16 certified coder auditing jobs found

Job Description Job Description Description:    About Primary Health Solutions Our Mission We meet people where they are and partner with them on their journey towards wellness. Our Vision The destination for servant leaders to provide comprehensive and exceptional care. Our Values R – Respect I – Innovation S – Stewardship E – Excellence  Billing and Coding Specialist Summary Responsible for entering/auditing/coding patient services to ensure encounters transfer properly for submission to insurance payers. Analyze coding related claim issues, process gaps and denials to trend feedback for providers by location and/or specialty.  A Day in the Life · Review provider documentation (including hospital procedures) and translate services into correct codes. Append payer specific modifiers and claim criteria when applicable.  · Review incomplete encounters and code based on available documentation in EHR systems. · Know and understand several different...

DaMar Staffing is seeking a Medical Coder to translate clinical documentation into ICD-10-CM and CPT codes for accurate billing and compliance. You will review patient reports, extract data, and apply coding guidelines across multiple specialties. Responsibilities include auditing E/M level selections, educating physicians on CMS regulations and documentation standards, identifying denial trends, and supporting workflow improvements. #J-18808-Ljbffr

Thank you for considering a career at Ensemble!Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!O.N.E Purpose:Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.Striving for...

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...

Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process. Department: Health Information Management Shift/schedule: Full Time (40 hrs/wk) GENERAL SUMMARY Works under the supervision of the HIM Manager (Operations & Auditing). The primary function of the HIM Coder - Professional is to code and charge medical office visits for professional claims. Must be able to review and edit charges in Meditech as well as review leveling criteria for E/M charging accuracy, charge for procedures and other billable services provided in the clinic/office setting. Must be able to code ICD-10 diagnoses and CPT codes while ensuring they are assigned correctly and sequenced appropriately. Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines. Performs other duties as assigned....

Health Information Management Coder - ProfessionalWorks under the supervision of the HIM Manager (Operations & Auditing). The primary function of the HIM Coder - Professional is to code and charge medical office visits for professional claims. Must be able to review and edit charges in Meditech as well as review leveling criteria for E/M charging accuracy, charge for procedures and other billable services provided in the clinic/office setting. Must be able to code ICD-10 diagnoses and CPT codes while ensuring they are assigned correctly and sequenced appropriately. Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines. Performs other duties as assigned.Qualifications:High School Diploma or successful completion of an equivalent High School Exam RequiredSuccessful completion of the HIM Coder – Professional/HCC competency exam within 6 months of...

Outpatient Coder (Remote)Full-time • Work From HomeMust have Surgical/OBS coding experience and documented billing edit experienceOb SummaryAs part of our hospital outpatient coding team, you will work outpatient coding quality and/or billing alerts/edits for hospital outpatient encounters (e.g., same day surgery, observation, wound care, emergency department, and/or diagnostic) to ensure complete and accurate code assignment. This is a great starting position for those wanting to move from production coding toward an outpatient coding quality review position.Job ResponsibilitiesVerifying accuracy of assigned CPT codes for complex and/or error prone procedures,Verifying the diagnosis coding accuracy for complex and/or error prone encounters,Validating certain discharge dispositions,Reviewing charge and procedure mismatches,Reviewing codes with revenue integrity for NCD/LCD coverage,Reviewing invalid codes, code conflicts, and missing modifiers,Working with other team members in...

Certified Coding Analyst 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 Coding Analyst will perform medical claim reviews for waste and error to ensure compliance with coding practices through a comprehensive record review for medical and institutional providers. The Analyst must have the ability to determine correct coding and appropriate documentation during the review of medical records. The Analyst must also ensure state; federal and company requirements are met. Conduct a comprehensive medical record audit to ensure the CPT/HCPCS or modifiers billed are consistent...

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. Position Summary The Certified Professional Coder (CPC) will perform medical claim reviews 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. Activities include: Conduct a...

