15 coding documentation compliance auditor jobs found

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....

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:...

Radiology Medical Coder Radiology Medical Coder Job Description Client Profile - An Indiana based Independent Physician-Owned radiology practices founded in 1967. Job Summary - The Radiology Coder is responsible for coding and charge submission activities, including abstracting CPT Professional Fee Coding and inpatient/outpatient coding and billing. This involves reviewing medical records and assigning appropriate ICD, CPT, and HCPCS codes. Job Duties Review and analyze medical records ensuring the correct assignment of ICD-10, CPT and HCPCS codes. Accurately code diagnostics imaging, interventional radiology procedures and other radiological services Ensure that documentation supports the assigned codes and matches physician orders and radiology reports Abstract relevant data such as procedural dates, providers, and patient demographics for billing and reporting. Collaborate with radiologists and other medical professionals to clarify diagnoses and procedures when...

Briljent is seeking a detail-oriented Certified Medical Coder / Medical Record Audit Specialist to support coding accuracy and billing compliance for Indiana Medicaid. This remote role requires reviewing records, identifying compliance issues, and preparing audit documentation. The ideal candidate has strong coding knowledge, certification (CCS, CPC, CPMA), and at least 1 year of relevant experience, particularly with Indiana Medicaid. Proficiency in Excel and collaboration skills are essential. Occasional travel within Indiana may be required. #J-18808-Ljbffr

At Lilly, we unite caring with discovery to make life better for people around the world. We are a global healthcare leader headquartered in Indianapolis, Indiana. Our employees around the world work to discover and bring life-changing medicines to those who need them, improve the understanding and management of disease, and give back to our communities through philanthropy and volunteerism. We give our best effort to our work, and we put people first. We’re looking for people who are determined to make life better for people around the world. Role Purpose The Medical Omnichannel Education (MOE) organization advances prioritized medical strategies and addresses clinical care gaps by delivering scientifically relevant, evidence-based, and customer-informed education through omnichannel solutions. The team’s ambition is to ensure healthcare professionals have access to the right educational content, tools, and experiences — through the right channels, at the right time, and with the...

Join CommunityThe Innovative Healthcare Collaborative of Indiana (IHCI) is a joint venture between Community Health Network and Deaconess Health system.Its goal is to support our sponsors and partners in their strategic evolution to positively impact and improve the healthcare delivery system.Make a DifferenceReporting to the Clinical Documentation Integrity Manager this role performs patient chart reviews to ensure the appropriateness andcompleteness of diagnostic coding with evidence based on CMS HCC standards.The Risk Adjustment Coder is responsible for :Timely accurate and complete review of patient charts following patient encounters utilizing a variety of technical platforms to completeworkflowsValidating diagnosis codes representing patient conditions along with necessary MEAT documentationEnsuring coding is consistent with guidelines from regulatory entitiesConducting audits to meet compliance with ACA standardsCreating post-visit queries with follow upCollaborating with...

JOB RESPONSIBILITIES: Abstracts pertinent information from patient records for provider services. Reviews the International Classification of Diseases, Clinical Modification (ICD), Current Procedural Terminology (CPT), or Healthcare Common Procedure Coding System (HCPCS) codes, including modifiers, assigned by providers. Works with providers to correct any codes or charges when errors are identified. Reviews medical records for diagnoses that meet medical necessity according to the CMS Local Coverage Determination (LCD) and/or National Coverage Determination (NDC) guidelines. Reviews and interprets provider notes using CPT and ICD coding books and/or software. Ensures codes are accurate and sequenced correctly in accordance with government and insurance regulations. Works with providers to correct any identified errors. Conducts chart audits for provider documentation and recognizes when it is necessary to obtain further clarification from providers when documentation is...

Description The Hospice & Palliative Care Medical Billing Specialist is responsible for the accurate and timely management of billing, reimbursement, and collections for all hospice and palliative care patients. As a newly established role, this individual will help shape workflows and processes through active feedback and collaboration. This role also ensures compliance with Accreditation Commission for Health Care (ACHC) standards, CMS hospice regulations, and all applicable federal and state requirements. Reviews and verifies patient eligibility for hospice and palliative care services, including certification of terminal illness and benefit period requirements. Confirms and documents patient insurance coverage, including Medicare Hospice Benefit, Medicaid, and commercial payers. Processes, verifies, and submits hospice claims (Medicare Part A, Medicaid, and commercial) in accordance with hospice billing requirements, including election dates, revocations,...

Certified Medical Coder / Medical Record Audit Specialist Brijlent is seeking a detail-oriented Certified Medical Coder / Medical Record Audit Specialist to support coding accuracy, medical record review, and billing compliance activities for Indiana Medicaid programs. This role is responsible for reviewing medical records and claims-related documentation for coding accuracy, identifying billing and compliance issues, preparing audit documentation and reports, and supporting appeals activities. The ideal candidate brings strong coding knowledge, regulatory awareness, and analytical and writing skills. This is a remote position with occasional travel required within Indiana. While this position is remote, Indiana residents encouraged to apply. Key Responsibilities Review medical records and related documentation to assess coding accuracy and compliance with Indiana Health Coverage Programs, CMS, AMA, and other applicable standards and regulations. Conduct coding and...

