49 coding auditor and educator jobs found

DRG Coder Department: HS - UM Employment Type: Full Time Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Reporting To: Alice Tejeda Compensation: $33.00 - $38.00 / hour Description The Senior DRG Coder is responsible for reviewing inpatient medical records and accurately assigning diagnosis and procedure codes using ICD-10-CM and ICD-10-PCS to determine the appropriate Diagnosis-Related Group (DRG) assignment. This role ensures coding accuracy, reimbursement integrity, and compliance with federal and state regulations, payer guidelines, and internal policies. In an Independent Practice Association (IPA) and Management Services Organization (MSO) environment, the Senior DRG Coder partners with utilization management, care management, finance, and provider network teams to support accurate payment, risk adjustment, quality reporting, and medical expense analysis. What You'll Do Review inpatient hospital records and assign accurate...

Facility: Copley Drive City San Diego Department Job Status Regular Shift Day FTE 1 Shift Start Time Shift End Time Certified Coding Specialist--Physician-based (CCS-P) - The American Health Information Management Association (AHIMA); Certified Professional Coder (CPC) - AAPC Hours : Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Flex hours are 6:00-9:00 am to 14:30-17:30 pm Weekend Requirements: As Needed On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $34.170 - $44.090 - $49.370 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.? The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates,...

Description Are you looking for a career that will make an impact? The Leidos Military and Veterans Health Solutions Operation has an opening for a Clinical Informaticist / Clinical Coder to join the Operational Readiness Directorate at the Naval Health Research Center in San Diego, CA. This position will provide support to the Epidemiology and Data Management Support Department and involves clinical coding and data abstraction to support research on the physical and mental health of military personnel to improve overall health and readiness. The person in this position will work closely with department professionals in records management, information technology, and research teams to ensure alignment of clinical coding with research needs. Are you ready for unique and exciting work? This is a full-time position in San Diego. The candidate for this position must be located within commuting distance of San Diego to work on-site at the Naval Health Research Center as needed....

Medical Coding Specialist Shift Start Time: 6 AM Shift End Time: 2:30 PM Additional Shift Information: 0600-0900 Start, 1430-1730 End Weekend Requirements: No Weekends On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $30.370 - $37.950 - $42.510 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do Ensure that all charges are submitted accurately, timely and meets department guidelines. Provides administrative and coding support to management, site support, staff and physicians. Identifies and reports documentation and coding opportunities and makes recommendations for improved...

Job Summary Hours: Shift Start Time: Variable Shift End Time: Variable. AWS Hours Requirement: 8/40 - 8 Hour Shift. Additional Shift Information: Flexible Hours – Start Time 6:00‑9:00am to End Time 14:30‑17:30. Weekend Requirements: As Needed. On‑Call Required: No. Hourly Pay Range: $30.370 – $37.950 – $42.510. The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. Job Responsibilities Ensure that all charges are submitted accurately, timely and meet department guidelines. Provide administrative and coding support to management, site support, staff and physicians. Identify and report documentation and coding opportunities and...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Job Description Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work. Job Summary: Reviews SDS and OBV records to identify the diagnosis and procedure codes performed during the patients stay are valid and in accordance with coding conventions and guidelines. Records types including same day surgery and observation encounter types. Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work. Job Requirements: Education and Work Experience: High School...

Coder III Coder III is responsible conducting clinically based concurrent and retrospective reviews of inpatient medical records. This review is to evaluate that the clinical documentation is reflective of quality of care outcomes and reimbursement compliance for acute care services provided. The CDS will work closely with the medical staff to facilitate appropriate clinical documentation of patient care. The CDS/Coder III abstracts and codes the diagnostic and procedural information for Inpatient Services and Surgery medical records utilizing the current version of International Classifications of Diseases in accordance with regulatory agencies and hospital specific guidelines. The CDS/Coder III enters the coded data and other abstracted data from the medical record into the electronic information system. This position assumes primary responsibility for clarifying ambiguous documentation, DRG optimization with the primary role in assisting medical staff members with improving...

