25 coding auditor educator jobs found

Job Description Interpret clinical documentation/records from patient records to ensure all diagnoses and procedures are documented and coded accurately. Ensure highest level of reimbursement practice efficiencies and compliance related to coding procedures. Provide feedback and support to physicians. Responsibilities Responsible for translating healthcare providers' diagnostic and procedural documentation into coded form, applying regulatory and organizational guidelines. Review patient reports and extract data necessary to apply appropriate ICD and CPT codes for billing, internal and external reporting, research and regulatory compliance. Utilize technical coding principals and reimbursement rule expertise to assign appropriate ICD diagnosis and CPT procedures in multiple specialties, with thorough understanding all elements in E/M coding with ability to audit for correct E/M level selection. Regularly communicates with the healthcare provider to ensure documentation and...

Thank you for considering a career at Ensemble!Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!O.N.E Purpose:Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.Striving for...

PURPOSE OF THIS POSITION This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization's operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. JOB DUTIES/RESPONSIBILITIES Duty 1: Maintains a thorough understanding and education of federal and state regulations and payer...

Medical Claims SpecialistThis position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization's operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts.Job Duties/ResponsibilitiesMaintains a thorough understanding and education of federal and state regulations and payer specific policies and...

Come join NRP's A+ team! We've been recognized as a "Top Workplace" because we promote a culture where our team can build long-term careers and connections. As we grow as a company, our goal is that you will grow in your career. NRP has been recognized with several industry awards including Top Workplaces; Best and Brightest Companies to Work For; and National Apartment Association's Best Places to Work. We value our employees by offering a competitive benefit package including: Commission and bonus opportunities Paid vacation and sick leave 11 Paid holidays Paid maternity & parental bonding leave Short & long term disability Medical/Dental/Vision/Life Insurance 401(k) Match Training, certification, & growth opportunities Employee referral & recognition programs Since its founding in 1994, NRP has been dedicated to building quality homes for our residents, regardless of income. The NRP Group is a full-service multifamily developer, general...

Supervisory Inpatient/Outpatient MRT CoderVA Northeast Ohio Healthcare System – Cleveland, OhioThis Position Is Contingent Upon Bid AwardDepartment of Veterans AffairsVA Northeast Ohio Healthcare System / Cleveland VA Medical CenterWade Park Campus10701 East BoulevardCleveland, OH 44106U.S. citizenship is required. Personnel must satisfy all VA suitability, background-investigation, PIV, privacy, information-security, and system-access requirements.Favorable VA screening, National Agency Check initiation, PIV eligibility, and applicable ADP-sensitive access requirements apply.Full-Time Contractor Position$39.22 per hour.Up to 56 hours per year, accrued in accordance with Fidelity Partners policy and applicable requirements.Work must be staffed within the Monday-through-Friday service window of 6:00 AM–6:00 PM local facility time. Individual schedules will be assigned based on operational needs; off-hours work requires prior approval.Remote work is authorized through an approved VA...

Certified Coder / Audit Specialist Summa Health Medical Group Akron, OH 44304 Full-Time Days Will work remote after training and orientation Two (2) years of work experience in a physician’s office or Out-patient/In-patient setting performing documentation review per compliance and Medicare/Medicaid Standards, diagnostic code sequencing and familiarity to Medical Terminology required. Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Certified Medical Coder (CMC), Certified Professional Coder (CPC), Certified ProfessionalMedical Auditor (CPMA) reqired. Summa Health System is recognized as one of the region’s top employers by a number of third party organizations, including NorthCoast 99. Exceptional candidates gravitate to Summa because of its culture, passion for delivering excellent service to our patients and families commitment to our philosophy of servant leadership, collegial working relationships at every level of the organization and...

