11 documentation coding auditor jobs found in Newark

Senior Risk Adjustment Coder The Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare Advantage Risk Adjustment. What you will do: Risk Adjustment Review May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing Reviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses. Evaluating medical records to verify that M.E.A.T criteria support the submitted diagnosis codes. Inquire with clinicians the recommended HCC diagnosis for chart addendum. Collaborating with other departments to address coding updates and support risk adjustment...

Coding Auditor (ICD-10) Position: Coding Auditor (ICD-10) Duration: Full-Time Location: Newark/Wall NJ Job Summary: This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on ICD9-CM, ICD-10, DRG assignment payment and auditing. Responsibilities: Identifies and presents billing discrepancies found during audit and coordinates referral of improper claim payments through the appropriate channels. Identifies error trends as they relate to medical record and or billing documentation or misinterpretation of provider contract stipulations. Compiles statistics and other audit information to present to accounts, regulatory agencies, and internal requesters....

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.Day - 08 Hour (United States of America)This is a Stanford Health Care - University Healthcare Alliance job.A Brief OverviewThe Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare Advantage Risk Adjustment.LocationsStanford Health Care - University Healthcare AllianceWhat you will doRisk Adjustment ReviewMay perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditingReviewing medical records to ensure accurate HCC coding and...

This is a remote based position. Applicants can be located nationwide Back 1d Outpatient Coding Auditor #2814 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? 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 team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced...

Coding Auditor (ICD-10) Position: Coding Auditor (ICD-10) Duration: Full-Time Location: Newark/Wall NJ Job Summary: This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on ICD9-CM, ICD-10, DRG assignment payment and auditing. Responsibilities: • Identifies and presents billing discrepancies found during audit and coordinates referral of improper claim payments through the appropriate channels. • Identifies error trends as they relate to medical record and or billing documentation or misinterpretation of provider contract stipulations. • Compiles statistics and other audit information to present to accounts, regulatory agencies, and internal...

Provider Liaison - Certified Professional Coder (CPC) / Certified Coding Specialist (CCS) A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description One of our direct client is looking for potential candidate with the below mentioned skills Direct Client: Immediate Interview Contract to Hire Position: Provider Liaison MUST HAVE: 5 years of experience into Project Management At least 2 years of experience after CPC or CCS certification Bachelor's degree is a must Certifications AAPC Certified Professional Coder (CPC) or AHIMA...

Medical Record Reviewer This position is accountable for accurately reviewing, interpreting, auditing, coding, and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment, and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities: Understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy, and compliance with applicable coding guidelines and regulations. Identify, compile, and code member/patient data using ICD-9/ICD 10-CM and other standard classification coding systems....

Ampcus Inc is looking for a Medical Coder to review, audit, and analyze medical record documentation for accuracy. This position requires proficiency in CPT and ICD coding to support audits under ACA and Medicare Advantage guidelines. Qualifications include a current RHIT or similar certification and 2-5 years of coding experience. Applicants should possess strong communication skills, demonstrate ethical practices, and work well in a team environment. #J-18808-Ljbffr

Summary This position is accountable for accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy and compliance with applicable coding guidelines and regulations. Identify, compile and code member/patient data, using ICD-9/ICD-10-CM and other standard classification coding systems. Support the...

Creative Solutions Services, LLC in Newark, NJ is looking for a Medical Coder responsible for auditing and coding medical record documentation. The ideal candidate will have a Registered Health Information Technician certification, with at least 2 years of medical coding experience. The role supports various audits for Medicare and commercial lines, requiring strong proficiency in coding guidelines, effective communication, and teamwork. #J-18808-Ljbffr

Job Title: HCC | Risk Adjustment Coder Location: Newark, NJ (100% Remote) Duration: 6 months (possible extension) Pay Rate: $30 - $35/hr. on W2 Schedule: Regular Business Hours. Important Details: Candidates can be located in any one of the five states: NJ, NY, PA, CT, and DE You will be required to travel for the pickup and return of equipment, and/or laptops that need servicing. Job Summary: Responsible for reviewing, auditing, coding, and analyzing medical records to ensure accurate diagnosis documentation and HCC abstraction. Supports Medicare, Medicaid, Commercial Risk Adjustment programs, and RADV audits while ensuring compliance with ICD-10 coding guidelines and risk adjustment regulations. Key Responsibilities Review medical records for coding accuracy, completeness, and compliance Abstract and validate HCC diagnoses using ICD-10, CPT, and HCPCS coding systems Support Medicare Advantage, Medicaid, Commercial, and ACA risk...