21 coding auditor educator jobs found

A healthcare organization in Champaign, IL is seeking a full-time Compliance Auditor/Educator. Responsibilities include ensuring compliance with regulations, conducting audits, and providing education on coding. The ideal candidate will have a CPC certification and at least 1 year of experience in coding or auditing. This position offers competitive pay and a comprehensive benefits package including health insurance and 401k. #J-18808-Ljbffr

Christie Clinic's department of Compliance Quality is seeking a full-time Compliance Auditor/Educator at our Clark Street location in Champaign from Monday-Friday 8:00am-5:00pm, with no night or weekend requirements. Duties include performing ongoing functions related to quality of care and compliance including government and clinic regulations and policies in support of the Christie Clinic Compliance System. JOB DUTIES: (This list may not include all of the duties assigned.) Screen, review, identify and document potential quality and compliance issues. Perform billing and coding audits with both random samples as well as provider and department specific samples; and as required. Meet with providers to share audit results and guidance for accuracy rate improvement. Prepare educational materials specific to new provider's specialty and assist with orientation sessions. Review new providers' daily charges and offer feedback. Notify providers of CPT and diagnosis...

Job Description Job Description *MUST LIVE IN ILLINOIS OR A STATE SURROUNDING ILLINOIS TO APPLY* The Ambulatory Coding and Reimbursement Specialist is responsible for reviewing, analyzing, and coding ambulatory and/or hospital encounters, diagnostic and procedural information used in the billing of charges for physician's services. Ensures compliance with established coding procedures, regulatory guidelines and reimbursement policies. Reviews medical record documentation for E/M encounters from multiple specialty departments for proper assignment of ICD-10, CPT, HCPCS and modifiers. Performs initial charge review to determine appropriate CPT and ICD-10 codes to be used in reporting physician services to third party payers. Essential Duties and Responsibilities: Analyzes provider documentation to assure the appropriate Evaluation & Management levels are assigned using the correct CPT and current Evaluation and Management Guidelines Interprets outpatient office visit...

Ann & Robert H. Lurie Children’s Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children’s Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.Day (United States of America)**Location**Ann & Robert H. Lurie Children's Hospital of Chicago**Job Description****Summary:**Conducts retrospective audit of ambulatory and inpatient physician documentation to ensure billing accuracy and compliance. Accounts for concurrent inpatient billing accuracy and compliance for selected Divisions. Provides physician education on coding and documentation guidelines.**Essential Job Functions:**• Reviews and audits physicians’ documentation in the medical record and...

Job Description Be a part of a world‑class academic healthcare system at UChicago Medicine as a Coding Auditor - DRG/APC Coordinator for the Health Information Management department. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area. In this role, the Coding Auditor - DRG/APC Coordinator is responsible for ensuring accuracy and quality of coding assignments for all records requiring DRG and/or APC coding, and ensures optimal and timely reimbursement. Essential Job Functions Performs data quality reviews on inpatient and outpatient records to ensure proper coding guidelines have been followed and appropriate DRG or APC assignments have been made for appropriate reimbursement Provides DRG/APC and coding quality information and statistical reports to the Coding Manager Communicates with the Medical Staff and House staff as needed to discuss clinical questions with respect to the assignment of ICD-10-CM and...

Inpatient Medical Coding Auditor page is loaded## Inpatient Medical Coding Auditorlocations: Remote Nationwidetime type: Full timeposted on: Posted Todayjob requisition id: R-397764# **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.Where you Come InHumana 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...

Medix - 9600 gross pt road [Medical Records Clerk] As a Coder at Medix, you'll: Analyze medical records to assign appropriate codes for billing and insurance purposes; Ensure accuracy and compliance with coding guidelines and regulations; Collaborate with healthcare professionals to clarify diagnoses and procedures; Maintain confidentiality of patient information; Update coding knowledge through continuous education and training; Assist in audits and reviews to improve coding processes and accuracy...Hiring Immediately >>

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 accuracy...

