10 quality coding auditor jobs found

We are seeking a detail-oriented, on-site Ophthalmology Coding Auditor to join our premier private practice. Under direct supervision of the Billing Manager, the Coding Auditor audits ophthalmology and optometry medical records for compliance with federal coding regulations and guidelines. Successful candidates will have extensive knowledge of auditing and education on CPT, ICD-10, and HCPCS codes and guidelines. In this role, you will work directly alongside our clinic team to review clinical documentation, surgical charts, and diagnostic reports, ensuring accurate coding, regulatory compliance, and optimal reimbursement. You will serve as our internal expert, identifying billing risk areas and providing face-to-face feedback and education to our providers and staff to support the financial health of our practice.   Key Responsibilities   Perform On-Site Audits: Conduct regular retrospective and prospective reviews of clinical charts, including complex surgical...

Claims Processing Supervisor AllCare Health | Claims Department We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages and an excellent benefits package, including affordable healthcare, 401(k) retirement, wellness programs, and flexible scheduling options. Summary of the Position The Claims Processing Supervisor ensures that internal and external departmental performance requirements are consistently met. This role oversees the day-to-day activities of the Claims Processing team, assigns work and coordinates efficient workflows to meet contractual and operational requirements, and serves as a hands-on resource for staff regarding training, questions, and claims processing best practices. Essential Duties Provides one-on-one support and initial training for new hires and facilitates monthly mandatory training sessions for Claims Processing staff. Establishes and maintains a professional, supportive, and provider...

Coding Auditor AllCare Health | Quality Department | Grants Pass, Oregon We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages and an excellent benefits package, including affordable healthcare, 401(k) retirement, wellness programs, and flexible scheduling options. Summary of the Position The Coding Auditor is responsible for developing, implementing, and maintaining auditing practices related to medical record coding and documentation to support accurate and complete risk adjustment outcomes for Medicare members. This position reviews medical records and coding for accuracy and compliance with Centers for Medicare & Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) requirements, identifies coding and documentation trends, and works collaboratively with providers and internal teams to improve documentation, coding accuracy, and risk adjustment outcomes. Essential Duties Ensures the accuracy and...

General Position Summary: The Medical Coding Specialist works as part of the Billing & Coding Department to review clinical documentation, abstract data from patient medical records, and accurately assign diagnosis and procedure codes in accordance with applicable coding guidelines and regulatory requirements.   Essential Duties and Responsibilities:   1.      Reviews patient medical records and assigns diagnosis and procedure codes in accordance with ICD-10-CM, CPT, HCPCS, and applicable coding guidelines. 2.      Ensure compliance with federal, state, payer, and organizational coding regulations and policies. 3.      Assigns and sequences diagnosis and procedure codes accurately for all services rendered. 4.      Ensures documentation and coding accurately reflect services provided and support quality reporting metrics. 5.      Identifies missed diagnoses, chronic conditions, and documentation deficiencies that may...