25 coding auditor jobs found

Inpatient Medical Coding Auditor - PPI Coding Disputes Become a part of our caring community and help us put health first. The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate DRG and ICD-10-CM/PCS coding assignments for accuracy within the coding disputes team from a variety of medical records. The Disputes Auditor - MSDRG Inpatient Coding on the Disputes Team consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality. Responsibilities: Will be an experienced medical coding auditor with in-depth experience in inpatient coding audits (MSDRG/APDRG) Ensures overall accuracy and compliance of coding disputes reviews by adhering to all appropriate coding guidelines and communicates disputes outcomes to providers in a professional and concise manner. Leverages advanced auditing expertise to make coding...

Medical Coding Auditor 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. This position requires: An experienced medical coding auditor with in-depth experience in outpatient DME...

A leading healthcare company is seeking an experienced Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement. Responsibilities include ensuring accurate claims payments and conducting coding audits. The role is remote with occasional travel for training, offering a competitive salary between $71,100 - $97,800, plus bonus opportunities. Candidates should hold RHIA, RHIT, or CCS certification with a strong background in medical coding. Join us to help prioritize health for our consumers and staff. #J-18808-Ljbffr

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...

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...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

A healthcare organization in Kenosha seeks a Physician Coder/Auditor responsible for auditing provider documentation and ensuring compliance with coding standards. The role requires a minimum of 1-3 years of relevant experience and certification as a CPC, CCS, or equivalent. Candidates must have strong knowledge of CPT and ICD-10 codes, as well as proficiency in Microsoft Office. Excellent communication skills and the ability to interpret clinical documentation are essential. The position is on-site in Kenosha, Wisconsin. #J-18808-Ljbffr

Position Summary J2 Integrity Solutions is seeking a Senior Auditor of Coding Quality & Education to lead the review and evaluation of clinical coding accuracy, documentation integrity, and compliance with applicable coding guidelines and regulatory standards. This role serves as a subject matter expert in ICD-10-CM, CPT, HCPCS, modifier, and applicable CMS and payer-specific requirements, ensuring high-quality coding practices that support accurate professional billing and revenue integrity. In addition to performing complex professional audits across multiple specialties and services lines, the Senior Audit develops and delivers targeted education to coders, providers, and documentation staff to promote best practices, reduce denials, and support continuous improvement. The ideal candidate is highly analytical, detailed-oriented leader with a strong understanding of healthcare reimbursement, coding workflows, and training methodologies. This position plays a critical...

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings and...

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...

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world. At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you're interested in joining a health care system that is changing the face of care and well-being in our community, we...

A healthcare organization in Wisconsin is seeking a coding auditor to conduct billing and coding audits, provide training, and ensure compliance with regulations. The ideal candidate has extensive experience in procedural and diagnostic coding, with relevant certifications. Strong attention to detail and communication skills are essential. This position offers a chance to work within a collaborative environment focused on compliance and accurate reporting. #J-18808-Ljbffr

Join our team at Sixteenth Street Community Health Centers! We are dedicated to the highest quality health care. JOB RESPONSIBILITIES: Review, abstract, and code clinical data such as diseases, operations, procedures, and therapies into computer system for billing and data collection within the established time frame. Assign appropriate ICD-10, CPT, HCPCS and modifiers to accurately report and support the need for each physician service. Identify physician services provided but not adequately documented in the medical record. Advise coding auditor/educator or Manager of deficiencies. Code and abstract patient care records to provide information for insurance/billing and to establish accurate working indices. Perform void/re-enter of charges and changes to insurance as indicated by the medical record and insurance nuances. Perform follow-up claim duties as required and assigned. Comply with the Sixteenth Street TB Control Plan including PPD testing. Perform...

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...

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...

Job Overview We are seeking a detail-oriented and motivated Certified Medical Coder/Professional Biller to join our dynamic healthcare consulting team. In this vital role, you will be responsible for accurately coding medical diagnoses, procedures, and services using standardized coding systems such as ICD-10, CPT, and DRG. Your expertise will ensure precise billing processes, optimize revenue cycle management, and facilitate seamless communication between healthcare providers and payers. This position offers an exciting opportunity to contribute to high-quality patient care through meticulous documentation and coding accuracy. Responsibilities Review and analyze medical records to verify appropriate ICD-10 diagnosis codes, CPT procedure codes, and modifiers. Ensure all billing information complies with current healthcare regulations and payer requirements Submit accurate claims electronically through Electronic Medical Record (EMR) or Electronic Health...

