48 coding auditor and provider educator jobs found

Coding Auditor & Educator (Remote | Contract-to-Hire) Our Client seeks an experienced Coding Auditor & Educator to support provider-based coding compliance and education across a large, complex health system. Key Responsibilities Audit and provide education for PB E/Ms, Diagnosis coding, and in-office procedures Audit 100 coders per quarter, reviewing 30 charts per audit Support audits across 1,000+ providers Deliver clear, actionable feedback to improve coding accuracy and compliance Qualifications Certifications: AAPC or AHIMA (RHIA or RHIT required) Strong knowledge of Professional-Based E/M and Diagnosis coding Preferred experience in Cardiology and/or Emergency Department coding Experience in large healthcare systems (500+ beds, Level 1 Trauma or Teaching Hospitals; ICU exposure preferred) Ability to quickly adapt to new workflows and work independently MD Audit experience a plus (training provided if needed) Systems EPIC 3M 360 CAC Position Details...

At Planned Parenthood of Greater New York (PPGNY), our greatest strengths are the employees who empower every individual with the information, resources, and care they need to live happy, healthy lives. Picture yourself here: We are a team of trusted health care providers, educators, and fierce advocates committed to advancing equity and improving health outcomes in communities that face systemic barriers to quality, innovative sexual and reproductive health services -- including birth control, pregnancy testing, emergency contraception, cancer screenings, STI testing and treatment, HIV testing and prevention, transgender hormone therapy, wellness exams, crisis counseling, and financial counseling. PPGNY also proudly provides compassionate, nonjudgmental abortion services. When you join PPGNY as a Medical Record Coding Auditor you will be responsible for This position will be responsible for performing on-going auditing of outpatient provider coding, and education. Individuals...

At Planned Parenthood of Greater New York (PPGNY), our greatest strengths are the employees who empower every individual with the information, resources, and care they need to live happy, healthy lives. Picture yourself here: We are a team of trusted health care providers, educators, and fierce advocates committed to advancing equity and improving health outcomes in communities that face systemic barriers to quality, innovative sexual and reproductive health services -- including birth control, pregnancy testing, emergency contraception, cancer screenings, STI testing and treatment, HIV testing and prevention, transgender hormone therapy, wellness exams, crisis counseling, and financial counseling. PPGNY also proudly provides compassionate, nonjudgmental abortion services. When you join PPGNY as a Medical Record Coding Auditor you will be responsible for This position will be responsible for performing on-going auditing of outpatient provider coding, and education....

Physician Compliance Auditor Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal...

Physician Coding Auditor This is a full-time, remote position that offers a flexible schedule. Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare, Medicaid, and third-party payer guidelines to ensure receipt of accurate reimbursement. Physician Coding Auditor is expected to adhere to MedKoder's internal coding/auditing policies and expectations set forth by department management. Physician Coding Auditor must prioritize daily duties, communicate effectively, and make the decisions necessary to complete all assigned tasks and accomplish their goals. Candidates ideally have recent auditing experience specializing in some of the following profee areas: Ophthalmology, Behavioral Health, Cardiovascular/Cardiothoracic Surgery, Complex ENT Surgery, Dental, Complex Plastic Surgery, Orthopedic Surgery, Peds...

Job Summary: Position Summary: Under the direction of the Compliance Officer the main duties for this position include: analysis of professional coding and billing data, review of applicable regulations or guidelines and professional coding and billing audits. Duties/Responsibilities: Analysis of coding and billing data, identification of trends and aberrations. Performance of routine and investigatory audits evaluating compliance with applicable laws, regulations, coding, and billing guidelines. Interpretation of coding, billing, and regulatory standards. Preparation and completion of audit reports including recommendations, education and corrective action. Knowledge, Skills and Abilities: Strong computer skills specifically Microsoft word and Microsoft excel applications. Strong analytical, problem-solving and time management skills. Expertise in report writing and oral communications. Ability to interpret regulations, payment and reimbursement systems, billing and coding...

Medical Coder Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting. We are seeking an experienced Medical Coder to join our healthcare consulting practice. The role is fully remote within the US, with infrequent travel to client locations for onboarding and training. We are proud of our national presence, and excited to offer great career opportunities within the organization. What you'll do: Accurately assign ICD-10 CM, E/M, ICD-10 PCS, CPT, HCPCS, modifiers and units based on documentation. Adhere to systems and standards required in multi-specialty medical coding encounters, including Outpatient, Emergency Room, Surgery, Inpatient facilities, Inpatient Professional Rounds, and others. Process encounters within required SLA on contract with deficiencies identified escalated as necessary. Review and respond to each audit within set...

