12 coding auditor jobs found in Jackson

Inpatient Medical Coding Auditor - PPI Coding Disputes Become a part of our caring community and help us put health first. The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate DRG and ICD-10-CM/PCS coding assignments for accuracy within the coding disputes team from a variety of medical records. The Disputes Auditor - MSDRG Inpatient Coding on the Disputes Team consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality. Responsibilities: Will be an experienced medical coding auditor with in-depth experience in inpatient coding audits (MSDRG/APDRG) Ensures overall accuracy and compliance of coding disputes reviews by adhering to all appropriate coding guidelines and communicates disputes outcomes to providers in a professional and concise manner. Leverages advanced auditing expertise to make coding...

A leading healthcare organization is seeking an Inpatient Medical Coding Auditor to work remotely. You will review inpatient hospital claims to ensure proper reimbursement and manage provider disputes in a metrics-driven environment. The ideal candidate holds a relevant certification and has experience in inpatient coding reviews. This position includes flexible business hours and offers various benefits, underscoring the company's commitment to employee wellness and professional development. #J-18808-Ljbffr

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 rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

COMPANY OVERVIEW: Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG currently bidding on a contract with the Federal Government for several coding positions. You would be a W-2 employee for HPMG and NOT a government employee. SUMMARY: Responsible for assignment of accurate ICD codes for diagnoses and procedures. Medical Severity - Diagnostic Related Group (MS-DRG) is automatically assigned by the grouper software) for inpatient stays. Inpatient coders may also be responsible for the assignment of accurate ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities from medical record documentation (paper or electronic) for inpatient professional services (a.k.a., rounds or IBWA encounters). Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities. MANDATORY KNOWLEDGE AND SKILLS: Position requires...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

Patient Account Representative (Medical Biller) Jackson, Michigan | Center for Family Health Make a difference in your community—every day. Join a mission-driven team dedicated to Opening the Door to Healthcare for All. What We Offer We provide a comprehensive benefits package designed to support your health, financial well-being, and work-life balance: Medical, Dental & Vision Insurance Flexible Spending Account (FSA) & Health Savings Account (HSA) Employee Assistance Program (EAP) Short-Term & Long-Term Disability Employer-Paid Life Insurance + Voluntary Life Options 403(b) Retirement Plan with 3% employer match after one year Continuing Education Fund Public Service Loan Forgiveness (PSLF) eligibility Generous Paid Time Off 9 Paid Holidays + 1 Personal Holiday Perfect Attendance Bonus (eligible hourly staff) Discounted Jackson YMCA Membership Your Day-to-Day In this role, you will: Submit and review medical and...

Coder 2 - Clinic To review and audit Network Provider medical records for documentation and coding compliancy and quality with federal and state laws and regulations. Responsibilities Quality and Performance Improvement Research, develop, and implement standardized processes for quality monitoring of inpatient and outpatient coding and abstracting. Conduct quality audits for coding according to pre-established criteria in coordination with the Coding and Reimbursement Specialist. Assist Management with evaluation of functions and processes of the coding area to determine opportunities to improve the efficiency and quality of the coding area. Implement innovative ideas and process changes. Attend meetings as required and strive to improve the quality of meetings by taking an active role in meeting topics. Participate in educational programs, in-services, and training sessions in an effort to share expertise with others and further the quality of education and personal growth...

Job Description Job Description Optimal Care is where your dedication meets a rewarding career. As a clinician owned and operated company, we create the opportunity and environment for each employee to realize their highest potential while maintaining a personalized focus on our Patients and Families every day. We are the Midwest's premier provider of Physician Services, Home Health, and Hospice Care. Our integrated care delivery model incorporates technology, innovation and best practices. We produce value based outcomes by managing chronic disease process, rehabilitation and end of life care. We live a simple Mission: Serve Together, Provide Value, and Deliver Exceptional Quality Care. What does this mean for you? At Optimal Care, you have our resolute commitment to being an exceptional place to work. Your expertise, passion and commitment to exceptional quality care will continue to thrive. With you we can build a remarkable place to work. Exceptional Benefits:...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

Job Description: The HIM Hospital Inpatient & Same Day Surgery Coding Analyst deciphers and interprets provider documentation in the health record and assigns diagnostic information using ICD-10-CM/PCS and CPT codes for a complex range of acute care services for Intermountain Health. The caregiver provides specific coding expertise in the various fields of NCCI edits, Drugs and Biologicals, Revenue Codes, Current Procedural Terminology (CPT) codes, ICD-10 & CPT codes, DRGs, anatomy and physiology, pharmacology. The analyst also performs audits, provides feedback, and advanced training to clinical teams and physicians on ICD-10 and CPT coding best practices. Essential Functions Reviews and analyzes inpatient medical records for completeness, accuracy, and compliance for Same Day Surgery, Observation and Inpatient acute services at Intermountain Health. Performs coding at an advanced level of complexity for inpatient hospitals including governmental and/or...

Category: Admin Support City: Jackson State: Tennessee Shift: 8 - Day (United States of America) Job Description Summary: Under the direct supervision of the Coding Supervisor/Clinical Manager, responsible for assigned 8 hour shift, 5 days a week with possibility as needed of overtime. ESSENTIAL JOB FUNCTIONS: Reviews electronic medical records and paper records to identify all treated diagnosis and significant procedures performed. Sequences diagnoses and procedures according to definition of principal diagnosis, other co-morbid conditions and complications, and according to definition of principal procedure and other procedures and using appropriate modifiers. Uses 3M Encoder to assign ICD- 9 diagnosis and CPT procedure codes and modifiers when indicated to ensure coding accuracy. Uses compliance advisor to determine medical necessity. Utilizes online coding references, Local Coding Determinations and National Coding Determinations, Medicare Part B...