16 certified coding auditor jobs found

Medical Coding Auditor The Medical Coding Auditor is responsible for performing internal QA audits on coding staff and supporting the quality of coding provided by coders. Minimum Requirements: Formal HIM education with national certification (RHIA or RHIT) or Bachelor's Degree required Additional coding certification (CCS, or CCS-P) preferred Minimum of three (3) years of inpatient and outpatient hospital experience (additional physician coding experience preferred) Minimum of three (3) years of inpatient and outpatient hospital coding/auditing experience preferred Must hold at least one of the following certifications: RHIA, RHIT, CCS, CCS-P, CPC, CPC-H (COC) or have a preferred minimum of 2 years relevant coding experience Must be at least 18 years of age Benefits At Amergis, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits: Competitive pay & weekly paychecks Health, dental, vision,...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

Physician Coding Auditor This is a full-time, remote position that offers a flexible schedule. Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare, Medicaid, and third-party payer guidelines to ensure receipt of accurate reimbursement. Physician Coding Auditor is expected to adhere to MedKoder's internal coding/auditing policies and expectations set forth by department management. Physician Coding Auditor must prioritize daily duties, communicate effectively, and make the decisions necessary to complete all assigned tasks and accomplish their goals. Candidates ideally have recent auditing experience specializing in some of the following profee areas: Ophthalmology, Behavioral Health, Cardiovascular/Cardiothoracic Surgery, Complex ENT Surgery, Dental, Complex Plastic Surgery, Orthopedic Surgery,...

At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Primary Function/General Purpose of Position Under the guidance of the Director, Compliance this position contributes to the Bon Secours Mercy Health mission and vision by serving as a senior auditor of provider revenue cycle compliance. This position provides compliance program-related audit activities relative to Bon Secours Mercy Health operations conducted at local and remote locations and supports provider compliance education and Leadership requests. Conducts specialized compliance investigative audits for Leadership and as part of due diligence to ensure the accuracy and completeness of provider documentation and coding that results in appropriate reimbursement and data integrity and validation of coded information. Essential Job Functions...

DRG Coding Auditor Principal Virtual:? ?? This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group...

DRG Coding Auditor Principal _Virtual: _ _ ​_ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group...

Billing Specialist Anderson Hills Pediatrics' Expectations of all Employees: Adhere to all Anderson Hills Pediatrics' Policies and Procedures Conduct self in a manner that represents Anderson Hills Pediatrics' core values at all times Maintain a positive and respectful attitude with all work-related contacts Consistently reports to work prepared to perform the duties of the position Meets productivity standards and performs duties as workload necessitates Primary Function: Assists the Billing Manager with the claims submission and revenue cycle of the practice. Major Duties and Responsibilities: Adherence to current HIPAA regulations and federal/state laws for patient protected health information (PHI) and/or medical records; adherence to all AHP policies/procedures as they pertain to patient PHI and the medical record; maintain strict confidentiality of all patient information Update patient demographic information including insurance coverage; make...

Based in Akron, Ohio, SummaCare provides Medicare Advantage, individual, family, and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5‑Star rating for 2025 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits. Position Summary Performs chart retrieval, medical record review, HCC identification and data quality oversight for risk mitigation and revenue recovery for both Medicare and ACA services. Assists in the development and management of activities in support of HCC coding while ensuring compliant practices for revenue management and reducing risk. Helps in the preparation with all Risk Adjustment Data Validations (RADV) audits as well as serving as the CMS liaison for coding questions/issues. Determines...

Overview Are you looking for a meaningful career where you can contribute to the accuracy, integrity and quality of healthcare data across Queensland19s public health system while supporting better patient outcomes? The Clinical Coder is a competent and experienced professional responsible for accurately assigning morbidity and procedural classifications to patient episodes across a broad range of specialties and clinical complexities. Working across Queensland Hospitals and Health Services, this role supports the timely completion of monthly coding requirements, particularly during periods of increased demand or workforce shortage. The Clinical Coder undertakes auditing, data verification and clinician liaison activities to ensure the accuracy, consistency and integrity of inpatient morbidity data, while also providing guidance and support to fellow coding staff. Responsibilities Assigning accurate ICD-10-AM and ACHI codes and performing AR-DRG grouping in accordance with...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We’re Looking For We’re looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this...

Scope of Position The Associate Director of Outpatient Coding Services performs at an expert level sustaining responsibility for timely and accurate coding of all facility outpatient visits and outpatient coding audits for The Ohio State University Wexner Medical Center (OSUWMC) including James Hospital. This position oversees the operations of denials, claim edits, and charge capture for reimbursement purposes. In this role, the Associate Director of Outpatient Coding Services serves as a liaison and coordinator for special projects regarding the coding of medical records. This position develops and implements policies and procedures to achieve organizational goals; and assists in the development of operational strategy. This position also re-evaluates processes to keep staff engaged and to assist in meeting department and organizational goals for OSUWMC. This position is critical to the financial and legal standing of the hospital for compliance and legal purposes. The director...

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divh2Job Title: Lead Inpatient Coder/h2pHow would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of whats possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in peoples lives./ppThe Lead Inpatient Coder serves as a key expert in ICD-10-CM, ICD-10-PCS, and DRG assignment, providing specialized knowledge and guidance to the Inpatient Coding team. This role is responsible for addressing complex coding questions, reviewing, and resolving external audit findings, and contributing to coding improvement initiatives. Additionally, the Lead Inpatient Coder plays a critical role in delivering ongoing education and training to the coding team, helping to...

Job Description: The HIM Hospital Inpatient & Same Day Surgery Coding Analyst deciphers and interprets provider documentation in the health record and assigns diagnostic information using ICD-10-CM/PCS and CPT codes for a complex range of acute care services for Intermountain Health. The caregiver provides specific coding expertise in the various fields of NCCI edits, Drugs and Biologicals, Revenue Codes, Current Procedural Terminology (CPT) codes, ICD-10 & CPT codes, DRGs, anatomy and physiology, pharmacology. The analyst also performs audits, provides feedback, and advanced training to clinical teams and physicians on ICD-10 and CPT coding best practices. Essential Functions Reviews and analyzes inpatient medical records for completeness, accuracy, and compliance for Same Day Surgery, Observation and Inpatient acute services at Intermountain Health. Performs coding at an advanced level of complexity for inpatient hospitals including governmental and/or...

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate...