24 coding auditor educator jobs found

POSITION DESCRIPTION :The Compliance Auditor / Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services.Provides professional expertise and education in CPT, ICD and HCC coding.The Compliance Auditor / Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations.This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution.Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance.ESSENTIAL JOB FUNCTIONS :Develops and leads audit projects for medical record integrity, service line or issues-related audits, identifies...

Siu Coder McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a SIU Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Position Overview: The Special Investigations...

Advanced Coding Position Positions Location: Lansing, MI Job Description General Purpose of Job: Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine Sparrow policies and procedures and maintains required quality and productivity...

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...

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...

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines Utilize encoders and various coding resources Perform CPT Procedure reviews...

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...

Coding Specialist Assigns ICD diagnosis and CPT procedure codes to assigned Outpatient work types. Employment Type: Full Time Weekly Scheduled Hours: Mon-Fri 7am-3:30pm Wage Range: $21.14-$31.70 Requirements: - High school diploma/GED, or higher education - Registered Health Info Tech (R-RHIT) required Preferred Requirements: - Registered Health Info Admin (R-RHIA) - Certified Coding Specialist (C-CCS) Coding: Based on clinical documentation, computerized encoding, accepted coding classification principals, and reference material, efficiently and accurately assigns appropriate ICD diagnosis codes CPT procedure codes and modifiers on assigned chart types. Verifies accuracy of completed fields. Maintains credentials and ongoing education in order to apply current policies and principals for accurate coding. Assigns appropriate ICD codes. Assigns appropriate CPT codes. Assigns appropriate Modifiers on APC accounts. Searches chart documentation for...

Benefits: 401(k) Dental insurance Health insurance Paid time off Parental leave Vision insurance WRS US Workers Billing offers a team-oriented and sales-driven culture focused on enriching our patients lives. As our medical billing team grows, we are looking to add a team member with a strong background in medical billing, customer service, and communication with third party adjusters. The ideal candidate will possess strong knowledge in these areas along with the ability to multi-task while staying organized. The WRS culture is one of caring and collaboration, and our team members enjoy working in a fast-paced, team-oriented environment. If this sounds like your ideal work environment, take a look at the job description below and apply today! Role and Responsibilities Audit records to ensure proper submission of services prior to submitting claim to payer Supply correct ICD-10-CM diagnosis codes on all claims Supply correct CPT code on all DME procedures and...

Benefits: 401(k) Dental insurance Health insurance Paid time off Parental leave Vision insurance WRS US Workers Billing offers a team-oriented and sales-driven culture focused on enriching our patients lives. As our medical billing team grows, we are looking to add a team member with a strong background in medical billing, customer service, and communication with third party adjusters. The ideal candidate will possess strong knowledge in these areas along with the ability to multi-task while staying organized. The WRS culture is one of caring and collaboration, and our team members enjoy working in a fast-paced, team-oriented environment. If this sounds like your ideal work environment, take a look at the job description below and apply today! Role and Responsibilities Audit records to ensure proper submission of services prior to submitting claim to payer Supply correct ICD-10-CM diagnosis codes on all claims Supply correct CPT code on all DME...

Job Description General Purpose of Job :   Ensure Revenue Cycle Coding and Billing are compliant with State and Federal regulations.  Respond to and Investigate compliance issues within Revenue Cycle.   Lead and/or coordinate audit activity with governmental audits.   Essential Duties : This job description is intended to cover the minimum essential duties assigned on a regular basis.  Team members may be asked to perform additional duties as assigned by their leader.  Leadership has the right to alter or modify the duties of the position. Ensures conformance with applicable laws, regulations and Medicare/Medicaid reimbursement rules to ensure UMHS is in compliance with federal, state and/or local regulations. Monitors, analyzes and reports on laws, regulations, audits and industry standards that impact the organization. Develops and maintains Professional and Hospital billing issues on the Revenue Cycle Compliance Work Plan. Reviews the OIG Work Plan,...

