120 coding auditor revenue management jobs found

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength...

CBO Coding Auditor/Educator Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing internal and external reporting and compliance with the Official Coding Guidelines for Coding and Reporting payer regulations and Clinic/hospital policy. Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure compliant coding and billing practices. Educates and trains coders to ensure both a working knowledge of coding and reimbursement guidelines and successful career ladder completion including the development of training materials and reference documents. Researches audit results error reports and denials and resolves by successful appeal staff education and correction of discrepancies. Serves in an educational and advisory capacity to the coding staff clinical staff and physicians as it relates to...

Job Summary: HIM Coding auditor/trainer will coordinate, monitor, and audit documentation and coding of inpatient and/or outpatient services in all applicable health care settings. Audits will focus on correct assignment of CPT, ICD-10, ICD-9- CM, HCPSC codes and clinician documentation to ensure that Kaiser Permanente is compliant with all regulatory guidelines and internal controls. Audits will encompass internal practitioners, contracted practitioners, coders, internal facilities and contracted facilities. The auditor will analyze audit results, identify patterns, trends or variations in coding and documentation practices and make recommendations for improvement. When necessary, this position will initiate corrective action plan to ensure resolution of problem areas identified during auditing and monitoring activity. This position will serve as a liaison with HIM staff, Revenue Cycle, External and Internal practitioners, and other regional departments as appropriate including...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength...

CCL Certified Professional Coder-Auditor The CCL Certified Professional Coder-Auditor jobs in this function provide coding and coding auditing services directly to providers. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Translate Medical Terminology into Medical Codes: Leverage understanding of disease process to identify and extract relevant details and data within clinical documentation and make determinations or identify appropriate medical codes Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code applicability, rules, and guidelines Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and...

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Hospital Coding Auditor, you will review hospital charges against medical record and all applicable documentation to determine appropriate code assignments on services provided (CPT / HCPCS codes). The Auditor must have a comprehensive understanding of medical terminology, coding, contractual agreements, and various payment methodologies. This position requires good time management skills and the ability to work independently. Here's what you will experience working as a Hospital Coding Auditor Review hospital charges against medical record and all...

PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYAs Revenue Integrity team in a quality assurance and project management role. RESPONSIBILITIES: Responsible for the accurate quality assurance review of PYA coding audits, as well as coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength in E/M and surgical coding, especially cardiology and orthopedic surgery. Expertise in facility inpatient and outpatient coding auditing is preferred but not required. The Consultant will assist PYA clients with provider documentation improvement, reviews for billing and other regulatory compliance with third...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength...

Job Type: Full-timeLocation: Hybrid, requiring 2 to 3 days in the officeJob Title: Revenue Cycle Risk AuditorWe are seeking a detail-oriented Revenue Cycle Risk Auditor to join our team. This role is essential in supporting our internal audit functions and compliance efforts by conducting risk-based audits, primarily focused on anesthesia coding, documentation, and billing. Under the direction of the Compliance Risk Manager, the Revenue Cycle Risk Auditor will ensure adherence to regulatory standards, identify trends, and support provider education.Key Responsibilities:- Conduct internal coder audits and concurrency reviews to ensure compliance with regulatory standards.- Generate operational reports to identify trends and areas for improvement.- Collaborate with the Compliance Risk Manager to develop and implement audit strategies.- Provide education and support to providers regarding coding and documentation best practices.Qualifications:- 2-4 years of coding experience, with 2-3...

Join Our Team at Skin and Cancer Institute! Are you passionate about dermatology and skin health? Do you thrive in a dynamic, patient-focused environment? Skin and Cancer Institute is looking for dedicated professionals to join our team! Why Join Us? At Skin and Cancer Institute, we are committed to excellence in dermatology, skin cancer treatment, and cosmetic procedures. We offer a supportive and collaborative work culture where your skills and dedication make a real impact. What You’ll Do: The Medical Coding Auditor is responsible for reviewing medical records to ensure accurate coding and compliance with regulatory requirements. This role ensures continuous quality improvement in coding practices while maintaining compliance with healthcare laws and organizational policies. The Medical Coding Auditor partners with practices, providers, and other departmental leaders to provide education regarding medical coding and documentation as required by current CMS regulations. The...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. General Description of the Job ClassCoordinate /review the work of vendor outsourcing partners and assist with the training and continuing education programs. Code medical records utilizing ICD-9-CM/ICD-10-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures, and appropriate/optimal reimbursement professional...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength...

Quality Assurance Nurse Auditor / Nurse Analyst / Coding Auditor PYA is seeking a Quality Assurance Nurse Auditor/Nurse Analyst/Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will be a member of the Revenue and Compliance Advisory Team . RESPONSIBILITIES Provide advisory services to ambulatory care, acute care, and post-acute care organizations, including documentation review and improvement for: Medical Necessity Level of Care Appropriateness of service and service location Billing documentation requirements and analysis of UB-04, Remittance Advices and Itemized Bills Assist with coding compliance reviews including professional, hospital outpatient, and inpatient hospital services Assist with regulatory compliance for Medicare, Medicaid, and third-party payers to include ambulatory, acute care (inpatient and outpatient), rehabilitation, and behavioral health services...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength...