Overview The HIM Certified Coder is responsible for accurate and timely coding of hospital inpatient, hospital outpatient and/or professional fee encounters using appropriate ICD10/ICDPCS, CPT, or HCPCs codes and appropriate coding software such as computer assisted coding and encoders as a means to ensure compliant billing of Carle claims. HIM Certified Coder is responsible for understanding and applying all regulatory coding guidelines, such as National and Local Coverage Determinations and application of CPT modifiers. HIM Certified Coder is also responsible for understanding and applying coding knowledge to resolve billing edits related to coding. HIM coder uses Carle electronic medical record systems to review clinical encounters. Qualifications Education: High School Diploma or G.E.D Certifications: Certified Inpatient Coder (CIC) — American Academy of Professional Coders (AAPC) Registered Health Information Administrator (RHIA) — American Health Information Management...

DRG Coding Auditor Principal This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients. Specializes in review of DRG coding via medical record and attending...

Overview IllinoisCareis seeking a highly organized Certified Professional Coder (CPC) to join our team as. As a Coding Specialist, you will translate descriptions of medical diagnoses and procedures into codes which record health care data. This is a great opportunity for someone who thrives in a detail-oriented environment and enjoys being a key part of a collaborative team. Pay & Benefits Pay Range: $18.00 – $28.00/hour (Based on experience, education, and other factors) Medical, dental, and vision insurance (multiple plan options) Special wellness programs – Maven, HingeHealth, Livongo, Vitality, and Wondr 401(k) retirement plan with employer contributions Company-paid life, short-term, and long-term disability insurance Health Savings Account (HSA) & Flexible Spending Accounts (FSA) Paid time off and holidays Employee Assistance Program (EAP) Discounts through our Perks Program Responsibilities What You’ll Do Assists office staff, physicians and other...

Overview Illinois CancerCare is seeking a highly organized Certified Professional Coder (CPC) to join our team as a Coding Specialist. As a Coding Specialist, you will translate descriptions of medical diagnoses and procedures into codes that record health‑care data. This is a great opportunity for someone who thrives in a detail‑oriented environment and enjoys being a key part of a collaborative team. Pay & Benefits Pay Range: $18.00 – $28.00/hour (Based on experience, education, and other factors) Medical, dental, and vision insurance (multiple plan options) Special wellness programs – Maven, HingeHealth, Livongo, Vitality, and Wondr 401(k) retirement plan with employer contributions Company‑paid life, short‑term, and long‑term disability insurance Health Savings Account (HSA) & Flexible Spending Accounts (FSA) Paid time off and holidays Employee Assistance Program (EAP) Discounts through our Perks Program Responsibilities Assists office staff, physicians and...

* 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 the charge capture and documentation processes.* Educate physicians and support staff on coding issues, including issues related to fraud and abuse as it relates to coding/professional billing/clinical documentation.* Attend and participate in meetings related to clinical revenue production and compliance.* Track physicians on inpatient service and ensure charges are captured for services provided.* Manage tracking log.* Audit and provide feedback to all providers rotating on inpatient service.* Other duties as assigned.* Thorough working knowledge of medical terminology, anatomy and physiology, as demonstrated by...

The Senior / Super Coder serves as a high-performing coding professional responsible for the accurate and timely assignment of ICD-10-CM/PCS, CPT, and HCPCS codes for all hospital services including inpatient, outpatient, emergency, surgery, and RHC encounters. This position functions as the department’s top-tier coder and provides advanced coding expertise, mentorship, and support to the Coding Team Leader, enabling her to focus on quality assurance, compliance, and education. The Senior Coder must maintain exceptional accuracy, productivity, and compliance with official coding guidelines, payer requirements, and FMH policy. Key Responsibilities Independently review and abstract complex clinical documentation for accurate code assignment. Assign appropriate ICD-10-CM/PCS, CPT, and HCPCS codes using the 3M encoder across multiple service lines. Resolve coding edits, medical necessity issues, and payer rejections efficiently. Collaborate with providers and the Coding Team...

