26 coding auditor provider educator jobs found

Professional Services Certified Coding Reviewer All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI's vision to be among the kindest, highest quality health systems in the country. Ensures data quality in compliance with State, Federal and regulatory requirements. Evaluates medical record documentation and charge reports to ensure completeness, accuracy and compliance with the Correct Coding Initiative Edits. Codes all professional charges to ensure accurate and timely billing Perform coding reviews and/or surgical coding for practices and providers. Evaluates and report audit findings or reviews and reports on results to physicians and/or operations directors. Provides technical guidance, training, and on-going coding education when instructed, to physicians and their office staff and other ancillary departments on both general and specific coding issues to include documentation and guidance in quality coding for proper...

Company Intro At American Vision Partners (AVP) , we partner with the most respected ophthalmology practices in the country and integrate best-in-class management systems, operational infrastructure, and advanced technology to provide the highest quality patient care possible. Our practices include Barnet Dulaney Perkins Eye Center, Southwestern Eye Center, Retinal Consultants of Arizona, M&M Eye Institute, Abrams Eye Institute, Southwest Eye Institute, Aiello Eye Institute, Moretsky Cassidy Vision Correction, Wellish Vision Institute, West Texas Eye Associates and Vantage Eye Center. We are focused on building the nation's largest and most comprehensive eye care practices and currently operate more than 120 eye care centers in Arizona, New Mexico, Nevada, California and Texas - including 25 ambulatory surgical centers. At AVP we value teamwork, providing exceptional experiences, continuous improvement, financial strength, and hard work. We are committed to providing...

Become a part of our caring community The 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 Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

Certified Professional Coder Salary: $21.26-$29.23 Depending on experience Schedule: Monday-Friday Job Purpose The Certified Professional Coder coordinates and performs the implementation of concurrent coding and querying processes, as well as performing administrative and fiscal duties, tasks, and assignments in support of the Business Office Department and its varied operations. A Certified Professional Coder is responsible for the translation of healthcare providers' diagnostic and procedural phrases into coded form, as well as the review and interpretation of health record documentation to ensure accurate coding services are rendered and submitted. A Certified Professional Coder ensures that all technical aspects of the assignment of diagnostic and procedural coding are carried out in accordance with established standards and comply with CMS, NCQA, third-party payers, and other regulatory agencies. The incumbent will support and assist in the training and education of...

PLEASE NOTE - This position may require temporarily relocation to other TONHC Facilities: Sells Hospital, Santa Rosa Health Center, San Simon Health Center, and San Xavier Health Center. Position Summary: The Lead Medical Coder serves as a certified professional coder and assists the Medical Coding Office Manager with oversight of daily coding operations. Performs the full range of coding, assigns ICD, CPT, HCPCS, and medical inpatient codes; abstracts data from the record; performs chart analysis, research coding issues; peer reviews; and serves as a medical documentation and coding technical expert to TONHC providers. Scope of Work: This position is located within Tohono O'odham Nation Health Care (TONHC). The work involves performing specialized medical record tasks and resolving problems using established processes, coding conventions, and guidelines. Performance of duties reflects directly on patient care by recording services performed on the patient. The...

Essential Functions for This Position Ensures that codes are assigned correctly and sequenced appropriately as per government and insurance regulations. Complies with all medical coding guidelines. Follows up and clarifies any information that is not clear with the rendering provider. Conducts ad‑hoc audits to ensure fidelity to coding guidelines. Serves as an expert for Southwest Network on accurate and efficient coding practices. Analyzes medical records and identifies documentation deficiencies. Nonessential Functions Follows policies and procedures and adheres to the requirements of the Corporate Compliance Program. Ensures confidentiality of verbal and written information in accordance with HIPAA standards and Southwest Network policy, and adheres to the legal, ethical, and professional guidelines adopted by Southwest Network. Other duties as assigned. Working Conditions and Driving Travel between Southwest Network sites as well as in the community is required. Must...

Essential Functions For This Position Ensures that codes are assigned correctly and sequenced appropriately as per government and insurance regulations. Complies with all medical coding guidelines. Follows up and clarifies any information that is unclear with the rendering provider. Conducts ad-hoc audits to ensure fidelity to coding guidelines. Acts as a relevant expert for Southwest Network on accurate and efficient coding practices. Analyzes medical records and identifies documentation deficiencies. Nonessential Functions Follows policies and procedures and adheres to the requirements of the Corporate Compliance Program. Ensures confidentiality of verbal and written information in accordance with HIPAA standards and Southwest Network policy, and adheres to legal, ethical, and professional guidelines adopted by Southwest Network. Other duties as assigned. Education And/or Experience, Licensure And Certification Associate degree in medical coding or successful...

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...

