14 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...

Join Datavant, a leading data platform company revolutionizing health data exchange. Our mission ensures that every healthcare decision is guided by the right data at the right time and in the right format. As the world's foremost health data network, our platform enables secure, accessible, and actionable data, empowering healthcare stakeholders including life sciences firms, government agencies, and care providers. By becoming part of Datavant's high-performing, values-driven team, you'll contribute to innovative technology solutions that address some of healthcare's most challenging issues. Our diverse team brings various professional, educational, and life experiences together to achieve our ambitious goals for the healthcare sector. What You'll Be Doing: Conduct audits of coded medical charts according to the client's guidelines as assigned by the quality supervisor. Navigate multiple client guidelines with ease. Maintain a 95% quality average at the...

At Revere Health, we believe there is a better path to healing and healthcare maintenance, and we're working on this mission-one patient at a time. We're a national leader in a movement called value-base care which aims to improve treatment outcomes and keep costs down. Our internal culture is one that promotes respect and consistently recognizes the impact that individual employees have on the mission of the organization. Position Summary: The Revenue Compliance Auditor supports the compliance program by identifying revenue leakage, underpayments, and reimbursement risk related to coding, documentation, and billing workflows. This role ensures compliance findings translate into financial and operational outcomes. Essential Job Functions: • Analyzes underpayments, denials, and payer adjudication patterns. • Researchs accounts to identify missed or incorrect reimbursement. • Tracks financial impact of compliance findings. • Identifies workflow gaps that lead to revenue loss or...

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...

Datavant is a leading data platform company revolutionizing health data exchange. Our mission is to ensure that every healthcare decision is made with the right data, delivered timely and in the appropriate format. Powered by the most extensive health data network in the U.S., our platform guarantees secure, accessible, and usable data to enhance health decisions. We are proud to be trusted by the foremost life sciences organizations, government bodies, and healthcare providers. By joining our team, you will be part of a high-performing and values-driven culture. Together, we are addressing some of healthcare's most challenging issues with innovative technology solutions. We embrace a diverse array of professional and personal experiences among our team members as we pursue our ambitious goals for healthcare. What We're Seeking We are on the lookout for seasoned and certified inpatient coders to join our team. The perfect candidate will have exceptional attention to...

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...

Abstractor/Coder The University of Chicago Physicians Group (UCPG) team is responsible for the overall management of clinical revenue for physician billing. This includes frontend revenue capture, working of edits and conducting audits for physician education. Ensuring the workflow of charge capture through invoice creation. UCPG is seeking an Abstractor/Coder to work with providers and staff on professional billing and compliance activities. Strong knowledge of evaluation and management coding guidelines and requirements is strongly preferred. This position is eligible for a flexible work arrangement. Responsibilities: Obtain appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses, and physician visits. Analyze denial and rejection reports, and appeal wherever appropriate. Submit charges in a timely manner. Work in collaboration with the Clinical Revenue Supervisor and others, provide guidance to faculty and staff on...

Team Lead Coder Coding Validation The Team Lead Coder Coding Validation position will have responsibility for supervising a team of Coding Validation analysts or coders. Team Leaders ensure that the work of others meets productivity standards, quality and client guidelines. Primary responsibilities include queue management, work distribution, performance and production optimization, audit planning, coder interactions, training of new hires/existing staff, on appeals support while meeting SLA obligations. The Team Lead goal is to ensure the team audits client data on behalf of our clients, generating high quality payment determinations and displays professional skepticism that enhances the work performed in order to achieve success in position. Responsibilities: Oversee onshore/offshore Coder Coding Validation team(s) in reviewing claims and producing well written appeals consistent with high level of integrity and meeting metrics Provides support needed to review quality...

Abstractor/Coder The University of Chicago Physicians Group (UCPG) team is responsible for the overall management of clinical revenue for physician billing. This includes frontend revenue capture, working of edits and conducting audits for physician education. Ensuring the workflow of charge capture through invoice creation. UCPG is seeking an Abstractor/Coder to work with providers and staff on professional billing and compliance activities. Strong knowledge of evaluation and management coding guidelines and requirements is strongly preferred. This position is eligible for a flexible work arrangement. Responsibilities: Obtain appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses, and physician visits. Analyze denial and rejection reports, and appeal wherever appropriate. Submit charges in a timely manner. Work in collaboration with the Clinical Revenue Supervisor and others, provide guidance to faculty and staff on...

Coding Validation Coder I Cotiviti has multiple openings for full-time coders. These roles will focus on claims audits for appeals, checking for completeness and accuracy based on coding guidelines. Experience with EandM coding and auditing is preferred. These are full-time remote positions and can be done anywhere within the continental US and will work a traditional day time schedule. Responsibilities: Perform daily audits on provider appeals for completeness and accuracy based on specified coding guidelines to ensure appropriateness for reimbursement. Apply client specific coding guidelines when applicable. Learns new appeal categories as production need requires. Stays current on coding guidelines appropriate to the position. Uses the Cotiviti applications to processes CV appeals to meet both production and accuracy standards. Reviews quality feedback from QA. Submits questions for clarification as needed. Utilizes the 'QA Resolution' process when disagreement...

Job Description: 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 including governmental and/or...

Job Type Part-time Description The Coder is responsible for reviewing clinical documentation and assigning accurate CPT, ICD-10, and HCPCS codes for services provided by pediatricians and other healthcare providers at Utah Valley Pediatrics. This role ensures that all coding is compliant with current guidelines and supports timely and accurate billing and reimbursement. Requirements Essential Behaviors and Characteristics: Exhibits a caring, positive, and cheerful attitude; is adaptable, positive and supportive, even during stressful situations. Treats everyone with the utmost respect and courtesy. Recognizes and supports the contributions of others, and shows patience and kindness in helping others as they learn and grow. Speaks positively and respectfully of others. Is honest in all of their dealings. Stays on task and uses time at work to benefit patients, coworkers, providers, and the company as a whole. Their actions reflect positively on Utah Valley...

Ambulatory Surgery Center (ASC) Cardiology Coder MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and above all excellent customer service. MedHQ, LLC, is a 2022 Becker's Top 150 Places to Work in Healthcare company. We believe our quality of service begins with our quality of team member. We offer exceptional benefits and working environments to exceptional employees. Position Summary The Ambulatory Surgery Center (ASC) Cardiology Coder is responsible for accurately reviewing,...

Tanner Clinic has an immediate opening for a full-time Coder position. This position is not remote and is located at our Kaysville Business Office. Essential Job Responsibilities: Responsible for maintaining coding compliance for multi-specialty clinic. Audit procedure and diagnostic codes for accuracy, detail and comprehensive description of clinical procedures Responsible for maintaining current ICD-9, ICD-10, CPT and coding skills Use word processing, spreadsheet, database, and e-mail Ability to interpret and apply Medicare (CCI) and payer edits Other duties as assigned Requirements Education: High School diploma required Certified Professional Coder is required Experience: Coding experience preferred Other Requirements: Demonstrates knowledge of medical terminology Must have strong knowledge of computer and other office equipment Performance Requirements: Knowledge: Knowledge of billing practices and clinic policies...