Join to apply for the HOME HEALTH CODER/OASIS (PT DAYS) role at Riverside Healthcare Overview The Home Health Coder/OASIS is responsible for ensuring accurate and timely coding of home health services, including OASIS (Outcome and Assessment Information Set) data, in compliance with regulatory requirements and Riverside Healthcares standards. This role plays a critical part in the home health billing and reimbursement process, directly contributing to optimal patient care and financial outcomes. The ideal candidate will have a strong background in home health coding, be detail‑oriented, and possess a deep understanding of OASIS documentation submission. Essential Duties Review, analyze, and code home health care documentation according to current coding guidelines and regulations. Ensure accurate and timely submission of OASIS assessments, collaborating with clinical staff to ensure completeness and accuracy. Monitor and audit coding practices to maintain compliance with...

Medical Coder II page is loaded## Medical Coder IIlocations: SRO Corporate Center Warrenville 4201 Winfield Roadtime type: Full timeposted on: Posted Todayjob requisition id: R36150**Hourly Pay Range:**$24.86 - $37.29 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.**Position Highlights:*** Position: Medical Coder II* Location: Warrenville, IL* Full Time/Part Time: Full Time* Hours: Monday-Friday, during normal business hours**A Brief Overview:** The Medical Coder II plays a key role in our hospital's revenue cycle by accurately coding diagnoses and procedures in accordance with established coding guidelines. This position is essential in maintaining financial accuracy and compliance with regulatory requirements. **What you will do:*** Assign accurate diagnostic (ICD-10-CM) and procedural (CPT) codes to medical records based on clinical documentation, ensuring adherence to coding guidelines and...

Pro Fee Coder, Surgical Hourly Pay Range: $26.61 - $39.92 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors. Position: Pro Fee Coder, Surgical Location: Hybrid (Skokie, IL and remote) Position Type: Full-time Hours: Monday-Friday, standard 8.5 hour workday, must be flexible to accommodate early am or pm physician meetings as needed. Travel: Flexible WFH arrangement, however this is not a fully remote position. Candidate must be able to occasionally travel between NS locations. What You Will Do: Provide virtual and in-person coding and documentation education to physicians, advance practice providers, practice managers, and revenue cycle coders. Perform billing provider audits to identify missed revenue and/or compliance risk. Analyze progress notes, op reports, pathology reports, explanation of benefits, patient insurance information, and various other health information documents for coding and billing...

7 months ago Be among the first 25 applicants Summary Responsible for assignment of accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities derived from medical record documentation (paper or electronic) for outpatient encounters. Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities. Summary Responsible for assignment of accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities derived from medical record documentation (paper or electronic) for outpatient encounters. Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities. Duties & Responsibilities Responsible for the assignment of accurate E&M, ICD, CPT, and...

Overview Illinois CancerCare is seeking a highly organized Certified Professional Coder (CPC) to join our team as a Coding Specialist. In this role you will translate medical diagnoses and procedure descriptions into accurate codes, ensuring high-quality health‑care data records. This is a great opportunity for someone who thrives in a detail‑oriented environment and enjoys being a key part of a collaborative team. Pay & Benefits Pay Range: $18.00 – $28.00/hour (based on experience, education, and other factors) Medical, dental, and vision insurance (multiple plan options) Special wellness programs – Maven, HingeHealth, Livongo, Vitality, and Wondr 401(k) retirement plan with employer contributions Company‑paid life, short‑term, and long‑term disability insurance Health Savings Account (HSA) & Flexible Spending Accounts (FSA) Paid time off and holidays Employee Assistance Program (EAP) Discounts through our Perks Program Responsibilities Assist office staff,...

Medical Coder II - Surgery Days This position has a deep understanding of disease process, A&P and pharmacology and acts as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the patient's service. Position Highlights: Position: Medical Coder II Location: Elmhurst Hospital Full Time/Part Time: Full Time Hours: Monday-Friday, day shift What you will do: Assigns diagnostic and procedure codes for compliant physician reimbursement and for both evaluation/management, preventive (HCC risk adjustment) and surgical services under general supervision. Communicates daily regularly with physicians and staff to resolve discrepancies with patient records and coding selections. Performs provider audits on E/M services and HCC review on Medicare/Medicare Advantage preventive services and educates providers as needed. Trains physicians and other staff regarding documentation, billing and coding, and documentation. What you...

DRG Coding Auditor Principal Virtual: _ This role enables associates to work virtually full-time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical‑expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology,...