19 coding auditor jobs found in Chicago

Inpatient Medical Coding Auditor page is loaded## Inpatient Medical Coding Auditorlocations: Remote Nationwidetime type: Full timeposted on: Posted Todayjob requisition id: R-397765# **Become a part of our caring community and help us put health first**The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.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-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and...

Job Description Be a part of a world‑class academic healthcare system at UChicago Medicine as a Coding Auditor - DRG/APC Coordinator for the Health Information Management department. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area. In this role, the Coding Auditor - DRG/APC Coordinator is responsible for ensuring accuracy and quality of coding assignments for all records requiring DRG and/or APC coding, and ensures optimal and timely reimbursement. Essential Job Functions Performs data quality reviews on inpatient and outpatient records to ensure proper coding guidelines have been followed and appropriate DRG or APC assignments have been made for appropriate reimbursement Provides DRG/APC and coding quality information and statistical reports to the Coding Manager Communicates with the Medical Staff and House staff as needed to discuss clinical questions with respect to the assignment of ICD-10-CM and...

DRG Coding Auditor Principal This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients. Specializes in review of DRG coding via medical record and attending...

DRG Coding Auditor Principal This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case...

Anticipated End Date: 2026-01-05 Position Title: Diagnosis Related Group Clinical Validation Auditor (CDI, MS-DRG, AP-DRG and APR-DRG) Job Description: Be Part of an Extraordinary Team Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical‑expense spending. Build the Possibilities. Make an Extraordinary Impact. Title: Diagnosis Related Group Clinical Validation Auditor (CDI, MS-DRG, AP-DRG and APR-DRG) Virtual: This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the...

DRG Coding Auditor Principal Virtual: This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. All candidates must be within a reasonable commuting distance from the posting location(s) unless an accommodation is required by law. Responsibilities Analyzes and audits claims by integrating advanced coding principles from the Official Coding Guidelines, Coding Clinics, and the ICD‑10 Alphabetic and Tabular Indices, complex clinical guidelines, and maintains objectivity in all audit activities. Draws on advanced ICD‑10 coding expertise, clinical guidelines, and industry knowledge to substantiate sophisticated conclusions. Utilizes audit tools, workflow systems, and reference information to make audit determinations and generate audit findings letters. Validates accuracy and quality standards as set by audit management for the auditing concept, valid claim identification, and...

A prominent medical institution seeks a Coding Auditor - DRG/APC Coordinator to ensure the accuracy and quality of coding assignments for healthcare records. This remote position requires a Bachelor's degree or equivalent, along with RHIT and CCS credentials. Candidates should have at least four years of coding experience, including two years of PPS coding and experience in an academic setting. Responsibilities include conducting data quality reviews, providing reports, and educating medical staff on documentation standards. Join us in advancing healthcare excellence. #J-18808-Ljbffr

DRG Coding Auditor Principal Virtual: _ This role enables associates to work virtually full-time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical‑expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology,...

A prominent health company seeks a DRG Coding Auditor Principal to audit medical records and claims based on DRG methodology. The role requires advanced coding expertise and the ability to work independently. Candidates must have significant experience in claims auditing and relevant health information certifications. This position offers the flexibility of a virtual work environment, promoting work-life integration, while ensuring professional growth and comprehensive benefits. #J-18808-Ljbffr

A leading health services organization seeks a professional for a full-time role focused on medical record auditing and ICD coding. You will be responsible for ensuring accuracy and compliance with regulations while utilizing clinical documentation. The ideal candidate must possess CPC or CCS-P certification and relevant experience in medical record review. The position offers a competitive pay range of $18.50 - $42.35 per hour, along with comprehensive benefits including medical plans and a 401(k). #J-18808-Ljbffr

Ann & Robert H. Lurie Children’s Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children’s Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.Day (United States of America)**Location**Ann & Robert H. Lurie Children's Hospital of Chicago**Job Description****Summary:**Conducts retrospective audit of ambulatory and inpatient physician documentation to ensure billing accuracy and compliance. Accounts for concurrent inpatient billing accuracy and compliance for selected Divisions. Provides physician education on coding and documentation guidelines.**Essential Job Functions:**• Reviews and audits physicians’ documentation in the medical record and...

