3 profee coding auditor jobs found in Raleigh

Certified Professional Coder (CPC) Independent Contractor Remote Who We Are Constellation Quality Health is a non-profit health care quality consultancy and QIO-like Entity certified by Centers for Medicare and Medicaid Services (CMS) founded by physicians in 1983. Headquartered in North Carolina's Research Triangle, we offer an array of quality improvement, clinical review, audit, technical, and consulting services and solutions to improve care delivery, system performance, and patient outcomes. What You'll Do The Certified Professional Coder (CPC) is responsible for reviewing and comparing provider service documentation to billed claims in order to determine compliance with clinical policies, state and federal regulations. We expect you to: Perform reviews in a manner consistent with contract requirements for timeliness and accuracy. Our requirement for this role: Associate or bachelor's degree required in a human services field or five (5) years...

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...

Certified Professional Coder, Independent Contractor Join to apply for the Certified Professional Coder, Independent Contractor role at Constellation Quality Health Constellation Quality Health is a non‑profit health care quality consultancy headquartered in the North Carolina Research Triangle. We offer a range of quality improvement, clinical review, audit, technical and consulting services to improve care delivery, system performance and patient outcomes. What You’ll Do Perform coding reviews in a manner consistent with contract requirements for timeliness and accuracy. Review and compare provider service documentation to billed claims to determine compliance with clinical policies and state and federal regulations. Qualifications Associate or bachelor’s degree in a human services field or five (5) years of related experience may substitute for degree. Certified Professional Coder (CPC) certification with at least two (2) years’ experience in DRG coding in an inpatient...