Candidates must reside either in Washintgon or Oregon to be considered for this position. To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP),...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength...

El Camino Health is committed to hiring, retaining and growing the best and brightest professionals who will carry our mission and vision forward. We are proud of our reputation in the community: One built on compassion, innovation, collaboration and delivering high-quality care. Come join the team that makes this happen. Applicants MUST apply for position(s) by submitting a separate application for each individual job posting number they are interested in being considered for. FTE 1 Scheduled Bi-Weekly Hours 80 Work Shift Day: 8 hours Job Description The Professional Coding Auditor performs reviews for professional/clinic based clinic visits and hospital setting claims reviewing provider's diagnosis and procedural coded claims in ensuring coded data is in compliance with Official Coding Guidelines and American Medical Association CPT/HCPCS procedural coding conventions. The role of the auditor is to educate providers performing services in clinic base and...

Job Description Job Description TTF is recruiting for DRG Auditors who have worked in Inpatient Revenue Integrity to work remotely for a company based out of the Southwest. We are seeking individuals with experience in CDI with either CCDS, CCS, or RHIT certifications.   This is a full-time, direct-hire role, where you can work anywhere in the United States. The starting salary is $46-$52/hour and comes with full benefits.   Qualified candidates must have: •CCDS, CCS, or RHIT certifications and education as a Registered Nurse •Five years acute care coding experience •Prior experience as CDI/Coding Auditor is preferred but not required For consideration, please send resumes to Jason at ggreer@ttfrecruit.com and Todd at tdixon@ttfrecruit.com.   TTF is a healthcare search and staffing company that partners with hospitals, physician groups, TPA's, medical management companies, pharmaceutical and pharmacy benefit plan organizations, surgery centers, DME/home health, consulting...

Job Description Job Description Description: About Jordan Valley Community Health Center: Jordan Valley Community Health Center (JVCHC) is a mission-driven organization dedicated to improving the health of individuals and families in underserved communities. We provide comprehensive healthcare services including primary medical, dental, vision, and behavioral health. Our mission is simple: Improve our community’s health through access and relationships. By working collaboratively with partners and continually innovating, JVCHC strives to be a leader in providing essential healthcare for the underserved, ensuring everyone in our community has access to quality healthcare. Job Summary: The Compliance Auditor is responsible for conducting E&M audits and ongoing review of 340B pharmacy program utilizing established criteria and auditing tools. The Compliance Auditor will be responsible for additional operational and compliance auditing processes to include...

Job Description Job Description Quadris Team, LLC - A Revenue Cycle Management Group, is searching for a dynamic person to join us, working with our highly skilled Medical Coding Team to fill the role of Senior Coding Auditor/Educator . We are a 100% remote team supporting our clients across the United States! See us at www.quadristeam.com. Job Focus: The Senior Coding Auditor may be responsible for a variety of duties and obligations, depending on the client and assignment. These responsibilities may include inpatient/outpatient/professional fee facility auditing, denial management, coding, implementation specialist, job aid creation, training, and specialty coding. The position may also be responsible for management of the audit team and project management. All coding and auditing are performed within the scope of regulatory and compliance law expectations. Auditing Responsibilities: May include conducting inpatient, outpatient and pro fee coding audits and...

Job Description Job Description TTF is recruiting for DRG Auditors who have worked in Inpatient Revenue Integrity to work remotely for a company based out of the Southwest. We are seeking individuals with experience in CDI with either CCDS, CCS, or RHIT certifications. This is a full-time, direct-hire role, where you can work anywhere in the United States. The starting salary is $46-$52/hour and comes with full benefits. Please send your resume to Jason Greer at jgreer@ttfrecruit.com for consideration. Qualified candidates must have: •CCDS, CCS, or RHIT certifications •Five years acute care coding experience •Prior experience as CDI/Coding Auditor is preferred but not required For consideration, please send resumes to Chelle at CBodnar@TTFrecruit.com TTF is a healthcare search and staffing company that partners with hospitals, physician groups, TPA's, medical management companies, pharmaceutical and pharmacy benefit plan organizations, surgery centers, DME/home health,...

Job Description Job Description About Legent Health At Legent Health , our mission is simple yet profound: “To provide first-class health care that puts YOU first.” Our vision reflects our commitment to excellence: “Through robust physician partnerships, become a nationwide leader in compassionate, quality healthcare focused on the patient and available to everyone.” Our values, also known as our brand pillars, define how we stay true to our identity in the healthcare industry and the communities we serve. These values are central to everything we do: Respect: We honor the time and trust of both patients and physicians by delivering organized, efficient services that ensure a seamless healthcare experience. Service: We are committed to highly personalized care for patients, their families, and the physicians who serve them, driving optimal outcomes for all. Leadership: We strive to be a trusted leader through innovation, clear communication, and...