Ambulatory Surgery MRT CoderVA Northeast Ohio Healthcare System – Cleveland, OhioThis Position Is Contingent Upon Bid AwardWork LocationDepartment of Veterans AffairsVA Northeast Ohio Healthcare System / Cleveland VA Medical CenterWade Park Campus10701 East BoulevardCleveland, OH 44106Citizenship / Access Requirements: U.S. citizenship is required. Personnel must satisfy all VA suitability, background-investigation, PIV, privacy, information-security, and system-access requirements.Security Requirements: No classified clearance is specified. Favorable VA screening, National Agency Check initiation, PIV eligibility, and applicable ADP-sensitive access requirements apply.Type of Employment: Full-Time Contractor Position with W-2 employment through Fidelity Partners.Estimated Compensation: $35.21 per hour.Paid Sick Leave: Up to 56 hours per year, accrued in accordance with Fidelity Partners policy and applicable requirements.Working Hours: Work must be staffed within the...

Thank you for considering a career at Ensemble!Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!O.N.E Purpose:Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.Striving for...

Job Description Using established policies and procedures; the Certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing. The Certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and may be called upon to code highly complex inpatient records (to include trauma, burns, open heart and transplant cases) based on experience and skill set. Responsibilities Coding Quality: Reviews inpatients, ambulatory, observation, emergency and outpatient accounts to assign accurate ICD-10 and/or CPT codes and DRG's. Interprets health record content to ensure that all diagnoses and procedures coded are supported by physician documentation. Maintains a coding accuracy rating of at least 95% on records assigned. Queries physicians when necessary to ensure documentation...

Job Description Job Description Description:    About Primary Health Solutions Our Mission We meet people where they are and partner with them on their journey towards wellness. Our Vision The destination for servant leaders to provide comprehensive and exceptional care. Our Values R – Respect I – Innovation S – Stewardship E – Excellence  Billing and Coding Specialist Summary Responsible for entering/auditing/coding patient services to ensure encounters transfer properly for submission to insurance payers. Analyze coding related claim issues, process gaps and denials to trend feedback for providers by location and/or specialty.  A Day in the Life · Review provider documentation (including hospital procedures) and translate services into correct codes. Append payer specific modifiers and claim criteria when applicable.  · Review incomplete encounters and code based on available documentation in EHR systems. · Know and understand several different...

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: Benefits may vary based upon position type and/or level. Job Summary...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We’re Looking For We’re looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

The salary range for this job posting is $43,950.00 - $70,319.00 annually + bonus + benefits. Pay Type: Hourly The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process. Encova Insurance is seeking a Medical Bill Adjuster. The ideal candidate will reside within a reasonable commuting distance of our Charleston, West Virginia office and be able to work a hybrid schedule. However, we are also open to highly qualified candidates who reside in any state where Encova is authorized to employ associates, as listed in this posting, and who wish to work remotely from a home-based office. Unique residence requirements are listed in each job posting, please review closely for details. Encova is only able to...

Job Description Using established policies and procedures; the Certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing. The Certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and may be called upon to code highly complex inpatient records (to include trauma, burns, open heart and transplant cases) based on experience and skill set. Location Cincinnati, OH, United States Qualifications Minimum Requirements High School Diploma or GED. Formal education in ICD-9-CM/CPT coding, medical terminology, anatomy, pathophysiology, and disease processes. At least 1 year of acute care coding experience or equivalent relevant experience. Certification in one of the following: Registered Health Information Technician (RHIT), Registered Health Information Administrator...

Job DescriptionInterpret clinical documentation/records from patient records to ensure all diagnoses and procedures are documented and coded accurately. Ensure highest level of reimbursement practice efficiencies and compliance related to coding procedures. Provide feedback and support to physicians.ResponsibilitiesResponsible for translating healthcare providers' diagnostic and procedural documentation into coded form, applying regulatory and organizational guidelines.Review patient reports and extract data necessary to apply appropriate ICD and CPT codes for billing, internal and external reporting, research and regulatory compliance.Utilize technical coding principals and reimbursement rule expertise to assign appropriate ICD diagnosis and CPT procedures in multiple specialties, with thorough understanding all elements in E/M coding with ability to audit for correct E/M level selection.Regularly communicates with the healthcare provider to ensure documentation and coding...

