11 quality coding auditor jobs found in Springfield

10 Sarah Bush Lincoln Health Center seeks a Coding Auditor - Professional to ensure proper coding for clinic services. This full-time role involves assisting coders, conducting audits, and maintaining high accuracy in documentation. Ideal candidates will have a high school diploma and relevant certifications like CPC and CEMA. The position offers remote or hybrid work opportunities within specific states. Benefits include tuition reimbursement and comprehensive health coverage. #J-18808-Ljbffr

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...

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...

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...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality...

Seeking an experienced Coding & Charge Capture Supervisor to lead and coordinate team activities while ensuring accuracy, compliance, and timely claim submission. The ideal candidate will have strong knowledge of governmental regulations and payer guidelines, along with the ability to collaborate effectively across Revenue Cycle departments to optimize workflows and support financial performance. Schedule: 40 hours per week Shift: Day Shift Hours ESSENTIAL DUTIES AND RESPONSIBILITIES Oversees the daily operations by monitoring workload and productivity of partners to achieve weekly and monthly goals while ensuring accuracy of work. Assists in the development of guidelines, policies, and procedures for areas of responsibility, retain compliant with governmental regulations or other reporting obligations as required by contract. Coordinates coding and quality audits to ensure compliance with governmental regulations and/or third party requirements. Report any infractions to...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

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,...

Job Summary We are seeking an experienced and certified Medical Coder - Inpatient & Outpatient to join our Health Information Management/Revenue Cycle team.The Medical Coder is responsible for accurately reviewing and coding inpatient and outpatient hospital medical records in accordance with official coding guidelines, CMS requirements, payer regulations, and hospital policies.This position plays an essential role in ensuring coding accuracy, regulatory compliance, timely reimbursement, and the integrity of clinical and financial data.The successful candidate will demonstrate strong knowledge of hospital coding, medical terminology, anatomy and physiology, reimbursement methodologies, and regulatory requirements.Essential Duties and Responsibilities Review inpatient and outpatient medical records and accurately assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes based on assigned account type. Assign and validate appropriate MS-DRG/APR-DRG, APC, Present on Admission (POA),...

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...

Medical Coder II The 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 II Location:Warrenville, IL Full Time/Part Time:Full-time (40 hours per week) Hours:Monday-Friday, during normal business hours What 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,...