12 coder quality auditor jobs found in Springfield

Coder Auditor-Professionals are responsible for auditing coding assignments with providers and coders, training coding professional staff, and pro‑fee based coding which includes the assignment of ICD‑CM, CPT, HCPCS codes, E&M assignment, modifiers, and charge posting. They interact with medical staff, nursing, ancillary departments, provider offices, and outside organizations. At this time, we are only able to consider applicants who reside in the following states: Alabama, Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, New Mexico, Ohio, Oklahoma, South Carolina, Tennessee, Texas. Responsibilities Assists coders with coding questions. Conducts the collection and reporting of provider and coder audit results and education. Works with coders and providers to ensure appropriate documentation for clinic services. Reports results to Coding Supervisor - Professional. Demonstrates ability to code all...

Coding Auditor - Professional Department: Physician coding Hours: Full-Time (40 hours per week) Location: Remote or onsite. Must reside in one of the following states: Alabama, Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, New Mexico, Ohio, Oklahoma, South Carolina, Tennessee, Texas. Pay: Starts at \$23.87/hour, based on experience. Estimated compensation range \$23.87 - \$37.00. Responsibilities Assist coders with coding questions. Conduct collection and reporting of provider and coder audit results and education. Work with coders and providers to ensure appropriate documentation for clinic services. Report results to Coding Supervisor – Professional. Demonstrate ability to code all types of encounters. Maintain 95% accuracy in diagnoses and procedures coding. Ensure data quality and optimum reimbursement under federal and state payment systems. Identify and refer trend patterns of coding and...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

We recommend using the following browsers to complete the application: Desktop: Google Chrome, Edge with Chromium Mobile: Google Chrome, Safari Description The Revenue Cycle Coding Auditor will perform reviews for employees in the Coding department. Audits will include, but are not limited to; employee productivity and quality based on proper documentation, accuracy and coding guidelines. The Auditor will also provide feedback and support relating to departmental/role specific productivity and quality expectations. The incumbent for this position will utilize a high level of in-depth knowledge of the coding role to perform all audits based on specific departmental need. Examples of Duties PBS Auditor: 100% Conduct quality and productivity reviews of coding staff using structured and consistent review programs and methods. Demonstrate in-depth knowledge and experience with SIU-HC supported applications, including but not limited to Athena IDX, TouchWorks,...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

Revenue Cycle Coding Auditor – Southern Illinois University School of Medicine Responsibilities Conduct quality and productivity reviews of coding staff using structured review programs and methods. Apply in-depth knowledge of coding guidelines and support the department’s productivity and quality objectives. Provide on‑site guidance and assistance to end users of key applications such as Athena IDX, TouchWorks, Epic, Cerner, and Precision BI. Analyze and interpret complex data sets to support strategic decision‑making and performance improvement initiatives. Independently conduct research, prepare detailed reports, and present findings to leadership. Maintain confidentiality, comply with federal and state health reimbursement guidelines, and ensure adherence to coding certification standards. Arrange and conduct training sessions for coding staff and medical specialties as needed. Attend meetings with coders, managers, and compliance personnel to discuss trends and...

QA Nurse / Coder (RN) As a QA Nurse / Coder, you will ensure the accuracy, completeness, and regulatory compliance of Home Health documentationparticularly OASIS assessments, the Home Health Plan of Care (485), and face-to-face encounter noteswhile properly sequencing diagnoses according to federal/state standards and agency policy. Core responsibilities include: Review OASIS forms and Plans of Care for appropriateness, completeness, and compliance. Assign and sequence ICD?10 codes in line with current home health coding guidelines. Ensure consistency and compliance of face-to-face encounter documentation with OASIS and care plans. Conduct additional clinical record audits and OASIS reviews as assigned. Stay current on Medicare reimbursement policies, home health regulations, and compliance requirements. Maintain relevant certifications (HCS?D, HCS?O or COS?C). Participate in quality assurance and performance-improvement efforts. Coordinate with physicians, facilities,...

Coding Auditor - DRG/APC CoordinatorBe a part of a world-class academic healthcare system at UChicago Medicine as a Coding Auditor - DRG/APC Coordinator for the Health Information Management department. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area.In this role, the Coding Auditor - DRG/APC Coordinator is responsible for ensuring accuracy and quality of coding assignments for all records requiring DRG and/or APC coding, and ensures optimal and timely reimbursement.Essential Job FunctionsPerforms data quality reviews on inpatient and outpatient records to ensure proper coding guidelines have been followed and appropriate DRG or APC assignments have been made for appropriate reimbursementProvides DRG/APC and coding quality information and statistical reports to the Coding ManagerCommunicates with the Medical Staff and House staff as needed to discuss clinical questions with respect to the assignment of ICD-10-CM and...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

Become a part of our caring community 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. Where you Come In 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 accuracy of...

Medical Coder IIThe Medical Coder II plays a key role in our hospital's revenue cycle by accurately coding diagnoses and procedures in accordance with established coding guidelines. This position is essential in maintaining financial accuracy and compliance with regulatory requirements.Position Highlights:Position:Medical Coder IILocation:Warrenville, ILFull Time/Part Time:Full-time (40 hours per week)Hours:Monday-Friday, during normal business hoursWhat you will do:Assign accurate diagnostic (ICD-10-CM) and procedural (CPT) codes to medical records based on clinical documentation, ensuring adherence to coding guidelines and conventions.Conduct internal audits of medical records and coding work to ensure the accuracy and consistency of code assignments.Examine clinical documentation in medical records, working with physicians and clinical staff to clarify and improve documentation as needed for accurate coding.Stay up-to-date with the latest coding guidelines, conventions, and...

New Jersey's largest Vascular Surgery group dedicated solely to the diagnosis and management of diseases of the arteries and veins. The Group has been delivering care throughout New Jersey since 1963 and is home to some of the best Vascular Surgeons in the country. Consistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Position Summary: We are seeking an experienced Senior Vascular Surgery Professional Coder with strong expertise in complex open and endovascular procedure coding, payer authorization workflows, and revenue cycle support. This role is responsible for accurate CPT, ICD-10-CM, and modifier assignment for a high-volume vascular surgery practice with extensive cardiovascular, endovascular, catheter-based, and imaging-guided procedural work. The position also supports prior...