18 coder auditor professional jobs found

Job Title Clinical Documentation Auditor Job Description General Summary Performs clinical documentation audits, evaluations and other reviews for the System to ensure and assess compliance with applicable laws and regulations. Prepares and presents written and oral reports summarizing audit work, issues identified and recommendations to correct issues to management. Develops and disseminates education and training programs to employees. Responsibilities Duties and Responsibilities Essential Functions: Performs proactive or reactive coding compliance reviews as needed to identify or quantify potential issues. Investigates and recommends action to be taken when compliance issues are found. Monitors implementation of recommended corrective action and performs follow up reviews where necessary. Assists with coding compliance implementation throughout the WellSpan. Assists in the development and dissemination of education and training processes for the...

Responsibilities Remote opportunity. Independence Physician Management (IPM) was formed in 2012 as the physician services unit. IPM develops and manages multi-specialty physician networks and urgent care clinics within the Acute Care and Behavioral Health Divisions. A subsidiary of UHS, IPM operates in 13 markets across 7 states - and counting. We help doctors manage their practices and clinical procedures so they can concentrate on caring for their patients. To learn more about IPM visit Physician Services - Independence Physician Management - UHS. Successful candidate must live in one of these locations: Pennsylvania Delaware Florida Nevada New Jersey Texas 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...

Professional Coding Auditor And Educator - Remote This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing.In addition, this role focuses on performing the following Health Information Management duties:Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information.An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a hands on environment.The majority of time is spent in the delivery of support services or activities, typically under supervision.An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education.Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation or...

Job Description Job Description Growing Hanover Family Practice Associates, LLC seeks Medical Billing Specialist with a minimum of two years billing experience to become an integral part of our in-office Billing/Collections team. This person will be a full-time, detail-oriented, goal-oriented, revenue-driven, highly accurate and motivated Biller. Primary duties include, but are not limited to: consistently follow up on unpaid claims utilizing monthly aging reports and filing appeals when appropriate to obtain maximum reimbursement. Secondary duties include but are not limited to: data entry of all patient demographic, guarantor and insurance information, posting procedures and insurance/patient payments, balance to daily deposits REQUIRED SKILLS Certified Professional Coder Computer experience is essential, including, but not limited to: practice management software, Electronic medical record software, Microsoft Office applications. EPIC and Excel experience is a...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in 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 role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

UPMC Corporate Revenue Cycle is hiring a Retrospective Appeal Coder to join our team! This position will work remotely, Monday through Friday. The Retrospective Appeal Coder provides support to the local coding departments by initiating the retrospective appeal process for coding denials. Drawing on a coding knowledge base and knowledge of payor regulations, the Retrospective Appeal Coder is responsible for assessing for the presence of criteria to recover denied reimbursement through appeal. If you have five years of inpatient coding and are ready to take the next step in your coding career, apply today! Responsibilities: Assist in determining system-wide coding needs through investigation of retrospective denials and identification of root cause. Review and resolve pre-bill edits as needed Maintain current knowledge of regulatory guidelines related to retrospective appeals. Serve as a liaison between coding and payors and facilitates payor/physician...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Inpatient CoderThe Western Region Consolidated Business Office delivers comprehensive insurance revenue services to our affiliated UHS facilities, encompassing billing, collections, cash posting, pre-access management, variance analysis, and customer service. Our dedication to associate satisfaction and growth is recognized by industry leaders, exemplifying our commitment to fostering a positive and inclusive workplace culture. Our associates can count on competitive salaries, top-tier medical, dental, and retirement benefits, career training, and support for continued professional development.The Western Region CBO is seeking a dynamic and talented Inpatient Coder for our Appeals department. The primary responsibility of the DRG Coder is to analyze third party coding audits of paid claims, draft detailed appeal letters, evaluate clinical level of care and review denial trends. This can be a remote/in-office position.Qualifications Key include:Perform DRG (Diagnosis Related Group)...

