57 coding compliance educator jobs found

Trinity Health - IHA is looking for a Compliance Auditor/Educator based in Ann Arbor, Michigan. This full-time position requires expertise in coding practices and compliance regulations to educate providers on proper procedures. The successful candidate will lead auditing projects and ensure regulatory compliance while providing training to the staff on various coding standards. A Bachelor’s degree and professional certification are required, along with 2+ years of relevant experience. #J-18808-Ljbffr

Senior Medical Records Coder Are you an experienced inpatient coder who thrives in fast-paced, academic environments and wants to make a lasting impact beyond the chart? This Senior Medical Records Coder role sits at the heart of two dynamic Family Medicine Residency programsCorewell Health Troy Beaumont and CHMG EastGrosse Pointesupporting highly productive faculty physicians, community preceptors, and more than 24 residents and medical students. In this highly visible and influential position, you'll serve as both coding expert and educator, guiding providers through complex documentation, billing, and compliance requirements while helping shape the next generation of primary care physicians through audits, one-on-one education, resident orientation, and ongoing regulatory review. Under general supervision and according to established procedures, provides technical support to the Inpatient Coding Staff and coordinates daily workflow based on the needs of the department. On a...

Overview Are you an experienced inpatient coder who thrives in fast‑paced, academic environments and wants to make a lasting impact beyond the chart? This Senior Medical Records Coder role sits at the heart of two dynamic Family Medicine Residency programs—Corewell Health Troy Beaumont and CHMG East–Grosse Pointe—supporting highly productive faculty physicians, community preceptors, and more than 24 residents and medical students. In this highly visible and influential position, you’ll serve as both coding expert and educator, guiding providers through complex documentation, billing, and compliance requirements while helping shape the next generation of primary care physicians through audits, one‑on‑one education, resident orientation, and ongoing regulatory review. Essential Functions Provides technical coding support to the Inpatient Coding Staff and coordinates daily workflow based on the needs of the department and as directed by the Manager of Coding. On a daily basis,...

Are you an experienced inpatient coder who thrives in fast‑paced, academic environments and wants to make a lasting impact beyond the chart? This Senior Medical Records Coder role sits at the heart of two dynamic Family Medicine Residency programs—Corewell Health Troy Beaumont and CHMG East–Grosse Pointe—supporting highly productive faculty physicians, community preceptors, and more than 24 residents and medical students. In this highly visible and influential position, you’ll serve as both coding expert and educator, guiding providers through complex documentation, billing, and compliance requirements while helping shape the next generation of primary care physicians through audits, one‑on‑one education, resident orientation, and ongoing regulatory review. Responsibilities Provides technical coding support to the Inpatient Coding Staff and coordinates daily workflow based on the needs of the department and as directed by the Manager of Coding. Submits departmental statistics...

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...

Hcc Coder Candidates must have a primary address located within the state of Michigan or willing to move to Michigan to be considered. Travel to provider office location/offices for HCC education as determined by manager Mandatory on-site team meetings in Midland 1 x per month To be part of our organization, every employee should understand and share in the MyMichigan Health Vision, support our Mission, and live our Values. These values include excellence, integrity, teamwork, and accountability – must guide what we do, as individuals and professionals. The HCC Coder, working under the direction of the Clinical Documentation Integrity Manager, utilizes coding expertise to identify areas of opportunity that impacts the quality and the completeness of the medical record documentation. Through prospective, concurrent, and retrospective evaluation of the medical record documentation, the HCC Coder will be responsible for working collaboratively with the clinical team members...

Coding Specialist General Summary: Ensures proper assignment of diagnosis and procedure codes, along with validating and adjusting charges according to the services the patient received. Works collaboratively with Clinical Documentation Improvement personnel to ensure coding is clinically supported. Participates in the identification and resolution of discrepancies in documentation; assists in training as necessary. Maintains a working knowledge of applicable coding and reimbursement Federal, State, and local laws and regulations, the Compliance Accountability Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior. Participates in quality assessment and continuous quality improvement activities. Performs all job duties and responsibilities in a courteous and customer-focused manner according to the Hurley Family Standards of Behavior. Supervision Received: Works under the...

