1380 coding auditor jobs found

A regional healthcare provider is seeking a Professional Billing Quality Coding Auditor to ensure accurate coding and mentor coders. This role involves reviewing multi-specialty coding, presenting findings monthly, and facilitating training for coders. Applicants should hold a Bachelor's degree and have three years of relevant coding experience, along with the necessary CPC and CPMA certifications. Join us to transform healthcare and serve the community effectively. #J-18808-Ljbffr

Inspire health. Serve with compassion. Be the difference. Job Summary The Professional Billing Quality Coding Auditor will support the Medical Group Coding and Education department by performing routine reviews of coders to ensure accurate coding. This position will also perform specialty reviews as identified by Coding and Education leadership. Prepares a summary of findings and presents reports to leadership on a monthly basis. Will assist with training coders on identified opportunities for improvement. Will also assist in preventing coding denials when applicable. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Performs multi-specialty reviews for the Medical Group validating the CPT, ICD-10, modifiers and HCPCS codes using official coding guidelines and CMS guidelines and prepares a summary of findings. Performs review of all coders within the...

Inpatient Medical Coding Auditor Become a part of our caring community and help us put health first. The Inpatient Medical Coding Auditor reviews a variety of medical records and determines appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT). 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. The Inpatient Medical Coding Auditor confirms appropriate diagnosis related group (DRG) assignments upon appeal. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Work Style: Remote, work at...

WelbeHealth Paced Program WelbeHealth Paced program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for Paced Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits and participate in provider education programs to ensure compliance with CMS risk...

Welbehealth Pace Coding Auditor And Educator WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews...

Welbehealth Pace Coding Auditor And Educator WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews...

Medical Coding Auditor 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 (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...

Overview Health Ministries Clinic (HMC) is seeking a Coding Auditor (with PCP auditing experience) as a trusted expert to join our integrated care team in Newton, Kansas. This is a full-time, on-site position offering the opportunity to support patient care in a collaborative, mission-driven environment. We provide a full spectrum of services including behavioral health, lab, diagnostic, pharmaceutical and dental. We are seeking an experienced Coding Auditor with a multi-speciality coding background. The Coding Quality Auditor is responsible for ensuring Health Ministries Clinic's compliance with national coding guidelines, FQHC coding guidelines and regulations. The role minimizes coding errors and prevents fraudulent activities, ensures accurate and consistent coding which results in appropriate reimbursement and data integrity. This role requires the ability to detect and correct discrepancies and coding errors, provide feedback and collaborate across departments to correct...

A community health center in Newton, Kansas is seeking a Coding Auditor to join their team. This full-time, on-site position involves ensuring compliance with coding guidelines and minimizing errors. The ideal candidate will have expertise in ICD-10, CPT, and HCPCS codes, along with strong analytical skills. The clinic fosters a supportive environment with a focus on patient care and offers competitive benefits including medical insurance and retirement plans. #J-18808-Ljbffr

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose Responsible for developing, conducting, administering, and analyzing clinical coding training and auditing programs. The Senior Clinical Coding Auditor & Trainer will conduct audits of inpatient coding processes for Fidelis Care and assist in development of training and audit tools. The Senior Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Responsibilities Develop and maintain complex audit processes and audit tools related to inpatient coding. Develop and conduct clinical education courses for existing and...

A healthcare facility in Georgia seeks a Professional Coding Auditor/Education Specialist. This role requires Certified Professional Coder (CPC) certification and entails conducting audits, educating providers, and developing training materials. Candidates should have extensive knowledge of ICD-10, HCPCS, CPT, and relevant experience. This full-time position is on-site with no remote options available and includes comprehensive benefits such as healthcare, 401(k), and paid time off. #J-18808-Ljbffr

Inpatient Medical Coding Auditor Become a part of our caring community and help us put health first. The Inpatient Medical Coding Auditor reviews a variety of medical records and determines appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT). 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. The Inpatient Medical Coding Auditor confirms appropriate diagnosis related group (DRG) assignments upon appeal. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Work Style: Remote, work at...

