10 payment integrity coder jobs found in Houston, TX

divh2Inpatient/DRG Validation Coding Auditor/h2pThe Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations./ppHas an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems./ppConducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding,...

Calling all bill review professionals, CPC coders, AAPC, and DRG coders! Dane Street is looking for highly motivated Coders, bill reviewers, and payment integrity reviewers candidates to join our team. Dane Street offers an exciting work environment, competitive compensation, and strong growth potential. Job Summary: A new program offering on the group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information and ensure all questions posed have been addressed, and ensure that reports are returned within client deadlines. Core Duties & Responsibilities: Evaluates the appropriateness of codes and determine whether they meet all established program standards. Ensures that the medical records are matched appropriately to the codes and if not,...

Coders, Bill Reviewers, And Payment Integrity Reviewers Calling all bill review professionals, CPC coders, AAPC, and DRG coders! Dane Street is looking for highly motivated coders, bill reviewers, and payment integrity reviewers candidates to join our team. Dane Street offers an exciting work environment, competitive compensation, and strong growth potential. Job Summary: A new program offering on the group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information and ensure all questions posed have been addressed, and ensure that reports are returned within client deadlines. Core Duties & Responsibilities: Evaluates the appropriateness of codes and determine whether they meet all established program standards. Ensures that the medical records are...

This is a remote based position. Applicants can be located nationwide Back Medical Coder #2621 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who has Profee Outpatient Coding experience. We need someone who is responsible for assignment of accurate Evaluation and Management (E&M) ICD-10-CM, ICD-10- PCS, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, modifiers and quantities derived from medical record documentation (paper or electronic) for encounters dependent upon record type. Tell us about your experience with Profee Outpatient Coding. Are you a team player and a self-motivator? What is your experience with conducting business in a way that is credit to a company? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you...

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...

Job Summary A new program offering on the group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information and ensure all questions posed have been addressed, and ensure that reports are returned within client deadlines. Core Duties & Responsibilities Evaluates the appropriateness of codes and determine whether they meet all established program standards. Ensures that the medical records are matched appropriately to the codes and if not, obtains them. Read & apply policy guidelines and healthcare terminology and delineate when criteria are/are not met. Evaluates claims for conflict of interest and criteria appropriateness. Works within established timeframes set by program parameters. Provides strong customer service skills and works closely...

What we do here changes the world. UTHealth Houston is Texas' resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That's where you come in. The Professional Coder II working in our Ob/Gyn Department is responsible for reviewing medical documentation provided by physicians or other health care professionals to validate or assign and sequence CPT/HCPCS, ICD-10CM, and modifiers for both clinic and hospital based professional encounters. The Coder applies coding conventions in accordance with official coding and regulatory guidelines, third-party payer policies, and departmental procedures. This role is responsible for inpatient/outpatient E/M encounters including office or hospital outpatient procedures, radiology and emergency department visits. Once you join us you won't want to leave. It's because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you'd expect from a...

Scion Staffing has been engaged to conduct a search for multiple Remote Inpatient Facility Medical Coder positions for a healthcare services partner. This is a fully remote direct hire position supporting U.S.-based healthcare systems. POSITION OVERVIEW: This role supports inpatient coding operations for a mission-driven healthcare services organization focused on improving access, quality, and efficiency in patient care. The Inpatient Facility Medical Coder will review clinical documentation, apply appropriate coding guidelines, and ensure accurate reimbursement outcomes. This position offers the opportunity to collaborate with multidisciplinary teams in a supportive, remote-first environment. PERKS: Hourly pay range of $35–$40 per hour , based on experience and credentials Comprehensive medical, dental, and vision insurance options Fully remote role with flexible scheduling to support work-life balance Inclusive and collaborative culture that values diverse...

Overview What we do here changes the world. UTHealth Houston is Texas’ resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That’s where you come in. The Professional Coder II working in our Ob/Gyn Department is responsible for reviewing medical documentation provided by physicians or other health care professionals to validate or assign and sequence CPT/HCPCS, ICD-10CM, and modifiers for both clinic and hospital based professional encounters. The Coder applies coding conventions in accordance with official coding and regulatory guidelines, third-party payer policies, and departmental procedures. This role is responsible for inpatient/outpatient E/M encounters including office or hospital outpatient procedures, radiology and emergency department visits. Once you join us you won\u2019t want to leave. It’s because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you’d...

Overview At Houston Methodist, the Lead Inpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to inpatient encounters based upon documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. Houston Methodist Standard...