Job DescriptionJob DescriptionMedical Coding Compliance SpecialistCompensation :Up to $85,000 annually, determined by your experience and qualifications.Job Location :Remote (US)Job Highlights :Work-Life Balance :Monday to Friday schedule for a fulfilling personal and professional life.Competitive Compensation :Be rewarded with a generous salary and benefits package.Career Growth Opportunities :Unlock your potential and advance in your career with our support.Supportive Work Environment :Join a team that values and appreciates your contributions.Comprehensive Training :Enhance your skills and knowledge through our extensive training programs.Compliance and Peace of Mind :Work with confidence knowing that we prioritize compliance with employment laws and regulations.Paid Time Off and Holidays :Enjoy well-deserved time off to relax and recharge.Life Insurance Coverage :Protect your loved ones with our employer-paid life insurance policy.Collaborative Team Environment :Thrive in a...

This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third-party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities. General responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks. Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days. Accurately post all insurance payments by line item. Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely* Collects on outstanding claims from third-party payers according to department benchmarks. Works on special billing projects as assigned by the Billing Supervisor in...

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a SIU Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Learn more about McLaren Health Plan at...

Overview The Health Information Management Coder Inpatient Level 2 provides timely and accurate clinical and administration data to ensure optimal reimbursement for inpatient, rehab and/or skilled nursing coding to support the facility needs. Primary patient contact is only social. Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation. Responsibilities Contributes to organization success targets for patient satisfaction. Formulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients, and other department staff members. Adheres to current coding rules, regulations and requirements for inpatient coding, DRG/APR-DRG assignment, rehab coding, skilled care coding, CMG assignment,...

Description Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future - we provide the venue for individuals who...

Overview The Professional Coder provides timely and accurate clinical and administration data to ensure optimal reimbursement for professional services performed at acute care, inpatient, outpatient, urgent care or physician offices to meet organizational needs. This position is responsible for ICD10CM diagnosis, CPT-4 coding and charge entry related to coding, documentation, billing and reimbursement issues. Works as a liaison between centralized billing staff, practice managers and office staff and may be required to meet with the office staff and physicians as needed. This position is responsible for the monitoring the quality of coding and stays current on professional coding changes, compliance issues, billing, documentation, reimbursement and interpretation of coding/documentation rules. Primary patient contact is only social. He/she demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards...

Description Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future - we provide the venue for individuals...

Medical Coder Compliance Spec Extended Site Maintenance We are performing updates and maintenance to our applicant experience. As a result, the site will be unavailable Saturday, February 7th at 8am EST through Sunday, February 9th at 7:30am EST. During this outage period, applications for job postings can not be submitted. Apply Now Job Summary Perform coding quality audits on outpatient records to assure appropriateness, accuracy, and compliance for CPT/HCPCs, ICD-10-CM code assignments, and modifier assignment in accordance with Center of Medicare and Medicaid Service (CMS) Guidelines, AMA and AHA Official ICD-10-CM Coding Guidelines. Provide ongoing feedback to managers and coders. Develop and implement educational programs regarding elements of the coding compliance program and act as a subject matter expert for the outpatient coding department. Mission Statement Michigan Medicine improves the health of patients, populations and communities through...

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...

Job ID: 52414 Positions Location: Lansing, MI Job Description General Purpose of Job: Ensure Description: Positions Location: Lansing, MI Job Description General Purpose of Job : Ensure Revenue Cycle Coding and Billing are compliant with State and Federal regulations. Respond to and Investigate compliance issues within Revenue Cycle. Lead and/or coordinate audit activity with governmental audits. Essential Duties : This job description is intended to cover the minimum essential duties assigned on a regular basis. Team members may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position. Ensures conformance with applicable laws, regulations and Medicare/Medicaid reimbursement rules to ensure UMHS is in compliance with federal, state and/or local regulations. Monitors, analyzes and reports on laws, regulations, audits and industry standards that impact the organization....

Job Opportunity Job ID:49762 Positions Location: Lansing, MI Job Description General Purpose of Job: Advanced Description: Positions Location: Lansing, MI Job Description General Purpose of Job : Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows...

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...

Job Description General Purpose of Job :   Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine – Sparrow policies and procedures and maintains required quality and productivity standards. Essential Duties : This job...