Revenue Cycle Position Conducts concurrent and occasionally onsite medical chart reviews for pediatric and neonatal ICU patients. Collaborates with medical directors and staff to enhance the quality of physician documentation, ensuring a precise representation of the patients' severity of illness, anticipated risk of mortality, and the complexity of care administered. Ensures the accuracy, completeness, and compliance of medical coding and documentation for all pediatric patient encounters. Strives to optimize coding practices, minimize denials, and maintain the highest standards of data integrity. Job Responsibility 1. Analyzes and interprets complex pediatric medical records to ensure accurate capture and coding of diagnoses, procedures, and appropriate levels of service, adhering to established coding guidelines (ICD-10-CM, CPT, HCPCS). 2. Applies advanced knowledge of pediatric anatomy, physiology, and medical terminology to interpret clinical documentation and assign the...

Birch Family Services is a leading provider of education, employment, and community support services for individuals with autism and developmental disabilities and their families in New York City. Every year, the organization supports more than 2,000 people across 31 locations in Manhattan, Queens, Brooklyn, and the Bronx. From preschool to graduation, employment, housing, and beyond, Birch Family Services provides fully integrated programs and services to support individuals in achieving their goals across their lifetime. Position Summary: Position will be responsible for Assisting with the processing of claims for participants in the agency's Community Service programs and Education Program, assuring that the agency is accurately capturing client and student billing information. In addition, this position will be responsible for assisting in maintaining and reconciling social security funds for the individuals who reside in the agency's residences and any records related...

Risk Adjustment Coder Join VillageCare as a Full Time Risk Adjustment Coder and embrace the opportunity to work remotely while making a significant impact in the Health Care sector. This role offers the flexibility of a work-from-home environment, allowing you to balance your professional and personal commitments without the daily commute. You'll be part of a dynamic team that thrives on innovation, problem-solving, and a customer-centric approach, all while contributing to the excellence and integrity that VillageCare stands for. With a competitive salary up to $77,506.87 - $87,195.23, this is not just a job but a chance to build your career in a forward-thinking organization dedicated to healthcare improvement. As a team member you'll be able to enjoy benefits such as PTO package, 10 Paid Holidays, Personal and Sick time, Medical/Dental/Vision, HRA/FSA, Education Reimbursement, Retirement Savings 403(b), Life and Disability, Commuter Benefits, Paid Family Leave, and Additional...

Job Description Job Description Conducts coding audits to optimize diagnosis related groupings. Develops and implements coding instruction classes. Prepares coding guidelines; implements coding changes. Job Responsibility 1.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. 2.Demonstrates effective skills in validation; provides ad-hoc education to the coding staff. 3.Able to communicate effectively with coders and CDI staff. 4.Demonstrates knowledge of coding policy and procedures. 5.Maintains knowledge of all current Federal and State coding guidelines; remains up-to-date on system literature from all agencies. 6.Monitors and evaluates case mix index; demonstrates comprehensive knowledge of case mix indexing. 7.Reviews potential reassignments; demonstrates accurate and timely review of all reassignments. 8.Implements coding changes; demonstrates ability to relate coding changes accurately and...

Coding And Billing Specialist Responsible for accurate coding and billing of provider office, inpatient and outpatient charges to ensure coding and billing compliance is maintained. Maintains an extensive knowledge of CPT Procedural Coding, ICD-10 Diagnosis Coding and HCPCS Level II coding along with Evaluation and Management (E&M) documentation requirements. Duties and responsibilities include: Reviewing and submitting charges from the coding workqueues (WQ). Manually entering off-premise charges in Charge Review. If applicable, manually entering in-house charges for certain specialty areas as designated. Ability to code for many different specialties as assigned. Provides cross-coverage in the department as needed and directed by the Coding and Compliance Manager /Data Collection Team Leader. If indicated, arriving the Surgery Schedule on a daily basis using the DAR function. Checking each patient in to create the visit number. Reviewing and processing re-submits....

HIM Outpatient Coder 2 Jackson Health System is a nationally and internationally recognized academic medical system offering world-class care to any person who walks through our doors. For more than 100 years, Jackson has evolved into one of the world's top medical providers for all levels of care, no matter if it's for a routine patient visit or for a lifesaving procedure. With more than 2,000 licensed beds, we are also proud of our role as the primary teaching hospital for the University of Miami Miller School of Medicine. Here, the best people come together to deliver Jackson's mission for our diverse communities. Our employees are committed to providing the best CARE by demonstrating compassion, accountability, respect, and expertise in everything we do. HIM Outpatient Coder 2 is responsible for coding and abstracting outpatient medical records, including outpatient surgeries, GI procedures, and cardiac catheterizations. The Coder 2 is responsible for reviewing the clinical...

