8 coding compliance auditor jobs found in Lansing

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines Utilize encoders and various coding resources Perform CPT Procedure reviews...

Job Description General Purpose of Job :   Ensure Revenue Cycle Coding and Billing are compliant with State and Federal regulations.  Respond to and Investigate compliance issues within Revenue Cycle.   Lead and/or coordinate audit activity with governmental audits.   Essential Duties : This job description is intended to cover the minimum essential duties assigned on a regular basis.  Team members may be asked to perform additional duties as assigned by their leader.  Leadership has the right to alter or modify the duties of the position. Ensures conformance with applicable laws, regulations and Medicare/Medicaid reimbursement rules to ensure UMHS is in compliance with federal, state and/or local regulations. Monitors, analyzes and reports on laws, regulations, audits and industry standards that impact the organization. Develops and maintains Professional and Hospital billing issues on the Revenue Cycle Compliance Work Plan. Reviews the OIG Work Plan,...

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...

Advanced Coding Position Positions Location: Lansing, MI Job Description General Purpose of Job: Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine Sparrow policies and procedures and maintains required quality and productivity...

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...

Job ID: 52414 Positions Location: Lansing, MI Job Description General Purpose of Job: Ensure Description: Positions Location: Lansing, MI Job Description General Purpose of Job : Ensure Revenue Cycle Coding and Billing are compliant with State and Federal regulations. Respond to and Investigate compliance issues within Revenue Cycle. Lead and/or coordinate audit activity with governmental audits. Essential Duties : This job description is intended to cover the minimum essential duties assigned on a regular basis. Team members may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position. Ensures conformance with applicable laws, regulations and Medicare/Medicaid reimbursement rules to ensure UMHS is in compliance with federal, state and/or local regulations. Monitors, analyzes and reports on laws, regulations, audits and industry standards that impact the organization....

Job Opportunity Job ID:49762 Positions Location: Lansing, MI Job Description General Purpose of Job: Advanced Description: Positions Location: Lansing, MI Job Description General Purpose of Job : Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows...

Job Description General Purpose of Job :   Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine – Sparrow policies and procedures and maintains required quality and productivity standards. Essential Duties : This job...