14 professional coding auditor jobs found in Houston

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,...

Compliance Coding Auditor Hours: Variable Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $48.140 - $62.110 - $76.080 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit...

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 : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, 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 posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates...

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...

*Registered Nurse Clinical Coder - DRG Audit (100% Remote)* *Position Type:* Contract *Schedule:* Full-time, Remote *Experience Level:* Intermediate (5+ years) *Pay:* $90,000 *Overview* Our client is seeking an experienced *Registered Nurse Clinical Coder* to support DRG audit activities for one of their major healthcare partners. This role focuses on reviewing inpatient medical records, validating DRG assignments, and ensuring coding accuracy from an *insurance and payerside perspective* rather than the provider side. This is an excellent opportunity for an RN with coding experience who enjoys analytical work, documentation review, and collaborating with audit teams. *Key Responsibilities* * Perform *DRG audits* on inpatient medical records to validate ICD10 coding accuracy and DRG assignment. * Review clinical documentation to ensure compliance with payer guidelines and audit standards. * Identify discrepancies, trends, and opportunities for coding improvement. *...

Responsibilities HIM/Medical Records Analyst/Coding Specialist Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility is fully accredited and included a 16-bed residential treatment center for adult chemical dependency. We offer a broad range of behavioral health programs for children, adolescents and adults. Treatment is offered at multiple levels of care including inpatient, partial hospitalization and intensive outpatient. We are available 24 hours a day, seven days a week to assist you and answer your questions about treatment options and insurance coverage. The hospital is easily accessible off the Southwest Freeway near the Galleria. Visit us online at: https://westoakshospital.com/ West Oaks Hospital is seeking a dynamic and talented HIM/Medical Records Coding Specialist to join our team of compassionate, dedicated professionals. The HIM/Medical...

Senior Professional Fee Coder San Antonio Summary Baylor College of Medicine CHRISTUS Childrens in San Antonio seeks a highly motivated and competent professional to serve as a Senior Professional Fee Coder. The candidate will manage and support the day?to?day functions of the revenue cycle under the direction of the Lead, Revenue Cycle. The role requires expertise in documentation reviews, denial analysis, coding, provider education, and revenue integrity initiatives. Job Duties Review provider documentation for compliance and accuracy; flag potential coding issues. Compile data for dashboards and audit summaries; support denial trend analysis and root cause identification. Assist in creating educational materials, handouts, and training sessions; track attendance. Serve as a resource for basic coding and documentation questions; route complex inquiries to Lead, Revenue Cycle. Provide administrative and operational support for revenue cycle projects and other...

Medix - 6621 Fannin Street [Medical Records Clerk] As a Coder at Medix, you'll: Analyze medical records to assign appropriate codes for billing and insurance purposes; Ensure accuracy and compliance with coding guidelines and regulations; Collaborate with healthcare professionals to clarify diagnoses and procedures; Maintain confidentiality of patient information; Update coding knowledge through continuous education and training; Assist in audits and reviews to improve coding processes and accuracy...Hiring Immediately >>

About Us MedAR is a dedicated medical billing company specializing in pathology, radiology and anesthesia services. We partner with healthcare providers to streamline their revenue cycle and ensure accurate reimbursement. We are currently seeking a meticulous and experienced Pathology Medical Coder to join our expert team. Job Summary The Pathology Medical Coder will be responsible for accurately applying billing codes to pathology reports for our client base. This role is crucial for ensuring compliance and maximizing revenue for our clients. The ideal candidate will have a deep understanding of CPT, ICD-10-CM, and HCPCS coding guidelines, with a specific focus on pathology services. Key Responsibilities Review provider documentation and accurately assign CPT, ICD-10-CM, and HCPCS codes to pathology and laboratory services, including surgical pathology, cytology, and molecular diagnostics. Apply correct modifiers and ensure NCCI edits, MUE , and payer...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary The Health Insurance Portability and Accountability Act (HIPAA) Auditor is responsible for performing HIPAA/ Information Privacy and Security compliance activities across all aspects of Memorial Herman Health System and its affiliates and subsidiaries. Job Description Minimum Qualifications Education: Bachelors Degree (Nursing, Health Information Management,...

A healthcare provider organization in Houston seeks a Risk Adjustment Coding Specialist II to ensure compliance with Medicare documentation requirements, conduct audits, and mentor staff. Candidates must have 3-5 years of experience in risk adjustment coding, relevant certification, and reliable transportation for travel. This position follows a hybrid model requiring travel to provider offices, offering a competitive salary between $70,000 and $85,000 per year. #J-18808-Ljbffr

Join to apply for the RCM0002_Medical Coder Lead role at Premier Medical Resources . Revenue Cycle Management is looking for a Medical Coder Lead to join our team! Summary The Medical Coder Lead is responsible for serving as a subject matter expert in coding processes, providing advanced technical guidance, and ensuring coding accuracy, compliance, and productivity standards are met. The position supports coders and auditors through consultation, mentoring, and expertise on complex coding scenarios. Essential Functions Serve as a resource and consultant for coders on complex or specialty coding scenarios. Review and provide guidance on challenging cases to ensure coding accuracy and compliance. Partner with auditors to resolve discrepancies and identify trends in coding errors. Provide mentoring and technical support to coders, promoting knowledge sharing and best practices. Assist in developing and updating coding procedures, guidelines, and reference materials....

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...

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...