16 coding documentation compliance auditor jobs found

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Senior auditor responsible for clinical or physician compliance topics. Assigned the most complex clinical/documentation/coding/billing reviews. Provides guidance to other auditors within AHN on audit approach and analysis. Responsible for creating and overseeing orientation of auditors. Leads all hospital or physician audits/investigations, auditing support and responses related to external audit activity. ESSENTIAL RESPONSIBILITIES: Establishes and implements orientation for all members of the AHN audit compliance team. Evaluates the progress of team members including review of reports and audit activities. Works with senior management responsible for AHN-wide case management/physician programs to develop processes that meet Medicare and 3rd party payor requirements. Provides guidance to staff auditors on audit topics and reports. (20%) Conducts educational sessions for...

Ambulatory Procedure Visit-Outpatient Coder COMPANY OVERVIEW: Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG currently has a contract with the Federal Government. You would be a W-2 employee for HPMG and NOT a government employee. SUMMARY: Responsible for assignment of accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic) for ambulatory procedure visits. Trains and educates MTF staff on coding issues and plays a significant role in departmental and clinic-wide coding compliance activities. MANDATORY KNOWLEDGE AND SKILLS: Position requires excellent computer/communication skills for provider and staff interactions. Knowledge of anatomy/physiology and disease process, medical terminology, coding guidelines (outpatient and...

A leading healthcare organization in St. Louis is seeking an experienced auditor to ensure compliance and accuracy in coding practices. This role includes responsibilities such as analyzing inquiries on compliance, training specialty providers, and conducting thorough reviews of documentation. Candidates should have 5-10 years of experience, a high school diploma or GED, and CCS/CPC certification. This position offers a remote opportunity and comprehensive benefits from day one, including medical, dental, and retirement contributions. #J-18808-Ljbffr

Coder Reimbursement Specialist - Hospital The Coding and Reimbursement Specialist, CCS is responsible for coding and abstracting thoroughly, clinical data from the medical record. This includes both inpatient, outpatient, commercial, Medicare, Medicaid, and Illinois Public Aid, plus any other payor types. This accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis, grouped to the DRG in accordance with rules and regulations and coding methodologies, resulting in reimbursement and billing compliances as set forth by the Office of Inspector General. Manages workload and assigns work to three inpatient and two outpatient coders and oversees the day to day workings of the coding/reimbursement area. Monitors various regulatory sources to keep HIM coding and other staff informed and trained on various coding rules, regulations and related issues. Works closely with patient financial services to resolve any...

Shift : Monday - Friday, 8am - 5pm Department : Coding & Data Management - Inpatient Coding Team. Remote Compensation : * Base Pay Range: o Non-Certified: $19.15 - $30.23 per hour, based on experience o Certified: $22.00 - $34.74 per hour, based on experience ABOUT THE JOB MU Health Care is looking for a detail-oriented Medical Coding Specialist to join our team. As a crucial member of our healthcare family, the ideal candidate will possess a passion for precision and a commitment to maintaining the highest standards in medical coding. We value individuals who demonstrate a deep understanding of technical coding principles, coupled with a strong knowledge of ICD-10-CM, ICD-10-PCS, and CPT codes. Our ideal candidate advances their coding expertise through continuous education, ensuring accurate and compliant coding practices. We seek someone who thrives in a fast-paced environment, excels in problem-solving, and actively contributes to audits,...

Hiring Department University Physicians Job Description #upjobs This part-time position is a dual post linked to Job ID 58803 -MCS-C - University Physicians, and the department will be hiring for one position. Job Duties: Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff...

Hiring Department University Physicians Job Description #upjobs This part-time position is a dual post linked to Job ID 58799 -MCS - University Physicians, and the department will be hiring for one position. Job Duties: Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff...

Your future role at a glance Location: Remote Department: Compliance Schedule: Full time, Days Salary range : $29.74- 40.23 per hour #LI-Remote Life at Ascension: Where purpose meets opportunity Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 99,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you'll find an inclusive and supportive environment where your contributions truly matter. Benefits that help you thrive Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options Financial security & retirement: employer-matched 403(b), planning and hardship resources, disability and life insurance Time to recharge: pro-rated paid time...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 58427 - MCS - University Physicians, and the department will be hiring for two positions. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of changes...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 58429-MCS-C- University Physicians, and the department will be hiring for two positions Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of...