Job Description Job Description Coder II Location: Remote Organization: Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder Overview Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder, is seeking a dedicated and skilled Coder to join our team remotely . As two of the region’s most respected providers of orthopedic and upper extremity care, we offer a collaborative, patient-focused environment that prioritizes clinical excellence, innovation, and ongoing professional development. Position Summary This role is responsible for accurately reviewing medical records and assigning ICD-10 and CPT codes in compliance with all applicable policies and regulations. It manages patient demographics, clinical documentation, and billing data across practice management systems and hospital records to ensure proper coding and reimbursement. The position also supports and educates clinical staff and providers on documentation and coding...

Job Description Job Description Description: Job Role The Clinical RN Chart Reviewer will perform clinical reviews of medical records and other documentation to validate issues of claims coding accuracy, medical necessity, and the appropriateness of treatment settings and services delivered. The Clinical RN Chart Reviewer will report to the Payment Assurance Manager and support a culture and work environment that promotes and inspires an active, continuous improvement philosophy regarding products and services in line with our company mission. This role requires certified coding expertise and a strong understanding of DRG validation, medical necessity, and regulatory guidelines. Requirements: Responsibilities will include: Audits and analyzes neonatal intensive care unit (NICU) claims according to ICD-10 coding principles and clinical guidelines. Analysis of claims data to optimize reimbursement by ensuring that the diagnosis codes, procedure codes, and supporting...

Department: 10407 Enterprise Revenue Cycle - Coding Production Operations: Inpatient Coding Operations Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Will support : A mix of inpatient community and academic coding. Includes service lines such as cardiology, neurology, and oncology. Schedule : Full-time, Monday-Friday 40hrs with a standard schedule of Monday through Friday, 8 hours per day, totaling 40 hours each week. Certification required : Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA). Remote opportunity: Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY Pay Range: $33.05 - $49.60 Major...

Job TitleClinical Documentation AuditorJob DescriptionGeneral SummaryPerforms clinical documentation audits, evaluations and other reviews for the System to ensure and assess compliance with applicable laws and regulations. Prepares and presents written and oral reports summarizing audit work, issues identified and recommendations to correct issues to management. Develops and disseminates education and training programs to employees.ResponsibilitiesDuties and ResponsibilitiesEssential Functions:Performs proactive or reactive coding compliance reviews as needed to identify or quantify potential issues.Investigates and recommends action to be taken when compliance issues are found. Monitors implementation of recommended corrective action and performs follow up reviews where necessary.Assists with coding compliance implementation throughout the WellSpan.Assists in the development and dissemination of education and training processes for the employees regarding coding compliance...

Sr. Coder Professional BillingREMOTEProfessional BillingSr. 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 years of experience...

Number of Positions In Requisition 1 Job Details Sr. Coder Professional Billing Job Description REMOTE Professional Billing 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...

Cardiology Consultants Of PhiladelphiaCardiology Consultants of Philadelphia (CCP) is a professional medical organization committed to the healing mission of Medicine and is part of a national cardiology platform, Cardiovascular Logistics (CVL). Together, we share the same mission to provide our patients with the highest quality cardiovascular care available. Join our team and be a part of an organization that is dedicated to improving patient outcomes and shaping the future of heart health.CCP specializes in providing comprehensive cardiology care and currently has over 30 locations throughout the Philadelphia region. We are currently hiring for full-time Electrophysiology Coder (CPC) to work at our Philadelphia, PA Office.SummaryThe Certified Professional Coder – Electrophysiology is responsible for accurate, compliant, and timely coding of the electrophysiology (EP) service line for Cardiology Consultants of Philadelphia (CCP). This is a full-time position dedicated to EP...

Description Full-time - This is not a remote position. Evaluates medical records, provides clinical abstracts and assigns appropriate clinical diagnosis and procedure codes for both inpatient and outpatient services in accordance with nationally recognized coding guidelines. Meets quality standards of having 95% of principal diagnoses and procedures correctly coded. Serves as a liaison between clinicians and the coding staff. Collaborates with all members of the revenue cycle to ensure data quality and optimum reimbursement allowable under the federal and state payment systems. Supervises the coding department in relation to the following: distribution of work assignments, dissemination of current coding guidelines and modern technology information, and provides relevant coding education to the coders, clinicians, and revenue cycle staff. Minimum Requirements Knowledge and understanding of ICD10 and CPT coding principles as recommended by the American Health...