26 coding auditor educator jobs found

The Professional Coding Auditor & Educator works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Responsibilities: Responsible for reviewing and analyzing all aspects of the department clinical documentation and care to ensure timely, accurate, and compliant charge capture and submission Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges Collaborates with Coding Supervisor to ensure clinical documentation in high-risk areas is consistent and complete Identifies inconsistencies in medical reports and works...

Professional Coding Auditor & Educator The Professional Coding Auditor & Educator works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Responsibilities: Responsible for reviewing and analyzing all aspects of the department clinical documentation and care to ensure timely, accurate, and compliant charge capture and submission Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges Collaborates with Coding Supervisor to ensure clinical documentation in high-risk areas is consistent and complete Identifies...

DEPARTMENT: Physician Practice Management FACILITY: Medical Office Building WORK TYPE: Full Time SHIFT: Daytime SUMMARY: Assess the educational needs of coding specialists and providers regarding coding and documentation and direct development of effective regularly scheduled educational programs that meet the needs of the health system. Serve as the primary resource to physicians for documentation and coding issues. Conduct ongoing coding and billing training programs for billing and coding specialists and providers. Creates presentations, develops learning material, handbook, and other training materials. Conducts coding and data quality reviews and prepares complex reports as required. Ensures all education activities comply with clinical billing standards and government regulation with concentration on hospital inpatient procedures, ambulatory, and specialty physician services. RESPONSIBILITIES: * Keeps abreast of pertinent federal, and state regulations...

Description WHAT IT'S LIKE AT SGMC HEALTH Purpose . No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place. Excellence . We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service. Team Spirit. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. Award Winning Performance. We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides. WHY YOU WILL LOVE SGMC HEALTH SGMC has great benefit options, depending on the role that you are going into- including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities...

South Georgia Medical Center seeks a Professional Coding Auditor/Education Specialist to conduct audits, educate healthcare providers, and manage coding compliance. Ideal candidates should hold a Certified Professional Coder (CPC) certification, with a strong foundation in medical coding, including knowledge of ICD-10, HCPCS, and CPT. The position is full-time, requiring on-site presence in Valdosta, Georgia, and offers benefits such as healthcare insurance, 401(k) with match, and tuition reimbursement. #J-18808-Ljbffr

A healthcare institution in Valdosta, GA is seeking a Professional Coding Auditor/Education Specialist. The ideal candidate will be a Certified Professional Coder (CPC) with expertise in medical coding including ICD-10, HCPCS, and CPT. Strong analytical skills and proficiency in Microsoft Office are essential for this full-time on-site role. Responsibilities include conducting audits, educating healthcare providers, and developing training materials to improve coding compliance and efficiency. Competitive benefits include 401(k), healthcare options, and tuition reimbursement. #J-18808-Ljbffr

Professional Coding Auditor/Education Specialist Job Location: SGMC Patient Financial Services Department: Revenue Cycle Medical Group Schedule: Full Time, 8 HR Day Shift, 8-5 on site Position Summary This position requires on-site presence at SGMC Health Main Campus. Remote work is not available for this role. The ideal candidate for the Professional Coding Auditor/Education Specialist role will be a Certified Professional Coder (CPC), with preference given to those holding a Certified Professional Medical Auditor (CPMA) or Certified Documentation Expert Outpatient (CDEO) certifications, although relevant experience may substitute for these credentials. The candidate must have a strong foundation in medical coding, including extensive knowledge of ICD-10, HCPCS, and CPT, along with expertise in multispecialty and complex coding, and experience in abstracting E/M and CPT codes. Proficiency in anatomy and physiology, medical terminology, and regulatory compliance related to...

Sgmc-Health-1 is seeking a Professional Coding Auditor/Education Specialist to join their Revenue Cycle Medical Group. The ideal candidate will possess a Certified Professional Coder (CPC) certification, with preferred qualifications including knowledge of ICD-10, HCPCS, and CPT coding. This role requires on-site presence in Valdosta and is focused on enhancing coding practices and compliance. The selected individual will perform detailed audits, educate healthcare providers, and assist in developing training materials to promote efficiency and accuracy in coding. Strong communication, analytical, and time management skills are essential for success. #J-18808-Ljbffr

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

Compliance Audit And Analysis Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more Description Reporting to the Manager, Compliance Audit and Analysis, develops and executes audit, monitoring, and education for inpatient hospital billing, coding and documentation programs that ensure compliance with regulatory standards. Continuously evaluates inpatient hospital/clinical billing compliance activities to assess compliance with the Compliance Audit and Analysis...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

Inpatient Drg Coding Auditor Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs...and more! Job Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. Reviews...

