20 data coder jobs found

Job Description Job Description Reviews and assigns working MS-DRG or APR-DRG on inpatient records within 24 hours of admission and re-reviews records as clinically indicated. Ideal candidate will have a CDIP or CCDS certificate to be considered Audits codes for clinical documentation integrity. Analyzes and interprets clinical data to identify documentation gaps, inconsistencies, or opportunities for improvement. Initiates concurrent, compliant queries following ACDIS/AHIMA query practice guidelines. Conducts follow-up on queries to ensure timely provider responses and appropriate documentation in the medical record. Clinical Documentation Duties Provides education and support to providers, patient care teams, and HIM professionals regarding clinical documentation, ICD-10-CM, and applicable risk-adjustment methodologies. Collaborates with interdisciplinary departments (e.g., Care Coordination, Performance Improvement, Compliance) to ensure documentation...

Quality Assurance Auditor Job Summary University Medical Billing ( UMB ) is a fully remote department that is viewed as the premier billing office for the University of Utah School of Medicine, serving over 1,800 providers and 30 different specialties across Utah and surrounding states. We strive to be a great place to work while providing the best service to our customers. Our leaders and employees value collaboration, innovation, and accountability, and believe a successful candidate will exemplify these attributes too. We are looking for an experienced Quality Assurance Auditor to join our team. As the Quality Assurance Auditor, you will conduct audits of medical coding to increase coding accuracy and identify opportunities for improvement and training within an organization that provides healthcare patient services. Review audit results with medical coding management and staff. Provide training on coding guidelines, medical terminology, and proper...

Job Title: RN Coder Summary: We're hiring RNs to oversee and work the claims data and review possible/flagged claims for overpayment. The main part of this job is the clinical decision making where they can either make a determination, ask for more documentation, or escalate to MDs for their review. For example, there are at times heart injuries that are upcoded to heart attacks and the payment is very large and overpaid. The nurses need to be able to review the clinical work and understand the coding and then be able to make the determination of next steps. RM will be getting batches of data with flags and comments of where they need the information and delineation from the clinical staff. They are building out an internal system that will mimic those like Cotiviti, etc. and they nurses will be trained on that program. The cases will be reviews of both inpatient and outpatient but the work will mainly skew inpatient because of the cost of the work. They will be...

Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. Responsible for the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience. 2. Certification in ONE of the following: Registered Health...

The In-Patient Coder will handle medical coding and data entry / abstraction for Hospital (Acute) In-patient visits. Specifically, will code CABG (cardio), Ortho, and Med cases. Additionally, this individual will use the 3M 360 Encoder HDM to streamline the coding/billing process. These Goals and objectives are not to be construed as a complete statement of all duties performed; employees will be required to perform other job related duties as required. Goals and objectives are subject to change. All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA and other regulations, as appropriate. Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include: Inpatient: Accurately assigns ICD-10-CM and PCS primary and secondary diagnoses and procedure codes based on the documentation in the record and in accordance with the site specific guidelines and policies....

Company Description LA Medical Associates is a multi-specialty medical group with seven clinics located throughout Palm Beach County. The organization provides a broad range of services, including Primary Care and Podiatric Medicine & Surgery, delivered by an experienced team of medical professionals. LA Medical Associates emphasizes the use of high-quality in-house technology to support accurate and efficient patient care. The group is committed to attentive service, detail-oriented clinical practices, and maintaining quality patient care as its highest priority. Team members join a patient-centered environment focused on meeting diverse healthcare needs in the community. Role Description This full-time, on-site Medical Biller & Coder role is based in West Palm Beach, FL. The Medical Biller & Coder will review clinical documentation, assign appropriate ICD-10 codes, and ensure accurate billing for insurance carriers, including Medicare and commercial plans. Daily...

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for an outpatient Certified Coding Auditor to work in its New York office or remotely. Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payors....

ABOUT THE ROLE The Coding Auditor / Educator is responsible for conducting coding and documentation audits to evaluate compliance with federal and state regulations, payer requirements, and organizational policies. As a member of the Legal & Compliance Department, this individual contributor role supports the effectiveness of the organization’s compliance program by identifying coding risks, monitoring documentation accuracy, validating reimbursement integrity, and recommending corrective actions. This role ensures accurate risk adjustment coding, HCC capture, and E/M documentation in a full-risk, value-based care environment. The position supports compliance with CMS-HCC risk adjustment guidelines, OIG audit expectations, and RADV preparedness. Working closely with providers, clinical leadership, revenue cycle, population health, and compliance teams, the Coding Auditor / Educator performs retrospective and prospective audits, analyzes coding trends, supports regulatory...

Inpatient Medical Coder (CCS certified) Assignment Details: 100% REMOTE Position Type: W2 Regular Employment At least 5 years of IP PCS Coding experience, required At least 3 years OP, preferred CCS certificate is required. Schedule: Weekdays, full-time hours Shift: Regular day shift hours System Experience: Cerner | Power Chart | 3M | EPIC Start Date: Immediately To be considered, IP and/or OP assessment test will be required to complete and pass a coding assessment test. Summary : IP/OP Coding Specialist demonstrates proficiency in coding all types of inpatient and outpatient accounts. Utilizes International Classification of Disease (ICD-10-CM and PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Responsibilities: 1. Examines the complete medical record to accurately determine the principal & secondary diagnoses, procedures, and...

* This is a hybrid position to be located in WI with travel required. * JOB SUMMARY The Coding and Billing Compliance Analyst plays a critical role in safeguarding the accuracy, integrity, and regulatory compliance of coding and billing operations across all service lines.  This position supports the organization’s revenue cycle and compliance initiatives by conducting detailed coding and billing reviews, identifying areas of risk, and contributing to the development of corrective action plans and educational programs.  The analyst ensures adherence to federal and state billing regulations, including Medicaid/Medicare guidelines, HRSA program requirements, and Office of Inspector General (OIG) guidance specific to Federally Qualified Health Centers (FQHCs).  The Analyst collaborates with providers, billing teams, compliance officers, and revenue cycle leadership, to improve clinical documentation, optimize reimbursement, and maintain full compliance with all applicable...