17 coding auditor facility jobs found

The Facility Audit Department at BCBST is searching for a talented Coding Auditor to join our dynamic team in performing detailed claims payment quality reviews and coding compliance audits. This role is essential in reviewing hospital claims to ensure appropriate reimbursement, as well as compliance with contracts, regulatory requirements, and BCBST guidelines. A unique aspect of this position is providing educational feedback and reports to TN facilities based on audit findings. While travel is not currently required, there may be rare occasions when traveling to a TN facility for an audit becomes necessary, so we're seeking candidates who reside in Tennessee or continuous counties. The ideal candidate will bring a Bachelor's degree or equivalent experience, together with at least two years of facility inpatient or outpatient coding and auditing experience, or reimbursement experience in a payer environment. An active AHIMA or CPC hospital certification (such as CCS, CIC, or...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

Overview Coding Educator, Clinical Document Integrity Full Time, 80 Hours Per Pay Period, Day Shift Must be located in East TN. Remote with onsite requirements.. Covenant Medical Group is Covenant Health’s employed and managed medical practice organization, with more than 300 top Physicians and providers spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include cardiology, cardiothoracic surgery, cardiovascular surgery, endocrinology, gastroenterology, general surgery, infectious disease, neurology, neurosurgery, obstetrics and gynecology, occupational medicine, orthopedic surgery, physical medicine and rehabilitation, primary care, pulmonology, reproductive medicine, rheumatology, sleep medicine and urology. Position Summary: Provides consulting services to the organization’s management and staff and may coordinate requested coding investigations. Responsible for education and training for all Covenant coders, CDI, and/or physician...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2675 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced knowledge...

Coding Specialist Under the direct supervision of the Coding Supervisor/Clinical Manager, responsible for assigned 8 hour shift, 5 days a week with possibility as needed of overtime. Essential Job Functions: Reviews electronic medical records and paper records to identify all treated diagnosis and significant procedures performed. Sequences diagnoses and procedures according to definition of principal diagnosis, other co-morbid conditions and complications, and according to definition of principal procedure and other procedures and using appropriate modifiers. Uses 3M Encoder to assign ICD-9 diagnosis and CPT procedure codes and modifiers when indicated to ensure coding accuracy. Uses compliance advisor to determine medical necessity. Utilizes online coding references, Local Coding Determinations and National Coding Determinations, Medicare Part B Announcements, Coding Alerts, Compliance Advisor, and other payer guidelines and to ensure appropriate code assignment for...

Coder Analyst Specialist, Clinical Document Integrity Full Time, 80 Hours Per Pay Period, Day Shift Covenant Medical Group is Covenant Health's employed and managed medical practice organization, with more than 300 top Physicians and providers spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include cardiology, cardiothoracic surgery, cardiovascular surgery, endocrinology, gastroenterology, general surgery, infectious disease, neurology, neurosurgery, obstetrics and gynecology, occupational medicine, orthopedic surgery, physical medicine and rehabilitation, primary care, pulmonology, reproductive medicine, rheumatology, sleep medicine and urology. Position Summary: Analyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding initiatives....

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. ***** FT and PRN Openings *** Up to $5,000 Sign On Bonus ***** 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...

Discover Vanderbilt University Medical Center : Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research. Organization: Compliance Operations - VUH Job Summary: Applies specialized skills and training independently to evaluate and advise whether professional,...

Who we are The real world is the next frontier, and at Metropolis, we are creating the artificial intelligence to make it responsive. We are pioneering the Recognition Economy - a future where mundane repetition disappears and being known unlocks access, comfort and belonging everywhere you go. From transforming parking into a seamless drive-in, drive-out experience for millions of Members to expanding our intelligence layer across retail and hospitality, we are building a world that feels instinctive and magical. The future isn't coming; it's here, and we need builders, innovators and problem solvers to help us create it. Who you are Metropolis is seeking an Operational Compliance Auditor to add value and improve our operations by bringing a systematic and disciplined approach to the effectiveness of risk management, control, and governance processes. The ideal candidate possesses thorough knowledge of accounting procedures and sound judgment, as you will review control...

Position Summary: The Surgical Coder in an Ambulatory Surgery Center (ASC) is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS Level II codes to surgical and procedural services based on thorough review of patient medical records. This role ensures coding compliance with current healthcare regulations and supports timely, accurate billing and data reporting. The ideal candidate has strong knowledge of surgical procedures, anatomy, and medical terminology, and is comfortable collaborating with clinical and administrative teams. This is a non-exempt position. Key Responsibilities: Assign appropriate diagnosis and procedure codes (ICD-10-CM, CPT, HCPCS) in accordance with documentation and regulatory requirements Analyze patient medical records, operative reports, and other clinical documentation to ensure completeness and accuracy in coding. Work closely with surgeons, nurses, and billing staff to clarify documentation and resolve coding...

Overview Coder Analyst Specialist, Clinical Document Integrity Full Time, 80 Hours Per Pay Period, Day Shift Covenant Medical Group is Covenant Health’s employed and managed medical practice organization, with more than 300 top Physicians and providers spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include cardiology, cardiothoracic surgery, cardiovascular surgery, endocrinology, gastroenterology, general surgery, infectious disease, neurology, neurosurgery, obstetrics and gynecology, occupational medicine, orthopedic surgery, physical medicine and rehabilitation, primary care, pulmonology, reproductive medicine, rheumatology, sleep medicine and urology. Position Summary: Analyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding...

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:...

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...

At Houston Methodist, the Lead Outpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to outpatient encounters based upon documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. FLSA STATUS Non-exempt...

Overview Become a part of our caring community and help us put health first Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Durable Medical Equipment (DME) auditing and is part of the PPI Coding Disputes Team with Humana. The Disputes Auditor – DME Outpatient Coding on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Responsibilities Will be an experienced medical coding auditor with in-depth experience in outpatient DME coding disputes...

Join to apply for the Physician Coder III, Remote role at Erlanger 3 days ago Be among the first 25 applicants Join to apply for the Physician Coder III, Remote role at Erlanger Erlanger Health hires employees for telecommuting/remote positions in the following states: AL, AZ, GA, FL, IN, KY, LA, MD, M I, MS, MO, NC, NV, OH, SC, TN, TX, VA, WI, WY REMOTE Job Summary: The Physician Coder III is responsible for coding of physician and/or mid-level provider professional services. Recognizes and completes a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follows set procedures to achieve goals. Displays professional office skills and ability to navigate a practice management system. Functions as liaison between management, the physician practices and employees working within physician practices. Coder will provide CPT, HCPCS and ICD-10-CM coding a minimum of 1-4 specialties. Specialties could include UR, Podiatry, Plastics,...