Become a part of our caring community 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. 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 decisions based on standard industry guidelines and best practices Manages multiple...

Datavant is seeking an Inpatient Auditing Specialist to join their team in Atlanta, Georgia. This remote position focuses on coding quality and compliance within a collaborative environment. Key responsibilities include performing coding audits and providing coder education. The ideal candidate will have 5+ years of experience in inpatient coding, maintain a high DRG accuracy rate, and possess familiarity with tools like Epic and Cerner. Competitive benefits and a sign-on bonus are offered. #J-18808-Ljbffr

Coding Auditor - Professional Coder Auditor-Professionals are responsible for auditing of coding assignment with providers and coders, training of coding professional staff, pro-fee based coding includes the assignment of Assigns ICD-CM, CPT, HCPCS codes, E&M assignment, modifiers, and charge posting. Interacts with medical staff, nursing, ancillary departments, provider offices, and outside organizations. Department: Physician coding Hours: Full-Time, 40 hours a week required Required: High School Diploma, CPC, CEMA within 6 months of hire, CPMA within 1 year of hire Pay: Based on experience, starting at $23.87/hour Location: Remote or onsite: At this time, you must reside in one of the following locations: Alabama, Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, New Mexico, Ohio, Oklahoma, South Carolina, Tennessee, Texas Responsibilities Assists coders with coding questions.,...

## Supervisor, Claims Audit - Medical Stop LossApplylocations: Kennesawtime type: Full timeposted on: Posted Todayjob requisition id: JR217The Supervisor, Claims Audit – A&H Core Team, is responsible for leading a team of claims auditors focused on reviewing and rendering decisions on liability for claims made under Medical Stop Loss policies issued to Skyward non captive insurance clients. This role oversees the claims audit process for accident and health captive programs, ensuring claims are handled accurately, efficiently, and in accordance with company standards and client expectations. The manager will guide and support staff, ensure compliance with audit protocols, and partner with stakeholders to drive quality results and client satisfaction.This position will work a hybrid schedule in our Kennesaw, GA office.**Essential Duties and Responsibilities** • Supervise, train, and mentor the Claims Audit team, ensuring adherence to claims audit standards and...

Surgical Coder - PHYS Overview At Piedmont Healthcare, you’ll love a shared purpose, be motivated to be your best, and be recognized for your contributions. Piedmont Healthcare leaders are in your corner and invested in your success. Our wellness programs and comprehensive total benefits and rewards will meet your needs for today and help you plan for the future. Responsibilities Reviews, analyzes, and codes medical record documentation to include, but not limited to, medical diagnostic and complex procedural information for general surgical specialties for the correct ICD‑10, CPT and/or HCPCS codes to the greatest specificity. Abstracts demographic and coding information into the information system accurately and completely. Reviews documentation for medical necessity. Audits orders and claims before submission for entirety and accuracy and to minimize claim denials. Assesses records and prepares reports. Provides technical guidance to physicians and other departmental staff in...

The Supervisor, Claims Audit – A&H Core Team, is responsible for leading a team of claims auditors focused on reviewing and rendering decisions on liability for claims made under Medical Stop Loss policies issued to Skyward non captive insurance clients. This role oversees the claims audit process for accident and health captive programs, ensuring claims are handled accurately, efficiently, and in accordance with company standards and client expectations. The manager will guide and support staff, ensure compliance with audit protocols, and partner with stakeholders to drive quality results and client satisfaction. This position will work a hybrid schedule in our Kennesaw, GA office. Essential Duties and Responsibilities Supervise, train, and mentor the Claims Audit team, ensuring adherence to claims audit standards and achievement of performance goals Oversee audits of medical claims across Skyward insurance programs (monitoring over/under payments, duplicate payments, contract...

BayCare is currently in search of our newest Team Member who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area. Position Details Location: Remote (must reside in the state of Florida, Georgia, North Carolina, or South Carolina) Status: Full time (non-exempt) Shift: 8:00am - 4:30pm Days: Monday through Friday This Specialty Coder II opportunity is a full-time remote position. This team member must reside in the state of Florida, Georgia, North Carolina, or South Carolina. Sign on bonuses available! Responsibilities The Specialty Coder II is a Certified Professional Coder who assigns diagnosis and procedural codes using ICD-10 CM and CPT-4 coding systems. The Specialty Coder audits physician documentation to assign appropriate CPT codes, diagnosis codes, and modifiers. Mentors and training of other Specialty Coders. Serves as...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...