20 coder quality auditor jobs found

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Senior Risk Adjustment Coder The Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare Advantage Risk Adjustment. What you will do: Risk Adjustment Review May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing Reviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses. Evaluating medical records to verify that M.E.A.T criteria support the submitted diagnosis codes. Inquire with clinicians the recommended HCC diagnosis for chart addendum. Collaborating with other departments to address coding updates and support risk...

divh2Capital Health Coding Specialist/h2pCapital Health is the regions leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region./ppCapital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates./ppThe listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may...

Job Description Responsible for supervising the work of staff who review, interpret, code and abstract medical records information according to standard classification systems; performs the most advanced medical records coding and abstraction duties; performs data quality reviews and prepares complex reports as required;and performs other related duties as assigned. Principal Accountabilities: 1. Promotes Coding Audit department goals by selecting, motivating, and training capable team members. 2. Leads the activities of assigned Coding Audit team members by communicating and providing guidance toward achieving department objectives. 3. Assists in analyzing common operational definition of metrics and assists in the development of regional reports to monitor individual hospitals in one database and develops processes to integrate clinical department managers in correction and resubmission of medical records. 4. Assists with the development of tools to track performance...

Job Description Responsible for supervising the work of staff who review, interpret, code and abstract medical records information according to standard classification systems; performs the most advanced medical records coding and abstraction duties; performs data quality reviews and prepares complex reports as required; and performs other related duties as assigned. Principal Accountabilities include promoting Coding Audit department goals by selecting, motivating, and training capable team members, leading the activities of assigned Coding Audit team members by communicating and providing guidance toward achieving department objectives, assisting in analyzing common operational definition of metrics and assisting in the development of regional reports to monitor individual hospitals in one database and developing processes to integrate clinical department managers in correction and resubmission of medical records, assisting with the development of tools to track performance...

divh2Provider Liaison - Certified Professional Coder (CPC) / Certified Coding Specialist (CCS)/h2pA Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing./ph3Job Description/h3pOne of our direct client is looking for potential candidate with the below mentioned skills/ppDirect Client: Immediate Interview/ppContract to Hire/ppPosition: Provider Liaison/ppMUST HAVE:/pulli5 years of experience into Project Management/liliAt least 2 years of experience after CPC or CCS certification/liliBachelors degree is a must/li/ulpCertifications/ppAAPC Certified Professional...

divh2Certified Professional Coder (CPC) Lead/Provider Liaison/h2pA Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing./ppThis is Contract position with my direct client/ph2Job Description/h2pDirect Client Need- Immediate Interviews- We have a strong hold, with many consultants working onsite! Location could be: Newark, NJ OR West Trenton OR Ewing OR Wall, NJ/ppDuration: Contract to Hire/ppJob Summary:/ppThe Provider Liaison is accountable for extracting insights specific to providers and provider groups regarding commercial risk adjustment and developing...

Position Summary The Outpatient Coding Auditor is responsible for auditing coded outpatient medical records to ensure compliance with official coding guidelines, regulatory agencies, and internal policies. This role supports coding accuracy, education, and process improvement through detailed review of encounters, identification of trends and variances, and communication with coding staff and leadership. This position also collaborates with external vendors to monitor performance and incorporate industry best practices into audit feedback and education. Education High school diploma or equivalent required. Experience Minimum of 5 years of experience in hospital auditing or education experience ICD-10-CM and Outpatient CPT-4, HCPCs coding experience required. Knowledge of Medical Necessity APC,OCE, LCD, and NCD edits required. 3M Encoder experience, Meditech, EPIC, or CERNER preferred. Skills CCS or COC, CPC, RHIT, RHIA required. Knowledge of ICD-10-CM, CPT-4 and HCPCs coding,...

Overview New Jersey’s largest Vascular Surgery group dedicated solely to the diagnosis and management of diseases of the arteries and veins. The Group has been delivering care throughout New Jersey since 1963 and is home to some of the best Vascular Surgeons in the country. Consistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Position Summary We are seeking an experienced Senior Vascular Surgery Professional Coder with strong expertise in complex open and endovascular procedure coding, payer authorization workflows, and revenue cycle support. This role is responsible for accurate CPT, ICD-10-CM, and modifier assignment for a high-volume vascular surgery practice with extensive cardiovascular, endovascular, catheter-based, and imaging-guided procedural work. The position also supports prior...

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...

Virtua Health Coding SpecialistAt Virtua Health, we exist for one reason to better serve you.That means being here for you in all the moments that matter, striving each day to connect you to the care you need.Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between we are your partner in health devoted to building a healthier community.If you live or work in South Jersey, exceptional care is all around.Our medical and surgical experts are among the best in the country.We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home.A Magnet-recognized health system ranked by U.S.News and World Report, we've received multiple awards for quality, safety, and outstanding work environment.In addition to five hospitals, seven emergency departments,...