Join to apply for the Professional Billing Coder II role at Onvida Health 2 days ago Be among the first 25 applicants Join to apply for the Professional Billing Coder II role at Onvida Health Get AI-powered advice on this job and more exclusive features. Job Description Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Job Description Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Days Pay Rate Type: Hourly Location: Remote Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $22.62 Mid = $28.28 Max = $33.93 Summary The Professional Billing Coder II is an intermediate-level coding professional responsible for independently reviewing medical documentation and assigning accurate diagnostic and...

Summary Join the Indian Health Service and make a meaningful impact in Native communities. In this role, you will support vital healthcare operations that ensure patients receive timely, high-quality care. If you're looking for a rewarding career where your work directly supports patient services and community well-being, we encourage you to apply. A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021). Learn more about this agency Duties Help All Grade levels MAY NOT be available at all locations. Total Compensation Package - Check out IHS's outstanding total compensation package for this job: Medical Records Technician Total Compensation | Pay (ihs.gov) Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final...

Job Description Staff Position Description Position Title: Professional Services Certified Coding Reviewer Position Code: Coder-8125 Department: Health Information Management Safety Sensitive: YES Reports to: HIM Director/Manager Exempt Status: NO Position Purpose: All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI's vision to be among the kindest, highest quality health systems in the country. Key Responsibilities Ensures data quality in compliance with State, Federal and regulatory requirements. • Evaluates medical record documentation and charge reports to ensure completeness, accuracy and compliance with the Correct Coding Initiative Edits. • Codes all professional charges to ensure accurate and timely billing • Perform coding reviews and/or surgical coding for practices and providers. • Evaluates and report audit findings or reviews and reports on results to physicians and/or...

Under general supervision of the HIM Director, the Certified Inpatient Coder is responsible for reviewing inpatient medical records and accurately assigning ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and MS-DRGs in accordance with official coding guidelines, federal regulations, and Tribal 638 facility policies. Upholds the principles of WIHCC's Vision, Mission, and Value Statements. Maintains confidentiality of all privileged information at all times. This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all-inclusive. Essential Duties & Responsibilities: Maintains regular attendance and punctuality. Review inpatient medical records to identify all diagnoses and procedures relevant to each patient encounter. Assign ICD-10-CM and ICD-10-PCS codes according to official coding guidelines. Determine and assign the appropriate MS-DRG. Ensure coding reflects the highest level of specificity...

Essential Functions Reviews and abstracts clinical documentation from complex inpatient orthopedic and spine surgery records to assign accurate ICD-10-CM, ICD-10-PCS, DRG, POA, and discharge disposition codes. Independently codes high-acuity inpatient orthopedic spine surgery cases including cervical, thoracic, and lumbar procedures, revisions, fusions, instrumentation, and neurological-related musculoskeletal procedures. Provides real-time feedback and training for coding staff to improve coding quality and productivity. Applies and validates accurate MS-DRG assignments while ensuring compliance with CMS, UHDDS, Official Coding Guidelines, and payer-specific requirements. Identifies coding trends, documentation gaps, and reimbursement risks and communicates findings to leadership. Maintains productivity and quality standards while managing high-volume and high-complexity inpatient workloads. Serves as a coding resource and mentor to less experienced coders and assists with...

Inpatient Surgical Coder "Complex spine coding highly desired" Job Category: Clinic Support Requisition Number: INPAT012321 Full‑Time Locations Showing 1 location Responsibilities Reviews and abstracts clinical documentation from complex inpatient orthopedic and spine surgery records to assign accurate ICD‑10‑CM, ICD‑10‑PCS, DRG, POA, and discharge disposition codes. Independently codes high‑acuity inpatient orthopedic spine surgery cases including cervical, thoracic, and lumbar procedures, revisions, fusions, instrumentation, and neurological‑related musculoskeletal procedures. Provides real‑time feedback and training for coding staff to improve coding quality and productivity. Applies and validates accurate MS‑DRG assignments while ensuring compliance with CMS, UHDDS, Official Coding Guidelines, and payer‑specific requirements. Identifies coding trends, documentation gaps, and reimbursement risks and communicates findings to leadership. Maintains productivity and...

Inpatient Surgical Coder "Complex spine coding highly desired" Reviews and abstracts clinical documentation from complex inpatient orthopedic and spine surgery records to assign accurate ICD-10-CM, ICD-10-PCS, DRG, POA, and discharge disposition codes. Independently codes high‑acuity inpatient orthopedic spine surgery cases including cervical, thoracic, and lumbar procedures, revisions, fusions, instrumentation, and neurological‑related musculoskeletal procedures. Provides real‑time feedback and training for coding staff to improve coding quality and productivity. Applies and validates accurate MS‑DRG assignments while ensuring compliance with CMS, UHDDS, Official Coding Guidelines, and payer‑specific requirements. Identifies coding trends, documentation gaps, and reimbursement risks and communicates findings to leadership. Maintains productivity and quality standards while managing high‑volume and high‑complexity inpatient workloads. Serves as a coding resource and mentor...

