26 coding compliance auditor jobs found

Option to be Hybrid/Remote. Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic’s policies and procedures and accepted guidelines for medical coding. Works closely with the Compliance Officer and Compliance coding Audit Coordinator to perform audits outlined in the work plan. Requires ability to present detailed analysis of audits in both written and spoken form. Relies on professional judgement to ensure Internal Audit and Compliance standards are used to assess compliance with CPT, ICD-9/10, HCPCS, Payor, CMS guidelines and TGC policies Experience: - Working knowledge of medical terminology, anatomy and physiology, and coding guidelines including CPT, ICD- 9 /10-CM, and HCPCS coding systems and guidelines, payer guidelines and requirements. - Minimum 1-year experience in Physician coding and billing and/or compliance field required 5 year of clinical experience and/or knowledge and understanding of Medical Records auditing...

Job Description Job Description Job Summary We are seeking a detail-oriented and motivated Auditor to join our dynamic team. In this vital role, you will be responsible for reviewing and analyzing medical records, billing practices, and coding accuracy to ensure compliance with industry standards and regulations. Your expertise will help maintain the integrity of healthcare data, improve billing processes, and support the overall quality of healthcare services. This position offers an exciting opportunity to contribute to the efficiency and accuracy of medical documentation and reimbursement processes while working in a collaborative and fast-paced environment. Duties: Conduct thorough audits of medical records to verify completeness, accuracy, and compliance with established guidelines. Review coding practices including DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding to ensure proper classification of diagnoses and...

Inpatient Medical Coding Auditor As an Inpatient Medical Coding Auditor, you will make an impact by auditing consultant inpatient. You will be a valued member of the Cognizant team and work collaboratively with stakeholders and teams. In this role, you will: Review ICD-10 inpatient patient records for accuracy and compliance Review physician documentation to verify diagnosis and procedures Communicate with physicians to obtain or clarify diagnosis and/or procedures via the query process Assign accurate ICD-10-CM and ICD-10-PCS codes utilizing an electronic encoder application, 3M, in accordance with practice policy and regulatory guidelines Complete reports as requested Provide ICD-10-CM and ICD-10-PCS education and mentoring to Company's clients in coding, billing and compliance Perform Peer Reviews of Company Health Information Management coding auditors and coders Assure that services provided to Clients of Company are current and up-to-date with industry standards...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This is a work from home position that requires the selected candidate to have a permanent address and live in New Mexico or be willing to relocate to New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217 Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical...

Company : Allegheny Health Network Job Description : *This role will cover Inpatient Auditors and will require Inpatient (AHIMA) credentials. GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants...

Clinical Coding Auditor & Trainer Location: Remote (U.S.) Must be willing to travel to New York twice annually Position Type: Full Time The Clinical Coding Auditor & Trainer is responsible for conducting clinical documentation and coding audits to ensure compliance with federal regulations, payer requirements, and company policies. This position focuses on DRG validation, inpatient...

Professional Coding Auditor And Educator - Remote This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Clinical Coding Auditor & Trainer Location: Remote (U.S.) Must be willing to travel to New York twice annually Position Type: Full Time The Clinical Coding Auditor & Trainer is responsible for conducting clinical documentation and coding audits to ensure compliance with federal regulations, payer requirements, and company policies. This position focuses on DRG validation, inpatient...

Coding Auditor Specialist Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation. At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric careand your career. CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means. Reporting to the Coding Operations and Compliance Manager, the Coding Auditor Specialist plays a key role in ensuring the accuracy and integrity of our...

Company Description *Candidate should ideally be located in Philadelphia or Pittsburgh* Monro's family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach. Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company's regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color. Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto service in the industry....

Certified Specialty Coder Three Rivers Orthopedics is seeking a Certified Specialty Coder to support 11 orthopedic surgeons specializing in areas including spine and foot/ankle at 200 Delafield Road, Suite 1040, Pittsburgh, PA 15215. This full-time position runs Monday-Friday, 8:00 AM-4:30 PM, with the potential for work-from-home flexibility after training. Responsibilities: Utilize advanced, specialized knowledge of medical codes and coding procedures to assign and sequence appropriate diagnostic/procedure billing codes, in compliance with third party payer requirements. Monitor billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling and other questionable practices; prepares periodic reports for clinical staff identifying unbilled charges due to inadequate documentation. Perform all coding functions, based on staffing needs and/or department requirements. Refer problem accounts to appropriate coding or management...

Job Type Full-time Description Why you'll want to work at nimble! Interested in becoming a part of a dynamic Coding team? This is a great opportunity to join a well-established and market-leading brand serving a high-growth end market while gaining valuable experience working closely with Executive leadership. As an organization, we are in high-growth mode through acquisition with a laser focus on positive culture building! Who we are: nimble solutions is a leading provider of revenue cycle management solutions for ambulatory surgery centers (ASCs), surgical clinics, surgical hospitals, and anesthesia groups. Our tech-enabled solutions allow surgical organizations to streamline their revenue cycle processes, reduce administrative burden, and improve financial outcomes. Join more than 1,100 surgical organizations that trust nimble solutions and its advisors to bring deep insights and actionable intelligence to maximize their revenue cycle. On a typical day, here's what...

