization focused on supporting patient outcomes and enhancing health care delivery through excellence in coding quality.Responsibilities :Lead, coordinate, and perform all functions of quality review for inpatient and outpatient coding across multiple facilities.Conduct routine, pre-bill, policy-driven, and incentive plan-driven coding quality audits to ensure compliance...

Quadris Team, LLC - A Revenue Cycle Management Group, is searching for a dynamic person to join us, working with our highly skilled Medical Coding Team to fill the role of Medical Coding Auditor & Educator.We are a 100% remote team supporting our clients across the United States! See us at.The ideal applicant will be a subject matter expert in both Facility and Profee medical coding auditing.Job Focus :The Senior Coding Auditor may be responsible for a variety of duties and obligations, depending on the client and assignment.These responsibilities may include inpatient / outpatient / professional fee facility auditing, denial management, coding, implementation specialist, job aid creation, training, and specialty coding.The position may also be responsible for management of the audit team and project management.All coding and auditing are performed within the scope of regulatory and compliance law expectations.Auditing Responsibilities :May include conducting inpatient,...

Virtua Health Coding SpecialistAt Virtua Health, we exist for one reason to better serve you.That means being here for you in all the moments that matter, striving each day to connect you to the care you need.Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between we are your partner in health devoted to building a healthier community.If you live or work in South Jersey, exceptional care is all around.Our medical and surgical experts are among the best in the country.We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home.A Magnet-recognized health system ranked by U.S.News and World Report, we've received multiple awards for quality, safety, and outstanding work environment.In addition to five hospitals, seven emergency departments,...

Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. Responsible for the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment. Minimum Qualifications EDUCATION, CERTIFICATION, AND/OR LICENSURE: Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience. Certification inONEof the following: Registered Health Information Administrator (RHIA) OR...

Job Summary We are seeking an experienced and certified Medical Coder - Inpatient & Outpatient to join our Health Information Management/Revenue Cycle team.The Medical Coder is responsible for accurately reviewing and coding inpatient and outpatient hospital medical records in accordance with official coding guidelines, CMS requirements, payer regulations, and hospital policies.This position plays an essential role in ensuring coding accuracy, regulatory compliance, timely reimbursement, and the integrity of clinical and financial data.The successful candidate will demonstrate strong knowledge of hospital coding, medical terminology, anatomy and physiology, reimbursement methodologies, and regulatory requirements.Essential Duties and Responsibilities Review inpatient and outpatient medical records and accurately assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes based on assigned account type. Assign and validate appropriate MS-DRG/APR-DRG, APC, Present on Admission (POA),...

Coding Auditor & EducatorThe Coding Auditor-Educator is an advanced level position utilizing ICD-10-CM, ICD-10 PCS, and CPT-4 Coding Classification systems who supports the facility and Coding Service Center. Responsible for answering coding and billing questions, onboarding and training new staff, performing coding audits, and development and deployment of coding education. Works in conjunction with the Coding Service Center leadership team in planning and performing coding education and training across the system. Responsible for performing internal audits and follow up education. Facilitates and promotes standardization of coding practices, monitors and communicates regulatory coding and billing changes for timely and accurate implementation. Participates in short-term and long-term strategic planning with regard to compliant coding and regulatory billing practices.Along with CO, KS and NM, this position is open to remote/out of state candidates residing in only these...

Billing Coder IIIInform Diagnostics, a Fulgent Genetics Company, is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology, dermatopathology, urologic pathology, hematopathology, and breast pathology.Founded in 2011, our parent entity, Fulgent Genetics, has evolved into a premier, full-service genomic testing company built around a foundational technology platform. Through our diverse testing menu, Fulgent is focused on transforming patient care in oncology, anatomic pathology, infectious and rare diseases, and reproductive health. We believe that by providing a wide range of effective, flexible testing options in conjunction with best-in-class service and support, we can redefine the way medicine is managed for patients and clinicians alike. Since integrating with our therapeutic development business, Fulgent is also developing drug candidates for treating a broad range of cancers using a novel...