Riverside University Health System (RUHS)is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience in an acute care...

Lead Outpatient Medical Coder The Lead Outpatient (OP) Medical Coder assists the HIM OP Coding Manager with administrative functions specific to all outpatient coding operations. Duties may be varied and may include many of the following: assisting the OP Coding Manager to organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of production-coder performance, develop and implement quality improvement activities, train and mentor staff, provide feedback coding error findings and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. The Lead OP Medical Coder is responsible for serving as a subject matter expert in coding processes, providing advanced technical guidance, and ensuring coding accuracy, compliance, and productivity standards are met. The position supports coders and auditors through consultation, mentoring, and...

Riverside Medical Clinic Coding Specialist Responsible for abstracting, reviewing, auditing and the education of all coding and compliance processes, as they relate to CPT, HCPCS and ICD 10 and/or HCC activity. Qualifications: To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: One year minimum experience in the HCC coding field and/or CPT, HCPCS and ICD 10 experience. Proficient in excel and computer friendly. Certificates, Licenses, and Registrations: Current Medical Coding certificate specific to CRC, CPC or CCS required. Essential Functions: Essential functions are those tasks, duties and responsibilities that comprise the means of accomplishing the job's purpose and...

Overview The Billing Medical Coder is responsible for the day-to-day coding and billing operations for all services billable under grants, federal, state, and county programs including Medicare, Medi-Cal, managed care and private insurances. Starting Bonus : $5,000 Location: Midtown - Sacramento, CA (95811). This role allows a hybrid schedule requiring 1-2 days per week on site. Training Training Period: 4–6 weeks onsite, 5 days per week Essential Functions Review and adjudicate coding of services from documentation in a timely manner. Code physician/provider visit procedure notes to identify appropriate ICD10 and CPT4 codes for charge processing. Ensures that all diagnosis ICD10 codes and procedure CPT, HCPCS codes are identified, sequenced, and coded in an accurate and ethical manner for optimized reimbursement. Assigns Evaluation and Management codes and key concepts/elements documented in the patient note, utilizing defined coding guidelines applicable to professional and...

Job Description Job Description MISSION, VISION, AND VALUES Our mission is to provide quality, comprehensive healthcare and supportive services to our community. Our vision is “Improving the Health and Well-Being of Our Community.” Our core values are Integrity, Compassion, and Excellence. Employees are expected to demonstrate a strong commitment to the mission, policies, goals, and philosophy of Harbor Community Health Centers. JOB SUMMARY Reporting to the Revenue Cycle Manager (RCM), the Medical Biller II is responsible for the billing and collection activities for the clinic’s primary care, pediatric, behavioral health, and dental services. This position works closely with providers, Front Office staff, and the Quality Improvement Department. ESSENTIAL DUTIES & RESPONSIBILITIES Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. An individual must be able to perform each essential duty...

Health Coder - Hcc & Risk Adjustment Burlingame, CA 94010 Overview Salary Range $42.79 - $48.75 Hourly Description The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance. Essential Job Functions: Hcc Coding and Risk Adjustment (Ra) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with Hcc and risk adjustment guidelines. Ensure all...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data integrity and validation of the coded information for external and internal affairs. This position typically reports to the Coding Compliance Manager. Minimum Qualifications Education: High school diploma or GED, required....

Job Details Job Location: Burlingame, CA 94010 Salary Range: $42.79 - $48.75 Hourly ESSENTIAL JOB FUNCTIONS HCC Coding and Risk Adjustment (RA) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines. Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance. Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy. Provider Training and Clinical Documentation Improvement (CDI) Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding. Provide one‑on‑one and group training to providers and clinical staff to improve documentation quality and accuracy. Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards. Data Analysis and Reporting Analyze coding data to identify trends,...

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. This position is hybrid- remote in Orange, CA. The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider partners, to successfully, monitor and implement HCC coding strategies. Audit all RAPS submissions to ensure accuracy in the data provided to Centers for Medicare and Medicaid Services (CMS). Provide...

