20 coding auditor jobs found

Become a part of our caring community and help us put health first Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Durable Medical Equipment (DME) auditing and is part of the PPI Coding Disputes Team with Humana. The Disputes Auditor - DME Outpatient Coding on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient DME coding disputes and expertise in...

LPS (Learning & Performance Solutions) QA Inpatient Coding Auditor Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The LPS (Learning & Performance Solutions) QA Inpatient Coding Auditor will provide expert coding audit services across various acute hospital organizations for inpatient services. Review medical record documentation and related coding of inpatient encounters utilizing the ICD-10-CM/PCS classification and CMS MS-DRG system. Verify coding accuracy and that coders base code assignment in a manner consistent with relevant laws,...

Description The Coding Auditor/Educator - Multi-specialty will assure consistent quality coding and training in evaluation and management, office procedures, and surgical coding through ongoing internal audits, training and education while adhering to official coding guidelines, in support of federal, state, local, and department requirements. This is a full-time role, flexible, remote, core business hours, 8:00 AM - 4:30 PM office out of Bloomington, MN. Revo Health is a professional services company that partners with multiple healthcare groups to deliver exceptional patient care. This position will be employed through Revo Health, working closely with Infinite Health Collaborative (i-Health) and its operating divisions. Essential Functions: Training and development of current and newly hired remote and on-site coding team members. Perform quality assurance reviews to assess comprehension of training efforts. Training and continued development based upon internal and...

Be Part of an Extraordinary Team Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, and is determined to recover, eliminate and prevent unnecessary medical?expense spending. Build the Possibilities. Make an Extraordinary Impact. Title DRG Coding Auditor (ICD?9/10CM, MS?DRG, AP?DRG, APR?DRG) Work Environment 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. 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. Alternate locations may be considered if...

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...

The Coding Auditor/Educator - Multi-specialty will assure consistent quality coding and training in evaluation and management, office procedures, and surgical coding through ongoing internal audits, training and education while adhering to official coding guidelines, in support of federal, state, local, and department requirements. This is a full-time role, flexible, remote, core business hours, 8:00 AM - 4:30 PM office out of Bloomington, MN. Revo Health is a professional services company that partners with multiple healthcare groups to deliver exceptional patient care. This position will be employed through Revo Health, working closely with Infinite Health Collaborative (i-Health) and its operating divisions. Essential Functions: Training and development of current and newly hired remote and on-site coding team members. Perform quality assurance reviews to assess comprehension of training efforts. Training and continued development based upon internal and...

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...

A healthcare organization in Minnesota is seeking a professional to conduct medical record audits and ensure compliance with established guidelines. The ideal candidate will need 7+ years of experience in billing and coding, with a preference for CPC certification. Responsibilities include auditing electronic medical records, training providers on documentation, and maintaining detailed records. The position offers a competitive salary range of $75,000 - $95,000 annually, along with a comprehensive benefits package. #J-18808-Ljbffr

Join Datavant, a pioneering data platform company transforming health data exchange. Our mission is to ensure that every healthcare decision is guided by accurate data at the right moment and in the most useful format. As a leading health data network, our platform offers secure, accessible, and actionable data, empowering various healthcare stakeholders, including life sciences firms, government agencies, and care providers. By becoming part of Datavant's high-performing and values-driven team, you'll play a vital role in creating innovative technology solutions that tackle significant challenges in healthcare. We celebrate a diverse team bringing together a wealth of professional, educational, and personal experiences to achieve our ambitious goals in the healthcare sector. Key Responsibilities: Conduct thorough audits of coded medical charts according to specific client guidelines as directed by the quality supervisor. Efficiently navigate and apply various client...

Your Future Evolves Here Evolent is on a mission to transform healthcare for individuals with complex and costly conditions. By collaborating with health plans and providers, we aim to create a more integrated healthcare system that offers high-quality care and compassion, just as we would want for our loved ones. We value work/life balance, offering flexible schedules that allow you to tailor your work to your life. Our commitment to diversity and inclusion ensures that you can bring your whole self to work. Join Evolent not only for the impactful mission but also for a supportive and inclusive culture. What You'll Be Doing: As a Program Integrity Coder and FWA Auditor, you will play a crucial role in ensuring the integrity of claims by reviewing and verifying complex claim submissions for compliance with coding standards and billing guidelines. You will foster meaningful partnerships with both internal and external stakeholders while thriving in a collaborative...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

Position Type Full Time Description Work Where You Matter! At St. Croix Hospice we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient’s quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Compliance Auditor (Clinical) Position Overview The Compliance Auditor is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that St. Croix Hospice complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations while collaborating with leadership...