Job Description Job Description Join Our Team as a General Coder! Are you a medical coder looking to advance your career in a supportive and dynamic environment? We are seeking a detail-oriented and dedicated General Coder to join our organization. This role offers hybrid remote work opportunities, providing flexibility and balance. INCENTIVES & GROWTH OPPORTUNITIES * $1,500 sign-on bonus (paid in two installments) * Consistent Monday Friday schedule-no weekends or holidays * Strong team culture and supportive leadership What Youll Do Review patient documents and accurately assign CPT, CPT Category II, ICD-10-CM codes, and quality reporting measures like HEDIS. Verify records for billing, reimbursement, and regulatory compliance, while effectively communicating with providers to ensure accurate documentation. Serve as a valuable resource for resolving insurance denials and answering coding-related questions from A/R management, residents, and providers....

Job Opportunity 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 standards....

Coder - Hospital Outpatient Services - Revenue Cycle Mid Services Shift: Days FTE status: 1 On-call: No Weekends: No Looking for a minimum of 1 year coding experience in ambulatory surgery and observation. General Summary: Under the direction of the Coding Supervisor and Manager, the Coder for Hospital Services is responsible for accurately coding outpatient conditions and procedures. The Coder reviews clinical documentation and diagnostic results in order to extract data for billing, internal and external reporting, and research, ensuring all codes are appropriately applied per the ICD-10-CM Official Guidelines for Coding and Reporting. When applicable, the Coder is responsible for accurately and completely capturing charges for hospital services provided by reviewing clinical documentation. This data is utilized for revenue processing, internal and external reporting, research and regulatory compliance as documented in the CPT guidelines. Knowledge, Skills and...

Coding Specialist Using established coding principles and procedures reviews analyzes and codes diagnostic and/or procedural information from the patients medical record for reimbursement/billing purposes. Accurately abstracts information from the medical record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. Education/Experience Required: High School Diploma or G.E.D. equivalent required. Additional specialty coding certification required or five (5) years coding experience. One to two...

Employment Opportunities Provides high level technical competency and subject matter expertise analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs (APR), Present on Admission (POA), as well as Severity of Illness (SOI) & Risk of Mortality (ROM) indicators for Inpatient records. Identifies Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, MS-DRG, APR DRG, POA, SOI & ROM assignments. Essential Functions: Knows, understands, incorporates, and demonstrates the Trinity Health...

Coding Specialist Remote Position General Summary: Using established coding principles and procedures reviews analyzes and codes diagnostic and/or procedural information from the patient's medical record for reimbursement/billing purposes. Accurately abstracts information from the medical record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. Principal Duties and Responsibilities: Identifies all diagnostic and operative procedures for coding by thoroughly reviewing the patient's medical...

Job Description Job Description Description: A Certified Professional Medical Auditor is responsible for reviewing and auditing medical documentation, including patient records, charts, and clinical notes, to ensure accuracy, compliance with regulations, and adherence to industry standards. This role is crucial in maintaining the integrity of medical records, billing processes, and healthcare facilities' compliance with applicable laws and regulations. Requirements: Key Responsibilities: Medical Documentation Review: Conduct thorough audits of patient medical records, including physician notes, progress notes, discharge summaries, and other relevant documentation. Examine medical records to verify their completeness and conformity with established standards, ensuring they accurately reflect the patient's condition, diagnosis, treatment, and other pertinent information. Verify that documentation adheres to established coding guidelines, such as ICD-10 and CPT, and...

Position Summary Applies CPT-4 and HCPCS codes to medical records for the cardiovascular lab and interventional radiology departments based on documentation provided by physicians. Adheres to strict federal coding rules and guidelines in selecting codes that appropriately reflect the services that were provided. Balances need for (95% accuracy) coding accuracy against timely account completion for billing deadlines. Essential Responsibilities Coding of surgical procedures performed by cardiologists, and interventional radiologists Verification of supplies used during procedures Use of encoders and other references Maintains appropriate non-leading queries to physicians Ability to abstract services from physician documentation and procedure logs. Reconciliation of monthly surgical logs Managing multiple job tasks daily (WQs, emails, surgical logs, census, etc.) Prepares Excel analysis, including V-Lookups and pivot tables. Gathers and compiles data in a systematic fashion,...

Medical Billing Specialist Administration - Flint, MI 48502 Overview Position Type Full Time Education Level High School Category Health Care Description 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...

Mission Statement Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society. Job Summary We are seeking a detail-oriented and knowledgeable Professional Surgical Coder to join our healthcare team. The ideal candidate will be responsible for accurately translating complex surgical procedures into standardized medical codes using ICD-10-CM, CPT, and HCPCS coding systems. The Surgical Coder plays a crucial role in ensuring that our surgical documentation is precise and in compliance with regulatory standards. This position demands a keen eye for detail, a deep understanding of medical terminology, and the...