Discover. Achieve. Succeed. Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility. This job is remote. FTE: 1.000000 Standard Hours: 40.00 Shift: Shift 1 Shift Details: Holidays: Weekends: Job Summary: This is a remote, high-level position functioning under general supervision and utilizing independent decision making. The Coder III correctly assigns ICD diagnosis and procedure codes, MS-DRGs, and APR-DRGs for inpatient hospital services for Froedtert Health, which includes an academic, Level I Trauma Center. The level III Coder completes coding on highly complex trauma and acutely ill patients, including mortality, extended length of stay, and high dollar cases. This position is differentiated from the Coder II level by the high complexity and longer lengths of stay. The Coder III will also be required to perform chart audits as needed for Coder Inpatient I's and II's. The senior coding staff in this position will apply all official and departmental coding rules,...

Coding Specialist Minimum of five years' of coding experience in an academic medical center or an equivalent combination of coding experience and education with demonstrated competency of knowledge base. Coding QA background or similar experience preferred. Satisfactory completion of college level courses in anatomy, physiology and medical terminology preferred. EPIC health information system experience preferred. Coding certification CCA, CIC, CPC-H, CPC, CCS, RHIT, or RHIA required Ensures the timely and accurate coding and completion of patient accounts within established departmental accuracy and productivity standards. Applies correct ICD CM/PCS (Inpatient) and ICD CM/CPT codes (Outpatient) guidelines meeting departmental policy regarding compliant methods, timeframes, use of applications and productivity. Assists in demonstrating medical necessity for procedures performed by ensuring that all documented disease processes are coded. Demonstrates proficiency in...

This position is full-time and will work 40-hours per week. It is full-time benefit eligible. Remote and/or hybrid can be an option after 6-months of on-site training. Coder Certified Come work where we specialize in you! We have nearly 2,000 reasons for you to consider a career with Prevea Health-they're our employees. We're an organization that values kindness, responsibility, inclusivity, wellness and inspiration. At Prevea, we provide continuous education, training and support so every member of the team contributes to our success. Together we are the best place to get care and the best place to give care. Job Summary The Certified Coder is responsible for accurately translating medical records and patient services into standardized numerical codes for billing and reimbursement purposes. This role ensures compliance with federal, state, and organizational regulations, while maintaining the highest standards of patient confidentiality. The Certified Coder works...

Overview Certified Coder – Green Bay, Wisconsin Location: Tulip Lane-023, Green Bay, WI Position status: Full-time, 40 hours/week; benefit eligible. Remote and/or hybrid option after 6 months on-site training may be considered. Job Summary The Certified Coder is responsible for accurately translating medical records and patient services into standardized numerical codes for billing and reimbursement purposes. This role ensures compliance with federal, state, and organizational regulations, while maintaining the highest standards of patient confidentiality. The Certified Coder works independently and collaboratively to support the revenue cycle and overall operational efficiency of the healthcare organization. What you will do (Responsibilities) Review and analyze patient medical records, physician notes, and other documentation to assign appropriate ICD-10, CPT, and HCPCS codes. Ensure accurate coding for diagnosis, procedures, and services for proper reimbursement. Review...

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...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The key challenge of this role centers around your ability to work quickly, accurately, and independently. You'll be challenged with daily production goals as well as maintaining a high accuracy rate to achieve your quality goals. Extensive use of electronic medical records in an ICD-10 environment is also required. Hours : This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 5am - 5pm. We offer 2-3 weeks of paid training. The hours during training will be...

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

POSITION ELIGIBLE FOR $2,000 SIGN ON BONUS Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility. This job is REMOTE. FTE: 1.000000 Standard Hours: 40.00 Shift: Shift 1 Shift Details: Holidays: Weekends: Job Summary: Job Summary: This is a remote, high-level position functioning under general supervision and utilizing independent decision making. The Coder III correctly assigns ICD diagnosis and procedure codes, MS-DRGs, and APR-DRGs for inpatient hospital services for Froedtert Health, which includes an academic, Level I Trauma Center. The level III Coder completes coding on highly complex trauma and acutely ill patients, including mortality, extended length of stay, and high dollar cases. This position is differentiated from the Coder II level by the high complexity and longer lengths of stay. The Coder III will also be required to perform chart audits as needed for Coder Inpatient I's and...