Work Where You Matter! At St. Croix Hospice we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient's quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Compliance Auditor (Non-Clinical) Position Overview The Compliance Auditor is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that St. Croix Hospice complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations while collaborating with leadership to mitigate risks and strengthen...

Work Where You Matter! At St. Croix Hospice we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient's quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Compliance Auditor (Clinical) Position Overview The Compliance Auditor is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that St. Croix Hospice complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations while collaborating with leadership to mitigate risks and strengthen...

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...

Join Senior CommUnity Care as a Medical Coder - Risk Adjustment Specialist and partner directly with physicians and Medical Directors to improve documentation, support CMS reporting, and strengthen value-based care for older adults in the PACE program. Medical Coder - Risk Adjustment Specialist- Remote Schedule: M-F 8:00 AM-5:00 PM Salary: $58,000-$66,000 (Based on Experience) Essentials: Collaboration for Risk Adjustment Integrity: Works closely with Medical Directors and PACE providers to uphold the integrity and accuracy of the risk adjustment reporting process. Engages in continuous dialogue with healthcare professionals to ensure that coding accurately reflects participant acuity. Medication Documentation Review and Diagnostic Coding: Reviews and interprets provider documentation to extract critical information. Assigns ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures from documented information in the medical record. Assures the final...

Join Datavant, a pioneer in health data exchange, and help transform the future of healthcare decisions. Our innovative platform is dedicated to providing secure, efficient data delivery that enhances decision-making in the healthcare sector. In this role, you will become part of a vibrant, values-driven team that tackles complex challenges in healthcare utilizing the latest technology. We celebrate diverse experiences and work collaboratively to achieve our shared goals. What We’re Looking For: We are in search of certified and skilled inpatient coders who possess a strong attention to detail and a solid understanding of medical terminology. This fully remote position offers flexible hours, enabling you to work at your convenience while making a meaningful impact in healthcare! Your Key Responsibilities: Precisely assign diagnostic and procedural codes using ICD-10-CM and ICD-10-PCS codes. Abstract and sequence medical codes from patient records, ensuring...

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together. The Medical Coder performs concurrent review of FFS coding rules within Epic, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. Schedule : Monday to Friday, 8 AM- 5 PM Location : Remote Nationwide You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary...

The Medical Coding Specialist will evaluate medical records and encounters to ensure completeness, accuracy, and compliance with the International Classification of Diseases Manual - Clinical Modification (ICD-10-CM), and the American Medical Associations Current Procedural Terminology Manual (CPT). The Specialist will also provide technical guidance and training on medical coding to physicians and staff. Essential Functions Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions. Assign codes to diagnoses and procedures, using ICD-10 (International Classification of Diseases) and CPT (Current Procedural Terminology) codes Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations and meet current policy coding guidelines Communication and training with provider(s) on any documentation that is insufficient or unclear to meet current policy coding guidelines...

We are seeking a detail-driven and collaborative Risk Adjustment & Coding Manager to support our Senior CommUnity Care (PACE) programs. This role works closely with SCC Medical Directors and providers to ensure accurate capture and reporting of participant acuity through compliant diagnostic coding. The position plays a critical role in maintaining CMS compliance while directly supporting the financial integrity and performance of our PACE programs. About the Job: Works in concert with Senior CommUnity Care (SCC) Medical Directors and providers to ensure an accurate representation of participant acuity is captured through diagnostic coding and reported to CMS. Assists in the development and implementation of systems and processes to ensure the integrity of diagnostic coding and reporting, directly impacting the financial performance and compliance of the PACE programs. Acts as a liaison between PACE providers and contracted providers to ensure timely response to inquiries...