Position Summary The Member Experience Clinical Coder & Medical Biller serves as a key contributor to internal medical billing review, payment integrity, and claims adjudication. Responsible for reviewing, validating, and repricing claims on behalf of payers, providers, and claim audit partners to support accurate reimbursement and strengthen payment integrity for our self‑insured clients. Translate medical diagnoses, procedures and services into standardized coding while ensuring compliance with established guidelines and reimbursement methodologies. Collaborate closely with providers, Third-Party Administrators (TPAs), and other stakeholders to identify coding discrepancies, provide analysis, and communicate findings that drive informed decision‑making and optimal claim outcomes. Key Responsibilities Medical Coding & Documentation Review Receive, analyze, and verify patient medical records for accuracy, ensuring all required information is present for proper billing and...

New Jersey's largest Vascular Surgery group dedicated solely to the diagnosis and management of diseases of the arteries and veins. The Group has been delivering care throughout New Jersey since 1963 and is home to some of the best Vascular Surgeons in the country. Consistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Position Summary: We are seeking an experienced Senior Vascular Surgery Professional Coder with strong expertise in complex open and endovascular procedure coding, payer authorization workflows, and revenue cycle support. This role is responsible for accurate CPT, ICD-10-CM, and modifier assignment for a high-volume vascular surgery practice with extensive cardiovascular, endovascular, catheter-based, and imaging-guided procedural work. The position also supports prior...

Senior Vascular Surgery Professional Coder New Jersey's largest vascular surgery group dedicated solely to the diagnosis and management of diseases of the arteries and veins. The Group has been delivering care throughout New Jersey since 1963 and is home to some of the best vascular surgeons in the country. Consistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Position Summary: We are seeking an experienced Senior Vascular Surgery Professional Coder with strong expertise in complex open and endovascular procedure coding, payer authorization workflows, and revenue cycle support. This role is responsible for accurate CPT, ICD-10-CM, and modifier assignment for a high-volume vascular surgery practice with extensive cardiovascular, endovascular, catheter-based, and imaging-guided procedural...

Provider Liaison - Certified Professional Coder (CPC) / Certified Coding Specialist (CCS) A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description One of our direct client is looking for potential candidate with the below mentioned skills Direct Client: Immediate Interview Contract to Hire Position: Provider Liaison MUST HAVE: 5 years of experience into Project Management At least 2 years of experience after CPC or CCS certification Bachelor's degree is a must Certifications AAPC Certified Professional Coder (CPC) or...

Certified Professional Coder (CPC) Lead/Provider Liaison A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. This is Contract position with my direct client Job Description Direct Client Need- Immediate Interviews- We have a strong hold, with many consultants working onsite! Location could be: Newark, NJ OR West Trenton OR Ewing OR Wall, NJ Duration: Contract to Hire Job Summary: The Provider Liaison is accountable for extracting insights specific to providers and provider groups regarding commercial risk adjustment and developing educational...

Become a part of our caring community 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 increasing the accuracy of...

Certified Professional Coder The Certified Professional Coder (CPC) serves as the primary liaison between the medical group and the external coding vendor. This role ensures consistent communication, accurate and compliant coding practices, timely issue resolution, and alignment with organizational policies and payer requirements. The Coding Liaison supports documentation integrity, monitors vendor performance, and acts as a subject matter expert for coding-related inquiries. This role works closely with providers, clinical staff, and revenue cycle teams to review medical records, validate documentation completeness, apply correct CPT®, ICD-10-CM, and HCPCS codes, and educate providers on documentation best practices. Key Responsibilities Coding and Documentation Accuracy Serve as the primary point of contact between the medical group and the outsourced coding vendor Review, monitor, and validate coding accuracy and consistency between internal standards and vendor...

API Lead Engineer As Lead Enterprise API & Platform Engineer, you will lead the design and delivery of enterprise technology platforms with a focus on API-first architecture, AI-native enablement, and modernization. You will develop and execute the key technology components of the API Hub Services and ensure alignment with Client's emerging API centric modernization strategy. You will work closely with other principals and senior strategic leaders to drive alignment with overall enterprise business and technology strategy and will guide engineering organizations to continually improve engineering practices and implementation outcomes. You are a results-oriented technical leader skilled at turning concepts into scalable solutions. Collaborates well across teams to ensure excellent delivery. Passionate about new technologies and improving developer experience. Self-driven, with strong technical leadership and a focus on process and quality. · Lead API and Platform Strategy:...

Wakefern Food Corp. is the largest retailer-owned cooperative in the United States and supports its co-operative members' retail operations, trading under the ShopRite®, Price Rite®, The Fresh Grocer®, Dearborn Markets®, Fairway Markets®, Gourmet Garage®, and Morton Williams® banners. Employing an innovative approach to wholesale business services, Wakefern focuses on helping the independent retailer compete in a big business world. Providing the tools entrepreneurs need to stay a step ahead of the competition, Wakefern’s co-operative members benefit from the company’s extensive portfolio of services, including innovative technology, private label development, and best in class procurement practices. The Quality Assurance Supplier Compliance Auditor is responsible for managing compliance programs for Wakefern Own Brands suppliers. This role develops and maintains an approved supplier program based on regulatory and corporate requirements to mitigate risk and ensure Wakefern and its...