23 coding auditor jobs found

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...

DRG Coding Auditor Principal Virtual:? ?? This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group...

Job Description General Purpose of Job :   Ensure Revenue Cycle Coding and Billing are compliant with State and Federal regulations.  Respond to and Investigate compliance issues within Revenue Cycle.   Lead and/or coordinate audit activity with governmental audits.   Essential Duties : This job description is intended to cover the minimum essential duties assigned on a regular basis.  Team members may be asked to perform additional duties as assigned by their leader.  Leadership has the right to alter or modify the duties of the position. Ensures conformance with applicable laws, regulations and Medicare/Medicaid reimbursement rules to ensure UMHS is in compliance with federal, state and/or local regulations. Monitors, analyzes and reports on laws, regulations, audits and industry standards that impact the organization. Develops and maintains Professional and Hospital billing issues on the Revenue Cycle Compliance Work Plan. Reviews the OIG Work Plan,...

Description 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...

Description 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...

HIM Hospital Inpatient & Same Day Surgery Coding Analyst 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...

Ambulance Billing Coder Michigan residents only. Join the team that is redefining how EMS and mobile healthcare is delivered in Michigan. Medstar provides 911 service to more communities in Southeast Michigan than any other provider, and our critical care, air medical, and inter-facility partnerships continue to grow throughout the region. We are currently looking to add an experienced ambulance billing coder to the Medstar team! If you are looking for a fast-paced, strategic atmosphere to call home, Medstar may be the place for you. This position can be in office, hybrid or remote for individuals located in Michigan. Job Summary The biller will input all claim information following the CMS coding guidelines. Provides accurate patient demographic and insurance information and inputs information into patient record. Essential Duties and Responsibilities Review patient care reports thoroughly, utilizing all available documentation in order to establish medical necessity,...

Coding Specialist Assigns ICD diagnosis and CPT procedure codes to assigned Outpatient work types. Employment Type: Full Time Weekly Scheduled Hours: Mon-Fri 7am-3:30pm Wage Range: $21.14-$31.70 Requirements: - High school diploma/GED, or higher education - Registered Health Info Tech (R-RHIT) required Preferred Requirements: - Registered Health Info Admin (R-RHIA) - Certified Coding Specialist (C-CCS) Coding: Based on clinical documentation, computerized encoding, accepted coding classification principals, and reference material, efficiently and accurately assigns appropriate ICD diagnosis codes CPT procedure codes and modifiers on assigned chart types. Verifies accuracy of completed fields. Maintains credentials and ongoing education in order to apply current policies and principals for accurate coding. Assigns appropriate ICD codes. Assigns appropriate CPT codes. Assigns appropriate Modifiers on APC accounts. Searches chart documentation for appropriate code...

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. Position Overview: The Special Investigations...

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...

Job Description Job Description 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:...

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...

Positions Location: Lansing, MI Job Description General Purpose of Job :   Ensure Revenue Cycle Coding and Billing are compliant with State and Federal regulations.  Respond to and Investigate compliance issues within Revenue Cycle.   Lead and/or coordinate audit activity with governmental audits.   Essential Duties : This job description is intended to cover the minimum essential duties assigned on a regular basis.  Team members may be asked to perform additional duties as assigned by their leader.  Leadership has the right to alter or modify the duties of the position. Ensures conformance with applicable laws, regulations and Medicare/Medicaid reimbursement rules to ensure UMHS is in compliance with federal, state and/or local regulations. Monitors, analyzes and reports on laws, regulations, audits and industry standards that impact the organization. Develops and maintains Professional and Hospital billing issues on the Revenue Cycle Compliance Work Plan....

Job Description Job Description About the Role: The Medical Biller Supervisor for Home Health (Homecare Homebase) plays a critical role in overseeing the billing operations within a home health care setting. This position ensures accurate and timely submission of medical claims, optimizing revenue cycle management while maintaining compliance with healthcare regulations. The supervisor leads a team of billers, providing guidance, training, and performance evaluations to enhance productivity and accuracy. They collaborate closely with clinical, administrative, and insurance teams to resolve billing issues and improve processes. Ultimately, this role drives financial performance by ensuring efficient billing practices and minimizing claim denials and delays. Minimum Qualifications: High school diploma or equivalent; Associate’s or Bachelor’s degree in healthcare administration or related field preferred. Minimum of 3 years of experience in medical billing within a home...

Certified Coder - Billing Onsite - Royal Oak, MI About Sciometrix Sciometrix is a leading digital Health company looking for RN Case Manager Spanish. We are a leader in Telehealth -healthcare Virtual care Management. Our mission to engage patients to Deliver better outcomes. Sciometrix is known among customers, peers, and patients for clinical excellence, patient experiences, and provider satisfaction. Since the inception of our patient count, technological solutions have been evolving. We empower healthcare providers with advanced technology and human expertise, revolutionizing a patient's experience. Our propriety software and related technologies ensure HIPAA compliancy with cloud access. We have established HIPAA-compliant Clinicus, an artificial intelligence (AI) bot that monitors patients 24/7 and ensures fast response in their care management program. Clinicas watches each patient's vitals and alerts our licensed team when a patient's program progress or vitals are...

Benefits: 401(k) Dental insurance Health insurance Paid time off Parental leave Vision insurance WRS US Workers Billing offers a team-oriented and sales-driven culture focused on enriching our patients lives. As our medical billing team grows, we are looking to add a team member with a strong background in medical billing, customer service, and communication with third party adjusters. The ideal candidate will possess strong knowledge in these areas along with the ability to multi-task while staying organized. The WRS culture is one of caring and collaboration, and our team members enjoy working in a fast-paced, team-oriented environment. If this sounds like your ideal work environment, take a look at the job description below and apply today! Role and Responsibilities Audit records to ensure proper submission of services prior to submitting claim to payer Supply correct ICD-10-CM diagnosis codes on all claims Supply correct CPT code on all DME procedures and...

Benefits: 401(k) Dental insurance Health insurance Paid time off Parental leave Vision insurance WRS US Workers Billing offers a team-oriented and sales-driven culture focused on enriching our patients lives. As our medical billing team grows, we are looking to add a team member with a strong background in medical billing, customer service, and communication with third party adjusters. The ideal candidate will possess strong knowledge in these areas along with the ability to multi-task while staying organized. The WRS culture is one of caring and collaboration, and our team members enjoy working in a fast-paced, team-oriented environment. If this sounds like your ideal work environment, take a look at the job description below and apply today! Role and Responsibilities Audit records to ensure proper submission of services prior to submitting claim to payer Supply correct ICD-10-CM diagnosis codes on all claims Supply correct CPT code on all DME...

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...

This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third-party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities. General responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks. Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days. Accurately post all insurance payments by line item. Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely* Collects on outstanding claims from third-party payers according to department benchmarks. Works on special billing projects as assigned by the Billing Supervisor in...

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,...

Overview The Professional Coder provides timely and accurate clinical and administration data to ensure optimal reimbursement for professional services performed at acute care, inpatient, outpatient, urgent care or physician offices to meet organizational needs. This position is responsible for ICD10CM diagnosis, CPT-4 coding and charge entry related to coding, documentation, billing and reimbursement issues. Works as a liaison between centralized billing staff, practice managers and office staff and may be required to meet with the office staff and physicians as needed. This position is responsible for the monitoring the quality of coding and stays current on professional coding changes, compliance issues, billing, documentation, reimbursement and interpretation of coding/documentation rules. Primary patient contact is only social. He/she demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards...

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...

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...