Outpatient Coder (Remote)Full-time • Work From HomeMust have Surgical/OBS coding experience and documented billing edit experienceOb SummaryAs part of our hospital outpatient coding team, you will work outpatient coding quality and/or billing alerts/edits for hospital outpatient encounters (e.g., same day surgery, observation, wound care, emergency department, and/or diagnostic) to ensure complete and accurate code assignment. This is a great starting position for those wanting to move from production coding toward an outpatient coding quality review position.Job ResponsibilitiesVerifying accuracy of assigned CPT codes for complex and/or error prone proceduresVerifying the diagnosis coding accuracy for complex and/or error prone encountersValidating certain discharge dispositionsReviewing charge and procedure mismatchesReviewing codes with revenue integrity for NCD/LCD coverageReviewing invalid codes, code conflicts, and missing modifiersWorking with other team members in billing,...

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:...

Outpatient Coder (Remote) Full-time Work From Home Must have Surgical/OBS coding experience and documented billing edit experience Ob Summary As part of our hospital outpatient coding team, you will work outpatient coding quality and/or billing alerts/edits for hospital outpatient encounters (e.g., same day surgery, observation, wound care, emergency department, and/or diagnostic) to ensure complete and accurate code assignment. This is a great starting position for those wanting to move from production coding toward an outpatient coding quality review position. Job Responsibilities Verifying accuracy of assigned CPT codes for complex and/or error prone procedures, Verifying the diagnosis coding accuracy for complex and/or error prone encounters, Validating certain discharge dispositions, Reviewing charge and procedure mismatches, Reviewing codes with revenue integrity for NCD/LCD coverage, Reviewing invalid codes, code conflicts, and missing modifiers, Working with...

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 Coding Analyst will perform medical claim reviews for waste and error to ensure compliance with coding practices through a comprehensive record review for medical and institutional providers. The Analyst must have the ability to determine correct coding and appropriate documentation during the review of medical records. The Analyst must also ensure state; federal and company requirements are met. Conduct a comprehensive medical record audit to ensure the CPT/HCPCS or modifiers billed are consistent with medical record...

University of Toledo Physicians' mission is to improve the human condition through excellence in patient care and medical discovery.Representing more than 200 physicians, UT Physicians are leaders in clinical care, research and education of the future physicians, providing care in a wide range of medical specialties from the most complex diagnoses and treatments to primary care for the entire family.The primary site of inpatient care services is at the University of Toledo Medical Center, but many of our physicians' practice at hospitals and medical offices throughout the region.University of Toledo Physicians offers competitive pay and benefits including:403B, Pension, health and tuition waiver at UT.POSITION SUMMARYThe Certified Coder is responsible for coding ICD diagnosis and CPT facility and professional codes.Assignment may include outpatient clinic visits, diagnostic procedures, outpatient surgeries, observation and inpatient encounters, and emergency room charges for the...

Inpatient Coder (Remote)Full-time • Work From HomeMust have CCS, RHIA, or RHIT certificationJob SummaryAs a Coding Integrity Specialist III WORK FROM HOME, you will review and evaluate hospital inpatient medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM and ICD-10-PCS codes. A CIS III performs coding and/or code/DRG validation across multiple entities by applying all appropriate coding guidelines and criteria for code selections.Job QualificationsAssign, sequence, validate, and/or edit codes/DRGs and abstracted data (e.g., physician, discharge disposition, query tracking) for inpatient records for multiple facilities using ICD-10-CM and ICD-10-PCSMaintain or exceed established accuracy standardsMaintain or exceed established productivity standardsUtilize the complete patient medical record documentation in code/DRG assignment, validation, and/or editing of codes/DRGsUndergraduate (Associate's or Bachelor's) degree in HIM/HIT...

Location ST. LOUIS, MO 63108 Scheduled Hours 37.5 Position Summary The purpose of the Washington University Compliance Program is to minimize instances of noncompliance with external laws and regulations, as well as related internal policies and procedures. Although university administration, faculty, and staff are responsible for various aspects of compliance as part of their roles, the Senior Lead Compliance Auditor plays a significant part in the overall compliance program. The Senior Lead Compliance Auditor works in the Office of University Compliance and Internal Audit. This position is responsible for evaluating the University’s state of compliance with federal research and other federal regulations, as well as related University policies. Such compliance is crucial to the success and mission of the University. Results of the compliance audits are critical measures for the University. The Senior Lead Compliance Auditor reports to the Director of Compliance Audit. The...