12 certified coder auditing jobs found in Dallas

Medical Coder III Location: Remote Duration: 12 Months Payrate: $27/hr. on W2 Will this role be fully remote?: Yes Are there any specific locations the candidates should be in (i.e., do they need to live in IL): Any approved states What is the expected schedule (include dates/time/time zone): 7-4pm or 8-5pm local time M-F. What are the day-to-day job duties? Abstract and review inpatient and outpatient medical records for (Hierarchical Condition Categories) HCCs to determine if the HCC is supported by the medical record documentation. Knowledge of ICD-9 ICD10 Official Coding Guidelines, AHA Coding Clinic, including Codling clinic clarifications for DOS year under review. CMS RADV Medical Reviewer Guidance (1/10/2020). Top Skills Required: Must have prior experience with CMS Contract Level Risk Adjustment Data Validation Audits (RADV) and HHS RADV audits and IPM audits. Must have prior vendor coding review experience. Must have the ability to complete chart review...

Key Responsibilities Conduct detailed audits of patient medical records to ensure clinical documentation supports quality care, medical necessity, and accurate billing practices. Identify documentation, coding, billing, and compliance discrepancies and develop corrective action recommendations. Prepare comprehensive audit reports and communicate findings to leadership and operational teams. Monitor compliance risks related to Medicare, Medicaid, and other federal healthcare programs. Provide consultative guidance regarding healthcare compliance regulations and best practices. Assist with responses to government audits, investigations, and regulatory inquiries. Review potential refund and repayment obligations related to federal healthcare programs. Support policy and procedure development based on regulatory updates and audit findings. Monitor changes in healthcare laws, regulations, and compliance requirements. Collaborate with clinical, revenue cycle, finance, legal,...

Hours of Work :8-4:30Days Of Week :M-FWork Shift :Job Description :Your Job:Responsible for assignment of accurate CPT/HCPCS, ICD10, and appropriate modifiers from medical record documentation (paper or electronic) for both outpatient and inpatient professional encounters. Assist in auditing E&M services against documentation (paper or electronic) within the medical record. Aid in training and educating providers and staff on coding issues, and play a significant role in coding compliance activities.Your Job Requirements:Bachelor Degree preferred -OR- Associate degree in Health Information Management preferred.A minimum of 2 years recent experience in the outpatient (primary care & surgical) setting.Surgical coding in Trauma, General Surgery, Orthopedics, and/or Neurosurgery preferredMust hold Certified Professional Coder (CPC) or Certified Coding Specialist – Physician (CCS-P) with the appropriate level of experienceYour Job Responsibilities:Communicate clearly and...

Job Summary (Par time-Potential for Fulltime) The Certified ER Medical Coding Auditor is responsible for auditing emergency department medical records to ensure accurate coding, compliance, and optimal reimbursement. This role also includes training and mentoring offshore coding teams to maintain high-quality standards and consistency across operations. Key Responsibilities Audit ER charts for accurate assignment of ICD-10-CM, CPT, and HCPCS codes Validate E/M level selection for emergency department visits Ensure compliance with payer guidelines and regulatory standards (CMS, HIPAA) Identify under coding, over coding, and documentation deficiencies Prepare detailed audit reports with corrective recommendations Provide education and feedback to coders and providers Train and mentor offshore coding teams on ER coding guidelines and audit findings Conduct regular quality review sessions and calibration meetings with offshore staff Develop and update...

Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: • Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to...

Hours of Work : 8-4:30 Days Of Week : M-F Work Shift : Job Description : Your Job: Responsible for assignment of accurate CPT/HCPCS, ICD10, and appropriate modifiers from medical record documentation (paper or electronic) for both outpatient and inpatient professional encounters. Assist in auditing E&M services against documentation (paper or electronic) within the medical record. Aid in training and educating providers and staff on coding issues, and play a significant role in coding compliance activities. Your Job Requirements : Bachelor Degree preferred -OR- Associate degree in Health Information Management preferred. A minimum of 2 years recent experience in the outpatient (primary care & surgical) setting. Surgical coding in Trauma, General Surgery, Orthopedics, and/or Neurosurgery preferred Must hold Certified Professional Coder (CPC) or Certified Coding Specialist – Physician (CCS-P) with the appropriate level of experience Your Job Responsibilities : Communicate...

Job Overview Role type: Risk Adjustment Coding Auditor. Quantity of resources: 2. Duration: 6 months. JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's. Required Skills MS Suite CPC certified CRC certified 5+ years of risk adjustment experience Equal Opportunity Statement We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. #J-18808-Ljbffr

Methodist Medical Group is seeking a skilled coder to assign accurate CPT/HCPCS, ICD-10 and appropriate modifiers from medical records for both outpatient and inpatient professional encounters. The role supports auditing E&M services and training providers on coding issues, contributing to coding compliance activities. The ideal candidate has 2+ years of outpatient coding experience, surgical coding in trauma/orthopedics preferred, and CPC or CCS-P certification. #J-18808-Ljbffr

Methodist Medical Group is seeking a skilled coder to assign accurate CPT/HCPCS, ICD10, and modifiers from medical records for outpatient and inpatient professional encounters. The role includes auditing E&M services, assisting in training providers on coding issues, and supporting compliance efforts; requires CPC or CCS-P and 2+ years outpatient coding, with surgical coding in trauma/GS/orthopedics/neurosurgery preferred. #J-18808-Ljbffr

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: 2. HEDIS 3. Medical Record Reviews (Accreditation) 4. 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 patient medical records. Assign appropriate...

Job Title Hours of Work: 8-4:30 Days Of Week: M-F Work Shift: Job Description: Your Job: Responsible for assignment of accurate CPT/HCPCS, ICD10, and appropriate modifiers from medical record documentation (paper or electronic) for both outpatient and inpatient professional encounters. Assist in auditing E&M services against documentation (paper or electronic) within the medical record. Aid in training and educating providers and staff on coding issues, and play a significant role in coding compliance activities. Your Job Requirements: Bachelor Degree preferred -OR- Associate degree in Health Information Management preferred. A minimum of 2 years recent experience in the outpatient (primary care & surgical) setting. Surgical coding in Trauma, General Surgery, Orthopedics, and/or Neurosurgery preferred Must hold Certified Professional Coder (CPC) or Certified Coding Specialist – Physician (CCS-P) with the appropriate level of experience Your Job...

Integrative Emergency Services, LLC ("IES") is seeking a Coding Specialist with emphasis on auditing surgical services. The Coding Specialist is responsible for accurate professional fee coding and documentation review for assigned surgical service lines (URSA/NTCC/TSN). This role evaluates medical records to ensure proper CPT, HCPCS Level II, and ICD-10-CM code assignment in accordance with payer guidelines and regulatory standards. The Coding Specialist supports documentation integrity, identifies coding compliance risks (including undercoding, overcoding, and unbundling), and contributes to clean claim submission and optimal reimbursement through coding analysis, audits, and special projects. Candidates can work in either a hybrid or remote setting. If remote, must reside in a state IES operates in: AZ, CO, TX, OK, IN, MO, AL, SC, FL IES is dedicated to cultivating best practices in emergency care, providing comprehensive acute care services, creating value, and supporting...