28 coding auditor jobs found in Wayne, PA

Coding Auditor The Coding Auditor is responsible for determining that ICD-10, CPT-4, and HCPCS coding is supported by the clinical documentation in the medical record as well as validating medical necessity per CMS Local Coverage Determination (LCD). Applies working knowledge of medical terminology, anatomy, CPT-4 and ICD-10 codes and coding skills/ experience to ensure timely and accurate audits of clinical documentation as requested. Key responsibilities include: Performs accurate and timely review of clinical documentation as requested to ensure that ICD-10, CPT-4 and HCPCs coding is supported by the clinical documentation in the medical record. Meets or exceeds established performance targets (productivity and quality) established by the Manager, Coding. Reviews audit samples following CBO IPM policy and utilizing established protocols, audit tools and worksheets to report accurate and timely findings to the Coding Manager. Meets or exceeds established performance...

Universal Health Services, Inc. seeks a Coding Auditor to determine ICD-10, CPT-4, and HCPCS coding alignment with clinical documentation and to validate medical necessity per LCDs. The role requires CPC certification and experience in professional billing, auditing, and the revenue cycle. The position involves reviewing documentation, educating providers on coding requirements, and ensuring timely, accurate audits across IPM services. #J-18808-Ljbffr

Position Overview Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi‑specialty physician networks and urgent care clinics that align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continued growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. Coder Certification Required . The Coding Auditor is responsible for determining that ICD‑10, CPT‑4, and HCPCS coding is supported by the clinical documentation in the medical record as well as validating medical necessity per CMS Local Coverage Determination (LCD). The role applies working knowledge of medical terminology, anatomy, CPT‑4 and ICD‑10 codes and coding...

Independence Physician Management (IPM), a UHS subsidiary, seeks a Coding Auditor to ensure ICD-10, CPT-4 and HCPCS coding is supported by medical records and meets CMS LCD guidelines. The role requires CPC certification, auditing experience, and strong knowledge of coding policies; you will review documentation, educate providers, and support front-end coding accuracy. IPM offers comprehensive benefits and opportunities within a national health system; on-site in Wayne, PA with collaboration #J-18808-Ljbffr

Coding Auditor The Coding Auditor is responsible for determining that ICD-10, CPT-4, and HCPCS coding is supported by the clinical documentation in the medical record as well as validating medical necessity per CMS Local Coverage Determination (LCD). Applies working knowledge of medical terminology, anatomy, CPT-4 and ICD-10 codes and coding skills/ experience to ensure timely and accurate audits of clinical documentation as requested. Key Responsibilities include: Performs accurate and timely review of clinical documentation as requested to ensure that ICD-10, CPT-4 and HCPCs coding is supported by the clinical documentation in the medical record. Reviews audit samples following CBO IPM policy and utilizing established protocols, audit tools and worksheets to report accurate and timely findings to the Coding Manager. Assists in educating providers on clinical documentation requirements to support their coding and ensure all coding (charge) possibilities are being...

Coding Auditor Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. POSITION OVERVIEW Coder Certification Required. The Coding Auditor is responsible for determining that ICD-10, CPT-4, and HCPCS coding is supported by the clinical documentation in the medical record as well as validating medical necessity per CMS Local Coverage Determination (LCD). Applies working knowledge of medical terminology, anatomy, CPT-4 and ICD-10 codes and...

Responsibilities Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. To learn more about IPM visit Physician Services - Independence Physician Management - UHS. POSITION OVERVIEW Coder Certification Required .The Coding Auditor is responsible for determining that ICD-10, CPT-4, and HCPCS coding is supported by the clinical documentation in the medical record as well as validating medical necessity per CMS Local Coverage...

Baylor Scott & White Health is seeking a Coding Auditor 1 to perform coding quality audits and provide feedback to coders. The role uses ICD-10-CM/PCS, HCPCS, CPT and other references to ensure accurate coding and DRG grouping. Candidate must have 5 years of coding experience and at least 1 year as a coding auditor with relevant certifications. We promote equal opportunity employment and offer competitive benefits. #J-18808-Ljbffr

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified 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 and...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

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...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level. Job...

Baylor Scott & White Health is seeking a Coding Auditor 1 to perform coding quality audits and provide feedback to coders. The role uses ICD-10-CM/PCS, HCPCS, CPT and other references to ensure accurate coding and DRG grouping. Candidate must have 5 years of coding experience and at least 1 year as a coding auditor with relevant certifications. We promote equal opportunity employment and offer competitive benefits. #J-18808-Ljbffr

Serco Inc. supports the Defense Health Agency's Medical Coding Program Branch. The Medical Coding Auditing Specialists perform routine audits across DHA Medical Treatment Facilities and dental clinics, developing annual work plans based on risk and conducting targeted audits as directed. They work with DHA-MCPB to ensure compliance with coding and documentation standards. The role requires extensive knowledge of ICD-CM, CPT, HCPCS, DRGs, PPS, and government regulations, with experience in #J-18808-Ljbffr

Serco Inc. supports the Defense Health Agency's Medical Coding Program Branch. The Medical Coding Auditing Specialists perform routine audits across DHA Medical Treatment Facilities and dental clinics, developing annual work plans based on risk and conducting targeted audits as directed. They work with DHA-MCPB to ensure compliance with coding and documentation standards. The role requires extensive knowledge of ICD-CM, CPT, HCPCS, DRGs, PPS, and government regulations, with experience in #J-18808-Ljbffr

Job Details Compliance Auditor Job Description JOB SUMMARY Under general supervision, performs risk-based audits of clinical documentation, coding, and billing records to ensure that documentation supports services billed and complies with applicable regulatory and organizational requirements. This position independently validates documentation and coding compliance, identifies areas of compliance risk, and supports internal audit activities and external audit readiness across hospital-and provider-based settings. This role is outcome-driven and requires the ability to independently manage audit workload, documentation, and deadlines. ESSENTIAL FUNCTIONS • Performs risk-based audits of clinical documentation, physician, technical, and specialty billing and payment records by analyzing medical records, coding records, and health system bills to validate that documentation supports services billed and complies with applicable regulations and guidelines. • Evaluates...

