13 coder quality auditor jobs found

Division: Eskenazi Health Sub-Division: Hospital Req ID: 25405 Schedule :Full Time Shift :Days Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus including at a network of Eskenazi Health Center sites located throughout Indianapolis. FLSA Status Exempt Job Role Summary This position completes timely and accurate auditing of coder and/or provider charges and clinical documentation and follows up with coder/provider education for Professional services as appropriate to facilitate compliant and optimized reimbursement, research, and PI initiatives. The Professional Coder, Auditor and Educator assists with workflow suggestions to Leadership. Proactively contributes to Eskenazi Health's mission: Advocate, Care, Teach and Serve with...

Registered Nurse - Diagnosis Related Group Coding Auditor Principal – Carelon Payment Integrity Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. 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) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients. Specializes in review of DRG coding via medical records and attending physician’s statements provided by acute care hospitals on paid DRG,...

Division: Eskenazi Health Sub-Division: Hospital Req ID: 25405 Schedule : Full Time Shift : Days Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus including at a network of Eskenazi Health Center sites located throughout Indianapolis. FLSA Status Exempt Job Role Summary This position completes timely and accurate auditing of coder and/or provider charges and clinical documentation and follows up with coder/provider education for Professional services as appropriate to facilitate compliant and optimized reimbursement, research, and PI initiatives. The Professional Coder, Auditor and Educator assists with workflow suggestions to Leadership. Proactively contributes to Eskenazi Health's mission:...

A company is looking for a Risk Adjustment Coder. Key Responsibilities Perform code abstraction of medical records, ensuring accurate assignment of ICD-9-CM, ICD-10-CM, CPT, and HCPCS codes Review medical records to validate documentation meets CMS requirements and identify improvement opportunities Support the Medicare Risk Adjustment team by educating providers on compliance and maintaining coding quality audits with a minimum accuracy of 95% Required Qualifications, Training, and Education Must have at least three recent years of experience in HCC/Risk Adjustment and/or inpatient coding Hold relevant certifications such as CPC, CRC, RHIT, or RHIA from AAPC or AHIMA Strong knowledge of clinical terminology, disease processes, anatomy, physiology, and pharmacology Familiarity with claims processing procedures and state, federal, and Medicare regulations Must reside in New York, New Jersey, or Connecticut

A company is looking for a Professional Billing (PB) Coder - Surgical Specialty. Key Responsibilities Assign accurate CPT, HCPCS, and ICD-10-CM codes for complex surgical procedures Review operative reports and documentation for complete and compliant coding Ensure compliance with billing guidelines and participate in quality reviews and audits Required Qualifications Minimum 2+ years of professional billing coding experience Experience coding complex surgical services Strong knowledge of CPT, ICD-10-CM, HCPCS, modifiers, and NCCI edits CPC or equivalent coding certification preferred Experience in hospital-based physician billing environments

Radiology Medical Coder Client Profile - An Indiana based independent physician-owned radiology practices founded in 1967. Job Summary - The Radiology Coder is responsible for coding and charge submission activities, including abstracting CPT Professional Fee Coding and inpatient/outpatient coding and billing. This involves reviewing medical records and assigning appropriate ICD, CPT, and HCPCS codes. Job Duties: Review and analyze medical records ensuring the correct assignment of ICD-10, CPT and HCPCS codes. Accurately code diagnostics imaging, interventional radiology procedures and other radiological services. Ensure that documentation supports the assigned codes and matches physician orders and radiology reports. Abstract relevant data such as procedural dates, providers, and patient demographics for billing and reporting. Collaborate with radiologists and other medical professionals to clarify diagnoses and procedures when documentation is insufficient or ambiguous....

Medical Coder Maple City Health Care Center (MCHCC) is a Federally Qualified Health Center dedicated to improving our community's health by making quality comprehensive healthcare accessible to all. We strive for a healthy community where everyone is cared for. The Medical Coder is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS Level II codes for medical, dental, and behavioral health services in compliance with federal, state, payer, and HRSA/FQHC requirements. This role supports timely and compliant billing, reimbursement optimization, and audit readiness. Essential Duties and Responsibilities Review provider documentation to ensure completeness, accuracy, and compliance with coding guidelines. Assign appropriate ICD-10-CM, CPT, and HCPCS codes for: primary care services, behavioral health services, dental services (as applicable). Ensure coding supports medical necessity, scope of practice, and payer requirements. Apply correct modifiers, place of...

ASSOCIATE DIRECTOR Ross Education Holdings, Inc. Mishawaka/South Bend - Campus based position Schedule: Full Time - Monday-Friday (3) days 8-5 and (2) afternoons 11-8 We are looking for a Medical Assistant with 3+ years of MA experience, an Associate's Degree or higher, and preferably some management experience to take your career to the next level. Apply with confidence knowing a human will read your resume. Come find your "WHY" at Ross Education! Ross Educations non-profit secondary education centers are working to provide all students with the tools to become much needed health care professionals. Ross is more than a place to work - we're a community built on shared values. As part of our team, you'll be asked to embody and uphold the Core Values that guide everything we do: Being Humble, Kind, a Good Steward, Embrace Accountability, Deliver an Exceptional Student Experience and Lead Responsibly If these principles resonate with you and you're looking...

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...

Job Full Description Company Info: Our client focuses on fulfillment of promotional material supply for the medical and pharmaceutical industry. Job Summary: verifying ship methods, item codes, counts for each item, etc. and they will be working in both sides of our warehouse (Production and Fulfillment) Inspects products, orders, projects, and services to determine compliance with job specifications, company's quality assurance system, shipping and packaging, and conformity to the ISO specifications. Ensure and evaluate job setup to safeguard item integrity. Lead audits on all HIPAA and high risk jobs to ensure quality and compliancy. Audit Fulfillment Activities & Inventory: Conducts inspection activity for product throughout production cycle and order fulfillment. Maintains physical inventory counts on specific product lines. Maintains physical location integrity in relation to the location master database. Carries out specified inventory...

Job Type Full-time Description Job Summary: Maple City Health Care Center (MCHCC) is a Federally Qualified Health Center dedicated to improving our community's health by making quality comprehensive healthcare accessible to all. We strive for a healthy community where everyone is cared for. The Medical Coder is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS Level II codes for medical, dental, and behavioral health services in compliance with federal, state, payer, and HRSA/FQHC requirements . This role supports timely and compliant billing, reimbursement optimization, and audit readiness. Essential Duties and Responsibilities Essential Duties and Responsibilities • Review provider documentation to ensure completeness, accuracy, and compliance with coding guidelines. • Assign appropriate ICD-10-CM, CPT, and HCPCS codes for: o Primary care services o Behavioral health services o Dental services (as applicable) • Ensure coding...

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. 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 increasing the...

Job Description Radiology Medical Coder Job Description Client Profile- An Indiana based Independent Physician-Owned radiology practices founded in 1967. Job Summary- The Radiology Coder is responsible for coding and charge submission activities, including abstracting CPT Professional Fee Coding and inpatient/outpatient coding and billing. This involves reviewing medical records and assigning appropriate ICD, CPT, and HCPCS codes. Job Duties Review and analyze medical records ensuring the correct assignment of ICD-10, CPT and HCPCS codes. Accurately code diagnostics imaging, interventional radiology procedures and other radiological services Ensure that documentation supports the assigned codes and matches physician orders and radiology reports Abstract relevant data such as procedural dates, providers, and patient demographics for billing and reporting. Collaborate with radiologists and other medical professionals to clarify diagnoses and...