Yeo & Yeo Medical Billing & Consulting 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...

Position Summary This role is responsible for accurately and appropriately coding ambulance claims, including claim submission, follow‑up on denied claims, and ensuring compliance with relevant billing regulations to facilitate timely reimbursement for services. Essential Job Functions Examines patient care reports to gather essential information for insurance documentation. Contacts facilities, hospitals, or patients to acquire missing information and physician certification statements. Collects data such as insurance company names, policyholder details, policy numbers, and services provided to accurately complete claim and/or billing records. 4. Communicates with insurance companies to verify coverage, determine payor schedules, and gather benefit details. Assigns relevant codes based on documented information in the patient care report and determines the appropriate level of ambulance service. Allocates charges for services supported by documentation in the patient care...

Certified Home Health Coder & QA Specialist Become a part of the Hope At Home Family! We currently have a position available for a Certified Home Health Coder & QA Specialist. Position Summary: Certified Home Health Coder & QA Specialist is required to have PDGM, Oasis D1 experience, and Kinnser software knowledge. Home Health Coder is responsible for coding using ICD-10 all diagnoses and applicable procedures of skilled service visits. The position is also responsible for reviewing OASIS and abstracting visit data for billing and data collection purposes. Responsibilities: Codes records using ICD-10-CM and coding guidelines. Reviews OASIS. Observes and reports unusual patterns in data collection and/or lack of adequate documentation for code assignments. Review documentation and provide ICD-10 coding recommendations based on current coding and Oasis guidelines. Performs other related duties as requested by the Home Health Supervision Must be...

Your experience matters UP Health System-Bell is a part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well‑being so you can provide exceptional care to others. By joining our team, you're embracing a vital mission dedicated to making communities healthier. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve. How you'll contribute Assigns accurate ICD diagnosis codes, using compliant documentation. Assigns accurate CPT/HCPCS codes to records, using compliant documentation. Applies knowledge of Coding Guidelines to select the appropriate diagnosis code. Uses available research and reference tools to understand the disease process and diagnosis. Interprets physician documentation within the coding guidelines and obtains clarification from physicians regarding vague or ambiguous...

Job Posting Candidates must have a primary address located within the state of Michigan or willing to move to Michigan to be considered. Candidate must have Denials experience to be considered. This position is responsible for coding all services including major and minor surgical cases performed in both the office and hospital setting for MyMichigan Medical Group, Family Practice Center and the MyMichigan Urgent Care locations. This position monitors compliance with third party payers guidelines while ensuring the maximum allowed reimbursement is attained. This position requires broad knowledge of current payer rules for all insurance companies we participate with, in addition to analytical skills to ensure all procedures are coded correctly for a timely and accurate reimbursement from all payers. This position must be able to work independently and make decisions based on their broad knowledge of current procedure terminology (CPT) and International Classification of Diseases...

Summary Candidates must have a primary address located within the state of Michigan or be willing to move to Michigan to be considered. This position is responsible for coding all services, including major and minor surgical cases performed in both the office and hospital settings for MyMichigan Medical Group, Family Practice Center, and MyMichigan Urgent Care locations. The role monitors compliance with third‑party payer guidelines to ensure maximum allowed reimbursement and requires broad knowledge of current payer rules and analytical skills to code procedures correctly for timely, accurate reimbursement. The coder works independently and makes decisions based on knowledge of CPT and ICD coding rules and regulations. Responsibilities Code visits and services performed in the office and hospital setting within 48 hours of receipt. (25%) Use Epic coding edits, CPT Assistant, and CMS coding guidelines to correct ICD, CPT, HCPCS codes, modifiers, and place of service for clean...

Employment Type: Full time Shift: Day Shift Description: Analyzes physician/provider documentation contained in assigned Emergency Department (ED) and Outpatient Observation health records (electronic, paper or hybrid) to determine the principal diagnosis, secondary diagnoses, principal procedure and secondary procedures. Accesses charge work queues and systems to assign ER and Observation charges if performed by HIM. May also require calculation of Observation hours if performed by HIM. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of Internal Classification of Diseases, Clinical Modification diagnosis and procedure codes, and Current Procedural Terminology / Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers. Utilizes coding guidelines established by: The Centers for Medicare/Medicaid Services (CMS) ICD-CM Official Coding Guidelines for Coding and Reporting, ICD-PCS...