24 coder quality auditor jobs found

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, Peds...

Company Description More Than Just Care,It’sCommunity Imagine doing meaningful work in a place where peoplevacation.That’slife at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties. If you want a career in healthcare and alifestylemost people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be Munson Material. To us, that means teammates who live by our values of excellence,teamness, positivity, creativity, and a commitment to creating exceptional experiences for our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country. Invested in You Grow: Tuition reimbursement, in-person and onlinedevelopment,and access to ourcareer hubto help you advance. Thrive: Full benefits, paid holidays, generous PTO,...

Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future – we provide the venue for individuals who have the desire...

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.,...

Siu Coder McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a SIU Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. The Special Investigations Unit (SIU) Coder...

Optimal Care Job Opportunity Optimal Care is where your dedication meets a rewarding career. As a clinician owned and operated company, we create the opportunity and environment for each employee to realize their highest potential while maintaining a personalized focus on our patients and families every day. We are the Midwest's premier provider of physician services, home health, and hospice care. Our integrated care delivery model incorporates technology, innovation, and best practices. We produce value-based outcomes by managing chronic disease process, rehabilitation, and end-of-life care. We live a simple mission: Serve Together, Provide Value, and Deliver Exceptional Quality Care. What does this mean for you? At Optimal Care, you have our resolute commitment to being an exceptional place to work. Your expertise, passion, and commitment to exceptional quality care will continue to thrive. With you we can build a remarkable place to work. Exceptional Benefits: Minimum of 3...

Overview Optimal Care is where your dedication meets a rewarding career. As a clinician owned and operated company, we create the opportunity and environment for each employee to realize their highest potential while maintaining a personalized focus on our Patients and Families every day. We are the Midwest's premier provider of Physician Services, Home Health, and Hospice Care. Our integrated care delivery model incorporates technology, innovation and best practices. We produce value based outcomes by managing chronic disease process, rehabilitation and end of life care. We live a simple Mission: Serve Together, Provide Value, and Deliver Exceptional Quality Care. What this means for you At Optimal Care, you have our resolute commitment to being an exceptional place to work. Your expertise, passion and commitment to exceptional quality care will continue to thrive. With you we can build a remarkable place to work. Benefits Minimum of 3 Weeks Paid Time Off (PTO) Company Vehicle...

Professional Coder A professional coder provides timely and accurate clinical and administrative data to ensure optimal reimbursement for services performed at acute care, inpatient, outpatient, urgent care, or physician offices. The role requires ICD10CM diagnosis, CPT‑4 coding, and charge entry, working closely with billing staff, practice managers and office personnel while maintaining high coding quality standards. Responsibilities Contribute to organizational success targets for patient satisfaction. Develop and maintain effective working relationships with HIM department staff, physicians, external customers, patients, and other staff. Adhere to coding rules for multiple specialties (neurosurgery, pediatric surgery, rehab, orthopedic, cardiology, etc.) ensuring high-quality coding based on documentation. Follow policies, procedures, and guidelines, while using analytical skills to review charts, interpret documentation, and apply codes. Ensure coding is completed on...

Clinical Supervisor RN Position Under general direction of nursing leadership, the Clinical Supervisor RN position is responsible for serving as a clinical resource and unit expert for staff. This position links nursing leadership with nursing care through the application of organizational and nursing service policies, procedures, and care delivery model. The Clinical Supervisor RN uses the Code of Ethics for Nurses with Interpretive Statements to guide leadership and practice. The Clinical Supervisor RN attains knowledge and competence reflective of current nursing practice; promotes innovation and futuristic thinking by incorporating evidence-based practice and research findings. Responsibilities (40%) Assesses competency of staff, and functions as a liaison to facilitate staff completing and maintaining their unit competencies. Acts as a resource and role model for clinical practice, develops and maintains excellent collaborative relationships and channels of communication...

divh2Advanced Coding Position/h2pAdvanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine Sparrow policies and procedures and maintains required quality and productivity standards./ppEssential Duties:/ppThis job description is intended to...

Job Description Job Description Description: CPC-As are not being considered at this time. We're coding rebels with a cause. KODE is a health-tech company developed by medical coders for medical coders looking to change the way things are done in the industry. Our company may be young but we're growing rapidly. That also means we're not buried in outdated policies and bureaucracies.Coders play a critical role in healthcare, but have you ever felt like you're just a cog in the machine? At KODE there are no cogs, there are people. We aren't looking for a coder to fill an open position simply. We're looking for a new teammate passionate about professional coding who wants to join our collective mission to be awesome.We're serious about two things: coding and treating you like the professional you are. If this intrigues you, please keep reading. About this Role We're looking for a Facility Inpatient Coder to join our company! Responsibilities: Review medical records...

Job Summary Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes 3M 360 in accordance with established workflow. Follows Michigan Medicine policies and procedures and maintains required quality and productivity standards. Mission Statement Michigan Medicine improves the health of patients, populations and communities...

