13 coder quality auditor jobs found

Coder Quality Auditor The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties. Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess coders'...

Physician Coding Auditor Ensemble Health Partners 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! The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW....

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g., ICD‑10‑CM, CPT, HCPCS). The role requires interpretation and independent determination of the appropriate courses of action, contributing to overall cost reduction by increasing the accuracy of provider contract payments in our payer systems and ensuring correct claims payment for appropriate CPT/HCPCS code assignments. The Auditor analyzes, enters and manipulates database data, responds to or clarifies internal requests for medical information, understands departmental, segment and organizational strategy and operating objectives, and follows established guidelines and procedures while making decisions in ambiguous situations. Where you come in The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g.,...

Home Health Clinical Quality Assurance Specialist (OASIS & Medicare Compliance) Base pay range: $55,000 - $75,000 per year. Actual pay based on skills and experience. Position Overview The Home Health Quality Assurance Specialist ensures the accuracy, compliance, and quality of patient care documentation, with a primary focus on OASIS data. Role involves reviewing patient records, conducting quality assurance checks, and exporting OASIS items to Medicare for compliance and reimbursement purposes. Key Responsibilities Review and validate OASIS assessments for accuracy and completeness before submission. Export OASIS data to Medicare, ensuring compliance with CMS regulations. Address discrepancies or errors in OASIS data and collaborate with clinicians to correct inaccuracies. Conduct regular audits of clinical documentation to ensure adherence to state, federal, and agency regulations. Monitor compliance with Medicare guidelines, particularly around OASIS and other key...

Become a part of our caring community and help us put health first 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...

Job Description Job Description Description: At STRIDE Community Health Center, we’re dedicated to more than just providing healthcare, we’re committed to making a lasting impact on the lives of our patients and the communities we serve. As one of Colorado’s largest Federally Qualified Health Centers, we offer comprehensive services—including primary care, dental, pharmacy, behavioral health, health education, and outreach, across our 13 clinics in the Denver Metro area. With over 35 years of serving our community, our growing team is at the heart of this mission. We believe healthcare is about more than treating illness; it's about fostering wellness and addressing the unique needs of every person, ensuring that no one is left behind. If you’re passionate about making a meaningful difference, thrive in a collaborative environment, and are ready for a career that transforms lives, including your own, STRIDE is the place for you. General Purpose: This Revenue Cycle Coder...

Inpatient Coder Opportunity 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...

Job Description Job Description OnPoint Medical Group is searching for an outstanding Certified Professional Coder to join our team! Come join a great group of medical professionals as our network continues to grow! OnPoint Medical Group is a physician-led network of skilled Primary and Urgent care providers who are committed to expanding access to quality healthcare in the most effective and affordable manner possible. Our "Circle of Care" has one primary goal – to ensure the health and wellness of members and their families. We do this by providing access to a comprehensive menu of medical services from one unified physician group in their neighborhoods. With doctors, nurses, specialists, labs and medical records all interlinked and coordinated, patient care has never been in better hands. About the Role: The Certified Professional Coder (CPC) plays a critical role in the healthcare industry by accurately translating medical diagnoses, procedures, and services into...

Adara Home Healthcare provides a pay range of $55,000.00/yr - $75,000.00/yr for the Home Health Clinical Quality Assurance Specialist (OASIS & Medicare Compliance) role. Your actual pay will be based on your skills and experience. Job Title: Home Health Clinical Quality Assurance Specialist (OASIS & Medicare Compliance) Position Overview: The Home Health Quality Assurance Specialist ensures the accuracy, compliance, and quality of patient care documentation. Primary focus is on OASIS data, reviewing patient records, conducting QA checks, exporting OASIS items to Medicare, collaborating with clinical staff to meet regulatory standards, and optimizing patient outcomes. Key Responsibilities: OASIS Data Review & Export: Review and validate OASIS assessments for accuracy and completeness before submission. Export OASIS data to Medicare ensuring compliance with CMS regulations. Address discrepancies or errors and collaborate with clinicians to correct inaccuracies....

Sr Analyst, Corp Compliance page is loaded## Sr Analyst, Corp Complianceremote type: Remotelocations: 09567 - Denver HQ Non-CA or CO Remotetime type: Full timeposted on: Posted Yesterdayjob requisition id: R0434559**Posting Date**11/24/20252000 16th St, Denver, Colorado, 80202-5117, United States of America**General Purpose of the Job**DaVita IKC is seeking a highly motivated and experienced Medicare Risk Adjustment Auditor and Educator to join our compliance team. This role is crucial for ensuring the accuracy, integrity, and compliance of our risk adjustment coding and clinical documentation related to professional services provided by both internal and external nephrology partners. The ideal candidate will serve as a subject matter expert, performing detailed medical chart audits and providing targeted education to providers and coding teams to support our commitment to high-quality patient care and adherence to all formal regulatory and coding guidelines.**Essential...

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...