Podiatry Coder Salary Range: $21.00 - $35.64 Hourly Position Type: Full Time Job Shift: Day Education Level: High School Travel Percentage: None Coder, Podiatry Job Summary The Podiatry Coder is responsible for reviewing, interpreting, and assigning accurate CPT, ICD-10-CM, and HCPCS codes specific to podiatric services, while ensuring compliance with federal regulations, payer policies, and organizational standards. This role reviews provider documentation and operative reports for podiatry-related proceduresincluding office visits, surgical procedures, wound care, and ancillary servicesto abstract and code clinical data using standard classification systems. Duties and Responsibilities Demonstrate our core values of being patient centered, team focused, service driven, accountable, and innovative every day. Review and audit physician documentation and surgical reports to accurately assign diagnosis and procedure codes for orthopedic services, including office...

Coder Quality Auditor The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties. Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess coders'...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217* Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical diagnoses and clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements. Trains, instructs and provides technical support...

Department/Unit: Health Information Management Work Shift: Day (United States of America) Salary Range: $55,895.80 - $83,843.71 The Professional Coder will review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 DX codes. This position is remote. Essential Duties and Responsibilities Effectively reviews, analyzes, and validates CPT, ICD-10 diagnosis codes, HCPCS, modifiers and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes. Understands National Correct Coding Initiative (NCCI) edits and relative value units as appropriate for the role. Ensure established productivity and quality standards are met. Review denials, research and respond...

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...

Req Number 180115 Job Description Conducts coding audits to optimize diagnosis related groupings. Develops and implements coding instruction classes. Prepares coding guidelines; implements coding changes. Job Responsibility 1.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. 2.Demonstrates effective skills in validation; provides ad-hoc education to the coding staff. 3.Able to communicate effectively with coders and CDI staff. 4.Demonstrates knowledge of coding policy and procedures. 5.Maintains knowledge of all current Federal and State coding guidelines; remains up-to-date on system literature from all agencies. 6.Monitors and evaluates case mix index; demonstrates comprehensive knowledge of case mix indexing. 7.Reviews potential reassignments; demonstrates accurate and timely review of all reassignments. 8.Implements coding changes; demonstrates ability to relate coding changes accurately...

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,...

Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $60,367.47 - $90,551.20 The Senior Hospital Coder is responsible for performing detailed coding quality audits, scheduled and random, on staff and providing thorough education and feedback, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI. Responsible for monitoring and tracking trends of staff, bringing forward concerns to leadership regarding coding quality and productivity, completes duties as assigned by the Quality Manager. Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. Senior Hospital Coder may be asked to assist with denials work, including researching and writing appeal letters. These individuals are highly skilled and considered experts in medical coding. Essential Duties and...

Medical Records - Coder I - Full Time - Days Department: CODING Job Summary Under the general direction of the Director CDI/Coding or designee, the Medical Records Coder I will improve documentation, data quality and revenue cycle operations. The coder assigns International Classification of Disease system- 10 (ICD), CM, and PCS codes according to AHA – AMA Guidelines, CMS and NGS. Core Job Responsibilities Assign diagnosis and procedure codes, for accurate and timely billing of most appropriate payer Audit charges and establish proper coding in collaboration with providers Initiate and follow up on queries with providers Assist departments with diagnostic and procedural coding Respond to Insurance, compliance and RAC denials Review and assist in the maintenance of coding related policies and procedures Perform other duties as required. Education/Experience Requirements REQUIRED: AS in Health Information Management , a...

Req Number 180673 We are looking for a Medical Biller with experience in multispecialty billing and strong knowledge of medical billing and insurance reimbursement processes to work for our external client, a world leading out-patient medical center, located in Manhattan, NY. In this role you will be responsible for full cycle claims processing, managing denials, and assisting with billing-related reporting and audits. This is a full-time, permanent job. Monday - Friday, 9:00am-5:00pm, 100% working from the office. Requirements: 2+ years of experience in medical billing and claims processing, and insurance follow-up. Certification in medical billing and coding preferred (e.g., CPC, CPA, or equivalent). In-depth knowledge of CPT, ICD-10, and HCPCS coding systems. Responsibilities: Timely and accurately submit claims to both private and public insurance carriers, including Medicare, Medicaid, and commercial plans. Investigate and resolve...

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...