A healthcare provider in Chicago is seeking a Compliance Auditor to perform audits on provider documentation and coding. Responsibilities include managing compliance issues and communicating effectively with providers regarding results. Candidates should have a Bachelor's Degree and relevant certifications like RHIA or CPC. Strong interpersonal skills and experience in healthcare compliance are preferred. This role offers competitive benefits and opportunities for professional growth. #J-18808-Ljbffr

Job Description Job Description The Coding Network, LLC (TCN) is the country’s premier broker of remote coding and auditing services, structured as a virtual company connecting healthcare professionals and health systems across the country with over 800 US based single specialty coders and auditors. Flexible Hours: We understand that everyone’s schedule is different and, as such, auditors enjoy the flexibility to commit to as few as 15 hours a week to however many hours work for them to render auditing services. It is one thing to have the freedom to work from home, but TCN coders possess the freedom to utilize the full 24 hour clock and choose when to work beyond the traditional 9-5. Whether you’re looking for extra income in addition to your day job or to make a more robust commitment, we are able to accommodate you. Position & Responsibilities: In order to support the growing need for E&M services and surgical divisions, there are abundant opportunities for...

Abstractor/Coder The University of Chicago Physicians Group (UCPG) team is responsible for the overall management of clinical revenue for physician billing. This includes frontend revenue capture, working of edits and conducting audits for physician education. Ensuring the workflow of charge capture through invoice creation. UCPG is seeking an Abstractor/Coder to work with providers and staff on professional billing and compliance activities. Strong knowledge of evaluation and management coding guidelines and requirements is strongly preferred. This position is eligible for a flexible work arrangement. Responsibilities: Obtain appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses, and physician visits. Analyze denial and rejection reports, and appeal wherever appropriate. Submit charges in a timely manner. Work in collaboration with the Clinical Revenue Supervisor and others, provide guidance to faculty and staff on...

Job Description Job Description *MUST LIVE IN ILLINOIS OR A STATE SURROUNDING ILLINOIS TO APPLY* The Ambulatory Coding and Reimbursement Specialist is responsible for reviewing, analyzing, and coding ambulatory and/or hospital encounters, diagnostic and procedural information used in the billing of charges for physician's services. Ensures compliance with established coding procedures, regulatory guidelines and reimbursement policies. Reviews medical record documentation for E/M encounters from multiple specialty departments for proper assignment of ICD-10, CPT, HCPCS and modifiers. Performs initial charge review to determine appropriate CPT and ICD-10 codes to be used in reporting physician services to third party payers. Essential Duties and Responsibilities: Analyzes provider documentation to assure the appropriate Evaluation & Management levels are assigned using the correct CPT and current Evaluation and Management Guidelines Interprets outpatient office visit...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from...

* Obtain appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses, and physician visits.* Analyze denial and rejection reports, and appeal wherever appropriate.* Submit charges in a timely manner.* Work in collaboration with the Clinical Revenue Supervisor and others, provide guidance to faculty and staff on the charge capture and documentation processes.* Educate physicians and support staff on coding issues, including issues related to fraud and abuse as it relates to coding/professional billing/clinical documentation.* Attend and participate in meetings related to clinical revenue production and compliance.* Track physicians on inpatient service and ensure charges are captured for services provided.* Manage tracking log.* Audit and provide feedback to all providers rotating on inpatient service.* Other duties as assigned.* Thorough working knowledge of medical terminology, anatomy and physiology, as demonstrated by...

* Maintains advanced-level expertise in CPT, ASA, ICD-10, HCPCS, modifier use, medical terminology, payer rules, HIPAA, and institutional billing requirements.* Independently reviews, abstracts, and codes highly complex anesthesiology services, including time-based anesthesia, staffing, and critical event documentation.* Ensures all services documented in the patient record are coded and posted accurately; obtains additional documentation in a timely manner following established protocols.* Meets or exceeds departmental productivity and accuracy standards.* Research and resolves coding-related edits, payer rejections, insurance denials, and PHA account issues.* Tracks inpatient anesthesia services and reconciles professional and PHA charges to ensure complete and accurate capture.* Reviews denial and rejection trends, identifies workflow, documentation, or compliance issues affecting reimbursement, and escalates issues as appropriate.* Serves as a knowledge resource to clinical...

The Senior / Super Coder serves as a high-performing coding professional responsible for the accurate and timely assignment of ICD-10-CM/PCS, CPT, and HCPCS codes for all hospital services including inpatient, outpatient, emergency, surgery, and RHC encounters. This position functions as the department’s top-tier coder and provides advanced coding expertise, mentorship, and support to the Coding Team Leader, enabling her to focus on quality assurance, compliance, and education. The Senior Coder must maintain exceptional accuracy, productivity, and compliance with official coding guidelines, payer requirements, and FMH policy. Key Responsibilities Independently review and abstract complex clinical documentation for accurate code assignment. Assign appropriate ICD-10-CM/PCS, CPT, and HCPCS codes using the 3M encoder across multiple service lines. Resolve coding edits, medical necessity issues, and payer rejections efficiently. Collaborate with providers and the Coding Team...