Ensemble Health Partners is seeking an experienced Outpatient Facility Coding Auditor to join a remote team with occasional onsite travel to client locations. You will audit outpatient coding quality, ensure accuracy of diagnoses, CPT/HCPCS codes and edits, and support client education through executive summaries and training materials. The role requires 3+ years in outpatient coding and auditing, with strong regulatory knowledge and proficiency in Microsoft Office. #J-18808-Ljbffr

Medical Coding and Billing Compliance Auditor Location: Remote Division: Coding Compliance About the Role: The Medical Coding Auditor is a detail-oriented position responsible for reviewing medical coding accuracy, documentation integrity, ensuring compliance with federal and state regulations, payer guidelines, and internal policies. The ideal candidate will bring strong analytical skills, extensive coding knowledge, and a passion for maintaining the highest standards of quality and compliance. The candidate will demonstrate a strong background in Microsoft Office applications including PowerPoint, Word, Excel, Outlook, TEAMS, and SharePoint. The Medical Coding Auditor will have a background in physician feedback and education on documentation integrity and coding accuracy. The ideal candidate will have extensive knowledge of CPT coding, ICD-10-CM coding, E/M coding, HCC methodologies, modifiers, telehealth, and HCPCS coding. The candidate will understand and know...

Thank you for considering a career at Ensemble!Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!O.N.E Purpose:Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.Striving for...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Job Details: Job Location: Reno Home - Reno, OH, Position Type: Full Time, Salary Range: Undisclosed, Job Shift: 8-Hour Day Shift, Job Category: Professional, In an environment of continuous quality improvement, the Coding Auditor will assist in the review of medical records documentation to ensure completeness, accuracy, and compliance with applicable federal and state regulations and guidelines. The Coding Auditor will also be responsible for all documentation and coding education that is provided to the coding staff and providers. Exhibits the Standards of Excellence and exercises strict confidentiality at all times. Job Functions: Manages quality improvement audits and training of designated coding staff and providers. Researches, analyzes, and responds to internal and external inquiries regarding compliance, inappropriate coding, denials, and billable services. Acts as expert coding resource to coders, clinical documentation improvement, providers, and other departments within...

Job Description Interpret clinical documentation/records from patient records to ensure all diagnoses and procedures are documented and coded accurately. Ensure highest level of reimbursement practice efficiencies and compliance related to coding procedures. Provide feedback and support to physicians. Responsibilities Responsible for translating healthcare providers’ diagnostic and procedural documentation into coded form, applying regulatory and organizational guidelines. Review patient reports and extract data necessary to apply appropriate ICD and CPT codes for billing, internal and external reporting, research and regulatory compliance. Utilize technical coding principals and reimbursement rule expertise to assign appropriate ICD diagnosis and CPT procedures in multiple specialties, with thorough understanding all elements in E/M coding with ability to audit for correct E/M level selection. Regularly communicates with the healthcare provider to ensure documentation and...

CVS Health is seeking a Certified Coding Analyst to perform medical claim reviews for waste and error to ensure coding accuracy and compliance. You will audit CPT/HCPCS and modifiers against medical records, apply CMS/state guidelines, and discuss findings with Medical Directors as needed. Responsibilities include identifying billing errors, preparing clear summaries, and supporting provider education. The role requires CPC certification, 2+ years coding experience, and proficiency with Excel #J-18808-Ljbffr

We're building a world of health around every individual – shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The Certified Coding Analyst will perform medical claim reviews for waste and error to ensure compliance with coding practices through a comprehensive record review for medical and institutional providers. The Analyst must have the ability to determine correct coding and appropriate documentation during the review of medical records. The Analyst must also ensure state; federal and company requirements are met. Conduct a comprehensive medical record audit to ensure the CPT/HCPCS or modifiers billed are consistent with medical record...