Job Description This is a remote position, with occasional travel required within Indiana. Certified Medical Coder / Medical Record Audit Specialist We are seeking a detail-oriented Certified Medical Coder / Medical Record Audit Specialist to support coding accuracy, medical record review, and billing compliance activities for Indiana Medicaid programs. Key Responsibilities Review medical records and related documentation to assess coding accuracy and compliance with Indiana Health Coverage Programs, CMS, AMA, and other applicable standards and regulations. Conduct coding and documentation reviews independently and provide preliminary findings to the Lead Reviewer. Identify potential coding discrepancies, documentation deficiencies, and billing compliance issues. Maintain detailed workpapers documenting procedures performed, records reviewed, findings identified, and conclusions reached. Assist with audit responses and appeals as needed. Ensure all work aligns with state,...

Radiology Medical Coder Radiology Medical Coder Job Description Client Profile - An Indiana based Independent Physician-Owned radiology practices founded in 1967. Job Summary - The Radiology Coder is responsible for coding and charge submission activities, including abstracting CPT Professional Fee Coding and inpatient/outpatient coding and billing. This involves reviewing medical records and assigning appropriate ICD, CPT, and HCPCS codes. Job Duties Review and analyze medical records ensuring the correct assignment of ICD-10, CPT and HCPCS codes. Accurately code diagnostics imaging, interventional radiology procedures and other radiological services Ensure that documentation supports the assigned codes and matches physician orders and radiology reports Abstract relevant data such as procedural dates, providers, and patient demographics for billing and reporting. Collaborate with radiologists and other medical professionals to clarify diagnoses and procedures when...

Overview Responsible for ensuring accuracy and quality coding assignments for all records requiring DRG and/or APC coding; ensures optimal and timely reimbursement. Responsibilities Principal Duties and Responsibilities (*Essential Functions) Performs comprehensive pre-billing coding audits, through the use of eValuator , to ensure claims are accurately coded and charged in compliance with coding and regulatory standards. Performs comprehensive pre-billing coding data quality reviews on inpatient and/or outpatient records to ensure proper coding guidelines have been followed and appropriate DRG (MS/APR) or APC assignments have been made for appropriate reimbursement. Responsible for completion of reviews within 72 hrs of import date to include new reviews of up to or exceeding 12 to 15 per day for inpatients and/or completion of reviews within 48 hrs of import date including up to or exceeding 50 per day for outpatient accounts. Maintains an audit response...

Brijlent is seeking a detail-oriented Certified Medical Coder / Medical Record Audit Specialist to support coding accuracy, medical record review, and billing compliance activities for Indiana Medicaid programs. This role is responsible for reviewing medical records and claims-related documentation for coding accuracy, identifying billing and compliance issues, preparing audit documentation and reports, and supporting appeals activities. The ideal candidate brings strong coding knowledge, regulatory awareness, and analytical and writing skills. This is a remote position with occasional travel required within Indiana. While this position is remote, Indiana residents encouraged to apply. Key Responsibilities Review medical records and related documentation to assess coding accuracy and compliance with Indiana Health Coverage Programs, CMS, AMA, and other applicable standards and regulations. Conduct coding and documentation reviews independently and provide preliminary...

Remote / Work from Home / Virtual / Hybrid Location Shadeland Station, Shadeland Ave, Indianapolis, IN 46256, United States Responsibilities Timely, accurate, and complete review of patient charts following patient encounters, utilizing a variety of technical platforms to complete workflows. Validating diagnosis codes representing patient conditions along with necessary MEAT documentation. Ensuring coding is consistent with guidelines from regulatory entities. Conducting audits to meet compliance with ACA standards. Creating post‑visit queries with follow up. Collaborating with CDI team members, particularly with clinical findings. Contributing to the provider education body of work, participating in pre‑encounter reviews as needed. Qualifications Applicants for this position should be able to collaborate with others in a team setting, have excellent communication skills, and a positive attitude toward problem‑solving. Critical thinkers. High School diploma or GED is...

Overview Job Title: Medical Coder (Junior Level) | Location: Downtown Indianapolis, IN (Local candidates strongly preferred; occasional onsite presence required) We are looking for a detail-oriented Junior Medical Coder to support a healthcare client engagement. You will be responsible for reviewing clinical documentation, assigning accurate medical codes, and ensuring compliance with payer and regulatory guidelines to support clean and timely billing operations. Responsibilities Review and analyze clinical documentation to assign appropriate ICD-10-CM, CPT, and HCPCS codes Ensure all coding is compliant with CMS, payer-specific, and internal guidelines Identify and resolve coding discrepancies and documentation gaps in collaboration with clinical staff Support the revenue cycle team in maintaining accurate and timely billing submissions Stay current with coding updates, regulatory changes, and payer policy revisions Requirements Required Qualifications CPC, CCS, or...