13 coder quality auditor jobs found

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. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines Utilize encoders and various coding resources Perform CPT Procedure reviews...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

Coder II Coder II assigns diagnosis and procedure codes using the appropriate coding classification system to reflect the care and services rendered to the patients in the emergency department, ancillary, and outpatient surgery settings. Ensure the accurate selection of the principal diagnosis and procedure and all other significant diagnoses and procedures. Abstract hospital-defined data from records for data collection purposes. Ensure compliance with official guidelines, AHA Coding Clinic, AMA CPT Assistant and Guidelines, AHIMA Standards of Ethical Coding and LifePoint Health Support Center (HSC) policies and procedures. People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Lake Cumberland Regional Hospital is a modern, state-of-the-art 295-bed acute care facility, offering an advanced neurosurgery program with Spine Center accreditation amongst other specialty services. The City of Somerset blends southern...

Coder-Outpatient The Coder-Outpatient is responsible for the ICD-10-CM, ICD-10-PCS, CPT and modifier assignment of diagnosis and procedures of an outpatient visit. Job Specific Responsibilities: Assign and sequence diagnostic and procedural codes for patient care, utilizing ICD-10, CPT, and HCPCS coding systems. Ensure accurate and compliant coding of medical services and procedures based on clinical documentation. Review patient records and physician documentation to validate coding accuracy and completeness. Work collaboratively with healthcare providers and staff to clarify and address documentation discrepancies. Maintain knowledge of current coding guidelines, insurance regulations, and compliance standards. Assist in audits and reviews to ensure coding accuracy and adherence to billing requirements. Resolve coding errors and respond to coding-related inquiries. Protect patient confidentiality and adhere to HIPAA regulations. Education and Experience: High...

Insurance Billing And Collections Specialist Education, Experience, and Licensing Requirements: High school diploma, GED, or equivalent University/college degree, or experience in medical records, claims or billing areas is an asset. CCA (AHIMA) CCS (AAPC) or greater Expectations of Role: Manages the insurance billing and collections processes. Excellent organizational skills and attention to detail. Processes, tracks claims, and ensures accuracy and timeliness in the billing process. Provides excellent customer service to our clients. Inputs patient information into the practice's billing software. Submits claims to insurance companies and follows up on unpaid claims. Posts ERA payments, resolves any issues that arise with claims or payments. Maintains accurate records of billing and collection activities. Generates monthly reports to track billing and collection performance. Accounts for coding and abstracting of patient encounters, including procedural...

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...

Join Datavant, a leading data platform company revolutionizing health data exchange. Our mission ensures that every healthcare decision is guided by the right data at the right time and in the right format. As the world's foremost health data network, our platform enables secure, accessible, and actionable data, empowering healthcare stakeholders including life sciences firms, government agencies, and care providers. By becoming part of Datavant's high-performing, values-driven team, you'll contribute to innovative technology solutions that address some of healthcare's most challenging issues. Our diverse team brings various professional, educational, and life experiences together to achieve our ambitious goals for the healthcare sector. What You'll Be Doing: Conduct audits of coded medical charts according to the client's guidelines as assigned by the quality supervisor. Navigate multiple client guidelines with ease. Maintain a 95% quality average at the...

Medical Records Certified Coder Opportunity Full Time, Dayshift Monday-Friday, Inperson $2,500 Sign On Bonus As the only free-standing psychiatric hospital in the Central Kentucky area, we are here to help. Please join our team as we expand our services to meet the needs of our community. The Ridge Behavioral Health System is a 110-bed hospital located in the heart of the Bluegrass, Lexington, KY. The Ridge provides psychiatric and substance use disorder treatment for children, adolescents, and adults. The Ridge offers Partial Hospitalization, Intensive Outpatient Programs, Individual Counseling, as well as Medication Management for all ages. We have provided behavioral health services to over 92 Kentucky counties for more than 39 years. Job Duties Include: Meets coding quality score of 95% accuracy in assignment of diagnoses and procedure codes as measured by the quarterly coding audit performed by Corporate. Coordinate treatment through treatment planning, the treatment...

Overview The Clinical Coder is responsible and accountable for reviewing medical record documentation and assigning codes for reimbursement and statistical purposes. Responsibilities Dependent upon level of expertise defined in the Education/Training section: Maintains a working knowledge of coding fundamentals: ICD-10-CM coding for inpatient, outpatient, and/or physician services; HCPCS coding, namely CPT-4 for surgical procedures, for outpatient and/or physician services; and/or HCPCS coding, namely Evaluation and Management, for physician services. Maintains a working knowledge of coding guidelines: Official Guidelines for Coding and Reporting, American Hospital Association’s Coding Clinics, and/or American Medical Association’s CPT Assistant. Maintains a working knowledge of reimbursement as it relates to coding: the government prospective payment systems for inpatient, outpatient, and/or home health agencies, skilled nursing facilities, inpatient...

Job Description Job Summary: Coder II assigns diagnosis and procedure codes using the appropriate coding classification system to reflect the care and services rendered to the patients in the emergency department, ancillary, and outpatient surgery settings. Ensure the accurate selection of the principal diagnosis and procedure and all other significant diagnoses and procedures. Abstract hospital-defined data from records for data collection purposes. Ensure compliance with official guidelines, AHA Coding Clinic, AMA CPT Assistant and Guidelines, AHIMA Standards of Ethical Coding and LifePoint Health Support Center (HSC) policies and procedures. Who We Are: People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Lake Cumberland Regional Hospital is a modern, state-of-the-art 295-bed acute care facility, offering an advanced neurosurgery program with Spine Center accreditation amongst other specialty services....

Overview The Clinical Coder is responsible and accountable for reviewing medical record documentation and assigning codes for reimbursement and statistical purposes. Responsibilities Dependent upon level of expertise defined in the Education/Training section: Maintains a working knowledge of coding fundamentals: ICD-10-CM coding for inpatient, outpatient, and/or physician services; HCPCS coding, namely CPT-4 for surgical procedures, for outpatient and/or physician services; and/or HCPCS coding, namely Evaluation and Management, for physician services. Maintains a working knowledge of coding guidelines: Official Guidelines for Coding and Reporting, American Hospital Association’s Coding Clinics, and/or American Medical Association’s CPT Assistant. Maintains a working knowledge of reimbursement as it relates to coding: the government prospective payment systems for inpatient, outpatient, and/or home health agencies, skilled nursing facilities, inpatient...

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...

Responsibilities Medical Records Certified Coder Opportunity: Full Time, Dayshift Monday-Friday, Inperson $2,500 Sign On Bonus As the only free-standing psychiatric hospital in the Central Kentucky area, we are here to help. Please join our team as we expand our services to meet the needs of our community. The Ridge Behavioral Health System is a 110-bed hospital located in the heart of the Bluegrass, Lexington, KY. The Ridge provides psychiatric and substance use disorder treatment for children, adolescents, and adults. The Ridge offers Partial Hospitalization, Intensive Outpatient Programs, Individual Counseling, as well as Medication Management for all ages. We have provided behavioral health services to over 92 Kentucky counties for more than 39 years. Job Duties include: Meets coding quality score of 95% accuracy in assignment of diagnoses and procedure codes as measured by the quarterly coding audit performed by Corporate. Coordinate treatment...