Santa Rosa Community Health is seeking a Certified Professional Coder responsible for ensuring coding compliance for services performed by healthcare providers. This role requires in-depth knowledge of governmental, commercial guidelines, and coding regulations. The ideal candidate will perform audits, educate providers, and support accurate medical coding. A CPC Certification and at least 4 years of relevant experience are required. Join us to ensure the high standards of medical coding! #J-18808-Ljbffr

Job Description Primary Duties And Responsibilities The Coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM, ICD-10-PCS, and CPT codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Abides by the standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to all official coding guidelines. Verifies that all ICD-10-CM and CPT codes are correctly captured. Verify that physician is correctly abstracted. Keeps abreast of coding guideline changes by self-study, assigned education, coding meeting attendance or related in-services. Participates in internal and external quality review meetings. Performs other duties as assigned. Medical Coding - Hoag Hospital Resolves billing related errors and assists with workflow changes and process improvement...

Default Work Shift: Day (United States of America) Hours: 40 Salary range: $23.97 - $36.42 Schedule: Full Time Shift Hours: 8 Employee Department: Patient Financial Services Job Objective Responsible for performing revenue cycle integrity audits within the Charge Descriptive Master and other revenue cycle charge capture and reconciliation processes. Job Description Education: Required: High school diploma, GED or higher level degree if hired after March 1, 2025. Preferred: Medical coding coursework or bachelor’s degree in related field. Licensure/Certification: Required: Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) within one (1) year if hired into position after January 1, 2021. Experience: Required: Two (2) years of medical billing, charge capture, coding or patient account auditing experience. Preferred: Revenue cycle experience, hospital/clinical experience. Reports To: Manager or Director. Supervises: N/A. Ages of Patients: N/A. Blood Borne...

Who We Are BioMarin is a global biotechnology company that relentlessly pursues bold science to translate genetic discoveries into new medicines that advance the future of human health. Since our founding in 1997, we have applied our scientific expertise in understanding the underlying causes of genetic conditions to create transformative medicines, using a number of treatment modalities. Using our unparalleled expertise in genetics and molecular biology, we develop medicines for patients with significant unmet medical need. We enlist the best of the best – people with the right technical expertise and a relentless drive to solve real problems – and create an environment that empowers our teams to pursue bold, innovative science. With this distinctive approach to drug discovery, we’ve produced a diverse pipeline of commercial, clinical and preclinical candidates that have well-understood biology and provide an opportunity to be first-to-market or offer a substantial benefit over...

Job DescriptionJob DescriptionSUMMARYThe Certified Risk Adjustment Coder is responsible for accurately abstracting provider services into ICD-10 codes from medical documentation.This role adheres to the coding ethics of organizations such as the American Academy of Procedural Coders (AAPC), American Health Information Management Association (AHIMA), and the National Alliance of Medical Auditing Specialists (NAMAS), as well as payer guidelines.The coder conducts concurrent, prospective, and retrospective reviews of medical record documentation to ensure the accurate and complete capture of the clinical picture, severity of illness, and complexity of patients.Additional duties include provider communication and education to support the closure of both risk adjustment and quality care gaps, as well as providing ongoing feedback to physicians regarding coding guidelines and requirements.ESSENTIAL JOB FUNCTIONSPerform coding quality audits of medical records to ensure ICD-10 codes are...

Job DescriptionJob DescriptionMUST ATTEND ORIENTATION IN PERSON IN ARCATA, CALIFORNIASUMMARY :The primary function of this position is to review ICD, CPT and HCPCS coding for data and reimbursement.The coding function is a primary source for data and information used in health care today, and promotes quality client care, captures accurate reporting numbers and optimizes reimbursement.The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.Other duties may be assigned.Level IPerforms comprehensive review of the health record, evaluates the record for documentation, consistency, accuracy and correlation of recorded data.Ensures the final diagnosis as stated by the provider is valid, complete and accurately reflects the care and treatment rendered.Consults with provider when conflicting or ambiguous documentation is...