Penn Medicine Coding Specialist Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work? Summary: Performs all coding and abstracting by reviewing medical records and selecting the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures accurately. Performs analysis of the DRG assigned to produce the highest level of reimbursement to which the facility is legally entitled according to stringent coding and compliance guidelines. Responsibilities: Examines...

General Summary Performs clinical documentation audits, evaluations and other reviews for the System to ensure and assess compliance with applicable laws and regulations. Prepares and presents written and oral reports summarizing audit work, issues identified and recommendations to correct issues to management. Develops and disseminates education and training programs to employees. Duties and Responsibilities Essential Functions: Performs proactive or reactive coding compliance reviews as needed to identify or quantify potential issues. Investigates and recommends action to be taken when compliance issues are found. Monitors implementation of recommended corrective action and performs follow up reviews where necessary. Assists with coding compliance implementation throughout the WellSpan. Assists in the development and dissemination of education and training processes for the employees regarding coding compliance related activities. Assists...

Hospital/Facility Revenue Cycle Manager Trajectory RCS joined the MedHQ family in the beginning of 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing healthcare cash flow through teamwork and collaboration. MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. MedHQ, LLC, is a 2022 Becker's Top 150 Places to Work in Healthcare company. The MedHQ LLC service line offerings have grown organically over the years, beginning by providing high quality traditional human resource, accounting, and staff...

Medical Oncology Coder UPMC Hillman Cancer Center at the Divine Providence Campus in Williamsport is currently hiring a full-time Medical Oncology Coder. This position offers a consistent day shift schedule from 8:00 AM to 4:30 PM, totaling 40 hours per week. The ideal candidate will hold a Certified Professional Coder (CPC) credential and have at least two years of experience in physician coding using Physician CPT and ICD-9. This is a great opportunity to join a dedicated oncology team and contribute to accurate, compliant coding that supports high-quality patient care. This is a hybrid position. The initial phase of employment will require on-site work at UPMC Hillman Cancer Center in Williamsport, PA for several months. After this period, mandatory attendance for monthly meetings and other required on-site sessions will continue. Ideally, the candidate will work minimum one day per week in the office at UPMC Hillman Cancer Center, with the remaining time remote....

Allegheny Health Network Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching plans in accordance with federal and state regulations and...

Job Description Job Description Description: Job Role The Clinical RN Chart Reviewer will perform clinical reviews of medical records and other documentation to validate issues of claims coding accuracy, medical necessity, and the appropriateness of treatment settings and services delivered. The Clinical RN Chart Reviewer will report to the Payment Assurance Manager and support a culture and work environment that promotes and inspires an active, continuous improvement philosophy regarding products and services in line with our company mission. This role requires certified coding expertise and a strong understanding of DRG validation, medical necessity, and regulatory guidelines. Requirements: Responsibilities will include: · Audits and analyzes neonatal intensive care unit (NICU) claims according to ICD-10 coding principles and clinical guidelines. · Analysis of claims data to optimize reimbursement by ensuring that the diagnosis codes, procedure codes, and supporting...

Job Title Collects, reviews, retrieves and codes Evaluation & Management services, Pathology, and minor procedures based on documentation in the medical record and reports for quality assessment, audit, and billing purposes. Duties And Responsibilities Essential Functions: Performs chart audits, reviewing for accuracy and compliance. Reviews operative reports and other documentation and assigns appropriate diagnosis (ICD-10) and procedure codes (CPT) for final billing. Researches and processes invoice corrections. Reviews and analyzes coding/billing procedures. Presents training and feedback concerning medical coding, compliance, and reimbursement to physicians/providers. Coordinates and implements reimbursement improvement activities with staff and providers. Adheres to WellSpan Coding Compliance Guidelines. Common Expectations: Maintains job specific standards and expectations relative to productivity and quality. Prepares and maintains appropriate...

Company Description *Candidate should ideally be located in Pittsburgh, PA* Monro's family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach. Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company's regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color. Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto service in the industry. Do you have...

Medical Coder Bizforce and our medical billing division, MedCore Solutions, are seeking skilled Medical Coders to join our growing team. As a Medical Coder at MedCore, you will be responsible for translating details from a patient's medical documents into medical codes for health insurance claims purposes. Additionally, you will be liaising with the client and team members for coding-related queries and concerns, performing audits for coding denials and missing information, and maintaining a tracking system for coded charts. MedCore allows the best talent in PH to work remotely from home with the latest technology and resources. We are partnering with some of the largest healthcare platforms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today! MedCore Solutions (MCS) is a single-source solution for Healthcare administration. MCS is an industry leader in medical billing, credentialing, scribing,...