757 auditor coding specialist jobs found

Job Title Full-Time (80 hours biweekly) 100% Remote Coding Certification required Minimum of two years current experience with ICDM 9, CPT coding, and health insurance provider rules and regulations required. Essential Functions: Responsible for coding and abstracting patients' records for professional billing. Reviews patient medical records retrospectively and concurrently for the coding and sequencing of diagnoses and procedures for reimbursement purposes. Interacts and assists with coding requests and questions from billers. Serves as a resource for difficult coding questions and assists with insurance denials for correction and re-filing. Makes process improvement recommendations to management as identified, specifically related to registration and charge posting. Performs in compliance with federal, state, insurance industry regulations. Follows established hospital policies concerning corporate compliance. Keeps abreast of insurance carrier rules and changes by...

A leading healthcare provider in Richmond, VA is seeking a qualified individual for a role that includes performing DRG validation reviews and analyzing medical records. The ideal candidate will have RN or LPN licensure, experience with coding regulations like ICD-10, and strong Microsoft Office skills. This position offers a competitive compensation package, generous paid time off, and opportunities for career development within the organization. #J-18808-Ljbffr

A leading outsourced digital services provider is seeking a Certified Professional Coder responsible for reviewing medical records and ensuring accurate coding for outpatient behavioral health services. Ideal candidates will possess CPC certification and a minimum of 2 years of medical coding experience. In this role, you will maintain compliance with coding guidelines and work closely with billing teams to ensure timely claims submission. The company offers a supportive workplace focused on employee well-being and professional growth. #J-18808-Ljbffr

A healthcare organization is seeking an ICD-10 Coding Specialist in Ann Arbor, Michigan. Your primary role will include ensuring the accuracy of coding for inpatient records, creating training programs, and supporting coding compliance. The ideal candidate will have a strong background in healthcare coding, effective communication skills, and the ability to work independently. This is an opportunity to contribute to quality patient care through effective coding practices. #J-18808-Ljbffr

A healthcare organization is seeking a Clinical Revenue Auditor based in New York. The role involves reviewing and verifying that billable services and procedures are accurately documented and submitted for payment. The ideal candidate will have a solid clinical background and must have 3-5 years of experience in a healthcare setting, alongside expertise in medical coding and auditing processes. This position plays a key role in ensuring compliance and financial health within the organization, and offers an annual salary range of $96,000 to $140,000. #J-18808-Ljbffr

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Description WHAT IT'S LIKE AT SGMC HEALTH Purpose . No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place. Excellence . We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service. Team Spirit. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. Award Winning Performance. We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides. WHY YOU WILL LOVE SGMC HEALTH SGMC has great benefit options, depending on the role that you are going into- including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities...

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare...

Are you ready to make a difference in the healthcare industry? Join PacificSource and play a vital role in helping our members access quality, affordable care! As an equal opportunity employer, PacificSource is committed to diversity and inclusivity in our hiring practices. All qualified candidates will be considered without regard to any protected status. The Medical Coding Auditor Specialist will engage with complex claims by utilizing advanced adjudication skills, and providing clinical interpretation to resolve grievances and appeals. You'll work collaboratively to refine our claims research policies with an emphasis on process improvement. Your expertise will be crucial in identifying potential fraud and managing erroneous payment recoveries. Key Responsibilities: Engage in the provider and member appeals process, addressing intricate claim issues with advanced adjudication expertise. Offer guidance on claims requiring in-depth research, conducting clinical...

Overview Hi, we\'re Oscar. We\'re hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. If...

Job Description Job Description Hi, we're Oscar. We're hiring a Senior Specialist, Coding Auditor to join our Payment Integrity. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: You will support issue resolution in the Oscar claim environment. You will be responsible for the end-to-end claims repayment quality, process improvement and supporting root cause analysis . You will report into the VP, Payment Integrity. Work Location: This is a remote position, open to candidates who reside in: Tempe, Arizona; Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; New York City, New York; Philadelphia, Pennsylvania; Salt Lake City, Utah. While your daily work will be completed from your...

Discover Vanderbilt University Medical Center Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. EOE/Vets/Disabled. Job Summary Applies specialized skills and training independently to evaluate and advise whether professional, outpatient and inpatient hospital documentation meets applicable standards for coverage, accuracy, and completeness as well as coding and general compliance, with the goals of identifying and preventing compliance risk and providing timely and effective education and remediation. Provides hands-on training and day-to-day productivity and...

Discover Vanderbilt University Medical Center : Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research. Organization: Compliance Operations - VUH Job Summary: Applies specialized skills and training independently to evaluate and advise whether professional,...

A leading healthcare provider in Mobile is seeking a Coding Specialist focused on ensuring accurate medical coding and billing processes. The role requires an Associate's degree in health information technology and a relevant certification. Responsibilities include performing audits, providing educational support to staff, and resolving coding-related issues. This position aims to improve compliance and coding accuracy, making a significant impact on the quality of care provided. Interested candidates should possess strong attention to detail and effective communication skills. #J-18808-Ljbffr

A leading healthcare provider is seeking a Coding Specialist in New York. The role encompasses ensuring accuracy in medical coding, performing audits, and maintaining compliance with coding guidelines. Candidates should hold relevant certifications and have at least three years of related experience. The position offers a comprehensive benefits package, supporting employees' health and well-being. Join us to make a significant impact in healthcare for women, babies, and children. #J-18808-Ljbffr

A leading health data platform company is seeking an Inpatient Auditing Specialist to perform coding audits, provide education, and ensure compliance with regulations. The role requires 5+ years of experience and proficiency in certain coding certifications. This position offers a fully remote setup with a flexible schedule, competitive compensation, and comprehensive employee benefits. Join a dynamic team dedicated to improving healthcare through data-driven solutions. #J-18808-Ljbffr

A nationwide health services company seeks a Nurse Auditor 2 to perform clinical audits and validate medical records to ensure accuracy and compliance. This remote position requires a current U.S. RN license and a minimum of 1 year of experience with Home Health Care Payment methodologies. Candidates should demonstrate solid judgment, MS Office proficiency, and excellent communication skills. The role is a full-time opportunity with a pay range of $78,400 - $107,800 annually, plus a bonus incentive plan. #J-18808-Ljbffr