This is a remote based position. Applicants can be located nationwide Back 1d Outpatient Coding Auditor #2814 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...

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...

Navajo Preference Employment Act TCRHCC is located within the Navajo Nation and, in accordance with Navajo Nation law and applicable federal law, has implemented a Navajo/Indian Preference in Employment Policy. Pursuant to this Policy, applicants who are enrolled members of the Navajo Nation, Hopi Tribe, and San Juan Southern Paiute Tribe and who meet the necessary qualifications for this position will be given preference in hiring and employment for this position. Applicants who are legally married to an enrolled member of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe, who have resided within the territorial jurisdiction of the Navajo Nation or other federally-recognized American Indian Tribe for at least one continuous year immediately preceding the date of application, and who meet the necessary qualifications for this position will be given secondary preference. Applicants who are enrolled members of any other federally-recognized American Indian Tribe and...

100% remote Medical Coder needed for part‑time contract / Must have hospital and/or acute care experience! Salary: $30 - $40 per hour Job Details We are currently seeking an experienced Inpatient Medical Coder to join our dynamic and fast‑paced team. The successful candidate will play a crucial role in accurately coding patient records for our inpatient services. This is a long‑term contract role with strong likelihood of converting to a permanent employee in 2027. Benefits 100% remote work Flexible work schedule Growth opportunities Responsibilities Reviewing and analyzing patient records to accurately assign ICD-10-CM and ICD-10-PCS codes for all diagnoses and procedures. Working closely with healthcare providers to clarify ambiguous or conflicting patient information. Ensuring compliance with established coding guidelines, third‑party reimbursement policies, and federal regulations. Conducting regular audits to ensure coding accuracy, completeness, and compliance with...

A health data exchange leader is seeking an Inpatient Auditing Specialist to perform coding audits, provide coder education, and ensure regulatory compliance. This fully remote position allows for flexible scheduling, catering to professionals with over 5 years of inpatient coding experience. Candidates should hold certifications like CCS, RHIA, or RHIT and have experience with software such as Epic and Cerner. #J-18808-Ljbffr

Our client is seeking an experienced Quality Assurance Coder/Auditor in Phoenix, AZ on a Hybrid basis. This opportunity will transition from a 6-month contract to direct hire position while being trained as a replacement by a seasoned employee. The Quality Assurance Coder/Auditor will develop a risk mitigation and provider education program. The Quality Assurance Coder/Auditor will perform risk mitigation analysis using available vendor tools to identify at-risk single occurrence of HCCs and OIG targets. Schedule 40 hours a week (plus any additional hours as requested or as needed to meet business requirements). Hybrid 1 day a week in office setting, remainder of week is remote Key Responsibilities Comprehensive understanding of HCC Coding rules, regulations and methodology Review medical records and supporting documentation, determine completeness and accuracy of medical records and supporting documentation, identify and eliminate barriers to correct coding, and recommend best...

Job Description Job Description ESSENTIAL FUNCTIONS • Reviews and abstracts clinical documentation from complex inpatient orthopedic and spine surgery records to assign accurate ICD-10-CM, ICD-10-PCS, DRG, POA, and discharge disposition codes. • Independently codes high-acuity inpatient orthopedic spine surgery cases including cervical, thoracic, and lumbar procedures, revisions, fusions, instrumentation, and neurological-related musculoskeletal procedures. • Provides real-time feedback and training for coding staff to improve coding quality and productivity. • Applies and validates accurate MS-DRG assignments while ensuring compliance with CMS, UHDDS, Official Coding Guidelines, and payer-specific requirements. • Identifies coding trends, documentation gaps, and reimbursement risks and communicates findings to leadership. • Maintains productivity and quality standards while managing high-volume and high-complexity inpatient workloads. • Serves as a coding resource and...

Medical Billing Specialist This position aids in properly capturing charges and correctly billing for services performed. The Medical Billing Specialist minimizes department rework, reprocessing of multiple claims from misaligned coding, and tracks and trends repeated missed opportunities for compliant charging and proactively finds and/or provides input regarding tools to streamline and/or improve charging processes. MAIN: Analyze daily financial exceptions from the charge capture audit reports to determine areas of leakage and partner with information technology and clinical service lines to rectify charge capture issues by assisting service lines to improve their ability to capture compliant charges. Performs assigned audits by researching documentation, analyzing information, and makes recommendations to improve flow of claim and enters all corrections into the systems. Perform root cause analyses, when warranted by continuous trends, to pinpoint areas, process gaps and...

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....