EXPERIENCED MEDICAL ASSISTANT WITH ASSOCIATES OR HIGHTER FOR ROSS CAMPUS DIRECTOR 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. Ross Education Holdings, Inc. Jackson, MI - Campus based position Schedule: Full Time - Monday-Friday (3) days 8-5 and (2) afternoons 11-8 Ross Educations non-profit secondary education centers are working to provide all students with the tools to become much needed health care professionals. Apply with confidence knowing a human will read your resume. Come find your "WHY" at Ross Education! 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 principles that guide everything we do: Be Humble, Be Kind, BE a Good Steward, Embrace Accountability, Lead Responsibly and Deliver an Exceptional Student Experience...

Medical Coder Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting. We are seeking an experienced Medical Coder to join our healthcare consulting practice. The role is fully remote within the US, with infrequent travel to client locations for onboarding and training. We are proud of our national presence, and excited to offer great career opportunities within the organization. What you'll do: Accurately assign ICD-10 CM, E/M, ICD-10 PCS, CPT, HCPCS, modifiers and units based on documentation. Adhere to systems and standards required in multi-specialty medical coding encounters, including Outpatient, Emergency Room, Surgery, Inpatient facilities, Inpatient Professional Rounds, and others. Process encounters within required SLA on contract with deficiencies identified escalated as necessary. Review and respond to each audit within set...

Job Description General Purpose of Job :   Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine – Sparrow policies and procedures and maintains required quality and productivity standards. Essential Duties : This job...

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a SIU Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Learn more about McLaren Health Plan at...

Datavant is a leading data platform company dedicated to health data exchange, with a vision that every healthcare decision is powered by accurate data at the right time. Our network is one of the largest and most diverse in the U.S., ensuring that data remains secure and accessible to enhance health decisions. Our clients include prominent life sciences firms, government agencies, and healthcare providers. Joining Datavant means becoming part of a high-performing, values-driven team that is committed to solving the intricate challenges of healthcare through technological innovations. Our diverse team members bring a rich array of professional, educational, and personal experiences to support our ambitious vision for the future of healthcare. Your Role: We are seeking credentialed inpatient coders who possess meticulous attention to detail and a solid understanding of medical terminology to join our dynamic team. This position offers the flexibility of fully remote work,...

Review and check certain inpatient records to make sure the coding is correct and follows rules for ICD-10 codes. This includes checking the DRG groups, Present on Admission indicators, Severity of Illness, Risk of Mortality, Hospital-Acquired Conditions, and Patient Safety Indicators according to guidelines set by the Centers for Medicare & Medicaid Services and the American Hospital Association. Provide ongoing feedback and training to the staff in the Coding unit. General Characteristics: Excellent customer service when working with Coding/CDI staff, clinicians, and other Michigan Medicine employees. Strong knowledge of ICD-10 coding and understand the Official Coding Guidelines well. Ability to review clinical documents to decide what information is needed for accurate DRG, POA, SOI, and ROM scores. Communicate effectively with the Coding/CDI team to ensure good outcomes. Write appropriate questions to the clinical care team following AHIMA Query Policy. Skilled in...

Job Summary Perform coding quality audits on outpatient records to assure appropriateness, accuracy, and compliance for CPT/HCPCs, ICD-10-CM code assignments, and modifier assignment in accordance with Center of Medicare and Medicaid Service (CMS) Guidelines, AMA and AHA Official ICD-10-CM Coding Guidelines. Provide ongoing feedback to managers and coders. Develop and implement educational programs regarding elements of the coding compliance program and act as a subject matter expert for the outpatient coding department. Mission Statement Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society....

Job Opportunity Job ID:49762 Positions Location: Lansing, MI Job Description General Purpose of Job: Advanced Description: Positions Location: Lansing, MI Job Description General Purpose of Job : Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows...

Overview The Health Information Management Coder Inpatient Level 2 provides timely and accurate clinical and administration data to ensure optimal reimbursement for inpatient, rehab and/or skilled nursing coding to support the facility needs. Primary patient contact is only social. Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation. Responsibilities Contributes to organization success targets for patient satisfaction. Formulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients, and other department staff members. Adheres to current coding rules, regulations and requirements for inpatient coding, DRG/APR-DRG assignment, rehab coding, skilled care coding, CMG assignment,...

Positions Location: Lansing, MI Job Description General Purpose of Job :   Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine – Sparrow policies and procedures and maintains required quality and productivity standards....

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...

ASSOCIATE DIRECTOR Ross Education Holdings, Inc. New Baltimore, MI - 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. Ross Educations non-profit secondary education centers are working to provide all students with the tools to become much needed health care professionals. Come find your "WHY" at Ross Education! 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 principles that guide everything we do: Being Humble, Kind, a Good Steward, Embrace Accountability, Deliver an Exceptional Student Experience and Lead Responsibly If these values resonate with you and you're looking to contribute to a purpose-driven team, we'd love to meet you....