Welbehealth Pace Coding Auditor And Educator WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews...

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 accuracy...

About Us All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients. ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. Our company is fully remote and offers a flexible work environment as well as schedules. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees. We also offer paid holiday, sick, birthday, and vacation time as well as a 410k matching plan. Additional employee paid coverage options available. Job Purpose The Medical Claims Coding Auditor supports the Managed Service Organization (MSO) by performing detailed medical claims reviews to ensure accuracy, compliance, and appropriate reimbursement across Medicare,...

Outpatient Coding Auditor – Surgical Specialty Join to apply for the Outpatient Coding Auditor – Surgical Specialty role at Home and Stone Investments. Location: Remote Employment Type: Full-Time / Contract (as applicable) Position Summary Sage Clinical RCM, LLC is seeking an experienced Outpatient Coding Auditor with a strong background in surgical coding. This role is responsible for auditing outpatient surgical encounters to ensure accurate code assignment, compliance with regulatory guidelines, and adherence to payer and client requirements. The ideal candidate has hands‑on experience auditing complex outpatient surgical cases and providing clear, constructive feedback to coding staff. Key Responsibilities Perform audits of outpatient surgical encounters, including operative reports and related documentation Validate accurate assignment of CPT, ICD‑10‑CM, modifiers, and applicable APCs Ensure compliance with CMS, payer, and official coding guidelines Identify trends,...

Senior Clinical Coding Auditor & Trainer You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for developing, conducting, administering, and analyzing clinical coding training and auditing programs. The Senior Clinical Coding Auditor & Trainer will conduct audits of inpatient coding processes for Fidelis Care and assist in development of training and audit tools. ***The Senior Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. *** Responsibilities: Develop and maintain complex audit processes and audit tools related to inpatient coding...

WelbeHealth Paced Program WelbeHealth Paced (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for Paced Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits and participate in provider education...

Coding Auditor (250002UP) Job Description Description The Coding Auditor demonstrates expertise in coding and billing compliance while performing audits to determine billing integrity of professional and facility/technical fees including detection and correction of documentation, coding and billing errors and/or medical necessity of services billed. Audits consist of evaluation of the adequacy and accuracy of documentation in support of services billed including ICD-10/CPT/HCPCS and other third party payor codes, DRG and EAPG assignments, medical necessity of the services, reimbursement overpayments and underpayments, and compliance with other documentation, coding and billing standards. The Coding Auditor applies standardized audit scoring methodology to consistently evaluate documentation and coding, and standardized audit findings methodology to report audit results. Qualifications Minimum Education Associate’s Degree. Candidates with 3 years of coding experience in lieu of...

Medical Coding Auditor 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 (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...

A leading children's hospital in Silver Spring, Maryland is seeking a Coding Auditor to ensure compliance in coding and billing practices. The ideal candidate will have an Associate's Degree or equivalent experience, along with certifications such as CCS or CPC. Responsibilities include performing audits, evaluating documentation and coding, and communicating effectively with team members. The position offers a salary range of $64,188.80 to $106,995.20, with additional job benefits in a full-time role. #J-18808-Ljbffr

WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits and participate...

Apply for the Coding Auditor, Physician Group role at ECU Health . Responsible for the creation and maintenance of audit and education programs that ensure success for all staff and employed providers, supporting accurate, compliant coding practices for ECU Health physicians in accordance with coding guidelines. Conduct internal audits of medical coding activities using concurrent, prospective, and retrospective models as appropriate. Review electronic health information to determine accuracy of coding, billing, and documentation, including validation of ICD‑10‑CM, CPT, HCPCS, and modifier assignments related to medical provider professional Part B services according to regulatory and institutional policy. Report findings, written and verbal, to leadership as necessary to include provision of corroborating regulatory or policy guidance. Maintain documentation of all audit activities and communicate findings to leadership. Utilize findings to generate topics for education and...

Welbehealth Pace Program WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits and...