Compliance Auditor Under general supervision, performs risk-based audits of clinical documentation, coding, and billing records to ensure that documentation supports services billed and complies with applicable regulatory and organizational requirements. This position independently validates documentation and coding compliance, identifies areas of compliance risk, and supports internal audit activities and external audit readiness across hospital-and provider-based settings. This role is outcome-driven and requires the ability to independently manage audit workload, documentation, and deadlines. • Performs risk-based audits of clinical documentation, physician, technical, and specialty billing and payment records by analyzing medical records, coding records, and health system bills to validate that documentation supports services billed and complies with applicable regulations and guidelines. • Evaluates the accuracy and appropriateness of coding, billing, and documentation...

About the Job Compliance Auditor - To $67K - Cherry Hill, NJ - Job # 2929 Who We Are? BritePros Healthcare Staffing is completely committed to sourcing only the best administrative and clinical talent in the healthcare industry. Our pool of candidates within the world of healthcare is unparalleled. We simply want your healthcare organization running smoothly so you can focus on providing the best health services to your patients. Healthcare organizations from across the country rely upon BritePros Staffing to present only the most qualified talent for each specific job. Our unique application of the Behavior-based Interviewing Model allows BritePros Staffing to properly vet and evaluate talent relative to key technical and cultural markers for each unique job opening. The Position We seek to fill a Compliance Auditor role in the Cherry Hill, NJ area. The candidate will be responsible for supporting the corporate compliance program. The position includes a...

ExamWorks is seeking a Medical Coding Specialist to join our team remotely. Ideal candidates hold CPC certification, with CPMA and Life Care Planner credentials preferred, and have at least one year of medical billing experience. Responsibilities include reviewing claims, ensuring HIPAA compliance, and delivering accurate coding reports. This role requires strong attention to detail, proficiency with CPT/ICD-10, and the ability to work independently in a fast-paced environment. #J-18808-Ljbffr

ExamWorks is seeking a Medical Coding Specialist to join our team remotely. Ideal candidates hold CPC certification, with CPMA and Life Care Planner credentials preferred, and have at least one year of medical billing experience. Responsibilities include reviewing claims, ensuring HIPAA compliance, and delivering accurate coding reports. This role requires strong attention to detail, proficiency with CPT/ICD-10, and the ability to work independently in a fast-paced environment. #J-18808-Ljbffr

Job Details Sr. Coder Job Description REMOTE Sr. Certified Coding Medical Records : Review patient medical records and assign appropriate codes using systems like ICD-10-CM, CPT, and HCPCS for diagnoses and procedures. Claims Processing: Prepare and submit claims to insurance companies, ensuring compliance with regulations and accuracy in coding to facilitate reimbursement. Collaboration: Work closely with healthcare providers, billing specialists, and other staff to clarify documentation and ensure accurate coding practices. Auditing and Compliance: Conduct audits of medical records to ensure coding accuracy and compliance with federal regulations and insurance standards. Training and Support: Provide training and support to healthcare staff on coding practices and documentation requirements. Required Qualifications Certification: Must hold a certification from recognized organizations such as AAPC (CPC) Experience: Typically requires a minimum of 2-3...

Candidate should ideally be located in Philadelphia or Pittsburgh Monro’s family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach.  Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company’s regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color.  Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto service in the industry.  Do you have what it...

Operations Support Compliance Auditor Reporting to the Director of Operations Support, this individual will evaluate, inspect, audit, and determine the effectiveness of compliance and store operational tasks. This individual will visit store locations daily and perform regularly scheduled audits. They must effectively establish strong credibility with the Monro Field Teammates and Field Leadership. Maintaining a positive and constructive attitude is critical as this role sits at the crossroads between the Store Support Center and Field Management. Compensation: The salary range for this role is $68,000 - $85,000. This role is eligible for additional compensation and incentives. Pay will be determined based on experience level. Essential Functions: Participates in the following areas of focus, including but not limited to Monro Forward initiatives, DM onboarding, inventory subject matter expert, inventory analysis, safety compliance, building and equipment maintenance, and...

Exam Works is looking for a Medical Coding Specialist to join our team remotely! *Must possess current coding certification in CPC. CPMA certification & Certified Life Care Planner certification preferred. The Medical Coding Specialist (Internally called a Coding Specialist) is responsible to create and write reports based on medical records and appropriate guideline criteria. This position utilizes the system database to determine usual and customary and/or state fee schedule allowances and this position is responsible for analyzing provider billing for proper coding and billing guidelines across all provider types and ensures reviews are completed with highest quality and integrity and that all work is in full compliance with client contractual agreements, regulatory agency standards and/or federal and state mandates. Schedule for this role is: Monday - Friday 8am-5pm EST ESSENTIAL JOB FUNCTIONS Receive and input client and examinee data in the system...