Job Description:Employment type:Contract (initial 3 months; likely extension) Schedule:Full-time, Monday“Friday (flexible daytime hours) Location:Remote (U.S. only) About the Role We're hiring an experiencedInpatient Medical Coderto support acute-care facility coding for a Level I Trauma Hospital. The ideal candidate is AHIMA-credentialed, highly accurate with ICD-10-CM/PCS and MS-DRG/APR-DRG assignment. Key Responsibilities Review inpatient medical records and assign ICD-10-CM/PCS codes with appropriate DRG assignment (MS-DRG/APR-DRG as applicable). Ensure compliance with AHIMA , AHA Coding Clinic , CMS , and facility guidelines. Query providers per policy to clarify documentation and support compliant code/DRG selection. Meet or exceed productivity and 95“98%quality standards. Collaborate with HIM/CDI teams to resolve discrepancies and optimize documentation integrity. Maintain HIPAA compliance and safeguard PHI in a remote work...

OverviewNAH reserves the right to make hiring decisions based on applicants state of residence if outside the state of Arizona.NAH currently hires for remote positions in the following states :AlabamaArizonaFloridaGeorgiaIdahoIndianaKansasMichiganMissouriNorth CarolinaOhioOklahomaPennsylvaniaSouth CarolinaTennesseeTexasVirginiaThe Coder 3 electronically records stores and reports on reams of data.Responsible for coding the following service types based on department and assignments.Facility HIM :Inpatient outpatient emergency room and outpatient clinical.Ambulatory :Coding and auditing professional inpatient outpatient emergency and clinic.Coders will need to apply a broad knowledge of procedure coding diagnosis coding medical terminology and anatomy / physiology.Hospital Coder Proficiency :ICD-10 PCS / DRG / CPT / HCPCS / ICD-10 CM.Professional Coder Proficiency :CPT / HCPCS / ICD-10 / CM.ResponsibilitiesCommunicationWorks in collaboration with physicians in tracking un-coded...

This position is responsible for reviewing, prioritizing, and analyzing adverse medical device events submitted via MedWatch reporting forms in hard copy or electronically to our customer, the Food and Drug Administration (FDA).Additionally, this position is responsible for processing and coding a variety of reports from device manufacturers (MFRs), importers, user facilities, healthcare professionals, and customers.While Analyst Coders may be assigned to perform the primary functions listed above, they will also be cross-trained to perform secondary duties as needed.MEDICAL CODER / ANALYST CODER II The interview will be on-site.This position requires on-site attendance in the office (Landover, MD) during the training period of 90 days minimally.After successful completion of training, the role may be eligible for remote or hybrid work arrangements, subject to manager approval.PLEASE READ THE REQUIRED QUALIFICATION:Required Qualifications: Must possess a Bachelor's degree in...

Coding SpecialistAt Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care.An unwavering commitment to our service vision is what makes the difference.It is the foundation of The Memorial Experience.Reviews medical record documentation.May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas / record types to ensure proper billing and compliance.For physician billing, collaborates with billing department to ensure all bills are satisfied.For hospital, routes to billing charge entry errors and / or account edits preventing completion of coding and / or billing.Makes appropriate coding corrections, when advised, and follows procedure to notify billing.Enhances and maintains coding knowledge and skills.Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes.Seeks...

JOB SUMMARYSupport and provide coding and compliance training to clinical personnel, billing, and / or other client staff.Establish effective communication with clinical staff, and / or hospital staff to address documentation, coding, and reimbursement issues.Use knowledge of coding and compliance guidelines to identify potential billing / reimbursement issues.Participate in special audits and system administration as necessary.ESSENTIAL DUTIES AND RESPONSIBILITIESInclude the following.Others may be assigned.Performs diagnosis data submissions to Client, Vendors and internal StakeholdersDevelop monthly productivity and revenue projectionsResponsible for chart assignment oversight and monitoring accounts on holdPrepares data collection reports for leadershipMonitors diagnosis submission progress; Audit diagnosis submission files to ensure accuracyReviews, analyzes and oversight of prebill / post bill reviews and pending accountsWorks to resolve workflow, systems and complex matters...