Spine Surgery Coder Remote Role 6-Month Contract to Hire Compensation: $30 per hour Start Date: ASAP ABOUT THE ROLE Our client is seeking a highly skilled Spine Surgery Coder for a remote, 6-month contract-to-hire opportunity. In this role, you will leverage your expertise in spine surgery coding-particularly within the outpatient Ambulatory Spine Center (ASC) environment-to ensure accurate and compliant coding of spinal procedures. You will play a critical part in supporting revenue integrity, audits, and denials prevention, while adhering to regulatory and payer-specific guidelines. The ideal candidate will have a strong background in CPT and ICD-10-CM coding for spine surgeries, with a focus on neurostimulator procedures, and familiarity with the Epic electronic health record system is preferred. This is an immediate need with a start date as soon as possible. WHAT YOU'LL DO Review full operative reports to assign accurate CPT and ICD-10-CM codes for...

Join a dedicated healthcare team serving the heart of the Midwest region. This role is perfect for a detail-oriented medical coder who thrives in a remote work environment and values accuracy and compliance. General Summary The medical coder ensures accurate billing by assigning appropriate ICD-10-CM, CPT, and HCPCS Level II codes in accordance with American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. This position involves insurance credentialing and educating providers and staff on coding and billing standards. Routine chart audits and timely documentation review are essential components of this role. Essential Duties and Responsibilities Assign ICD-10-CM, CPT, and HCPCS Level II codes to finalized medical documentation to create accurate medical claims. Abstract relevant data from patient records to determine appropriate claim modifiers. Communicate with providers to clarify unclear or incomplete documentation and...

Coder Reimbursement Specialist - Hospital Full‑time position. The Coding and Reimbursement Specialist (CCS) is responsible for coding and abstracting clinical data from the medical record, including inpatient, outpatient, commercial, Medicare, Medicaid, Illinois Public Aid, and all other payor types. Accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis and DRG in accordance with rules and regulations and coding methodologies, resulting in reimbursement and billing compliances as set forth by the Office of Inspector General. The CCS manages workload, assigns work to three inpatient and two outpatient coders, and oversees day‑to‑day operations of the coding/reimbursement area. The CCS monitors regulatory sources to keep HIM coding and other staff informed and trained on coding rules, regulations and related issues, works closely with patient financial services to resolve claim denials, assists in...

Spine Surgery Coder Remote Role 6-Month Contract to Hire Compensation: $30 per hour Start Date: ASAP ABOUT THE ROLE Our client is seeking a highly skilled Spine Surgery Coder for a remote, 6-month contract-to-hire opportunity. In this role, you will leverage your expertise in spine surgery coding—particularly within the outpatient Ambulatory Spine Center (ASC) environment—to ensure accurate and compliant coding of spinal procedures. You will play a critical part in supporting revenue integrity, audits, and denials prevention, while adhering to regulatory and payer-specific guidelines. The ideal candidate will have a strong background in CPT and ICD-10-CM coding for spine surgeries, with a focus on neurostimulator procedures, and familiarity with the Epic electronic health record system is preferred. This is an immediate need with a start date as soon as possible. WHAT YOU’LL DO Review full operative reports to assign accurate CPT and ICD-10-CM codes for outpatient spine...

Spine Surgery Coder – Remote – 6-Month Contract-to-Hire Compensation: $30 per hour Start Date: ASAP ABOUT THE ROLE Our client seeks a highly skilled Spine Surgery Coder for a remote 6‑month contract‑to‑hire opportunity. The role focuses on accurate coding of outpatient spine procedures within an Ambulatory Spine Center (ASC) setting, supporting revenue integrity, audits, and denial prevention while adhering to regulatory and payer guidelines. WHAT YOU'LL DO Review operative reports and assign accurate CPT and ICD‑10‑CM codes for outpatient spine surgeries. Abstract and code all billable components of spine cases, ensuring completeness and accuracy. Apply correct modifiers and validate procedures against CMS and commercial payer ASC‑approved code lists for ASC and hospital outpatient reimbursement. Maintain strict adherence to coding and regulatory standards, including CMS, payer‑specific spine policies, and internal compliance guidelines. Support audits, denial prevention, and...