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...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

At Datavant, we're transforming healthcare by improving data collaboration. Our mission is to ensure health data is secure, accessible, and actionable. As a key player in the healthcare ecosystem, we provide crucial data solutions for providers, health plans, researchers, and life sciences companies. Whether fulfilling a single patient's medical records request or driving innovation in healthcare with AI, our dedicated team is committed to shaping the future of health data. Join our vibrant and cooperative team as a Full-Time Inpatient Coding Auditor . This fully remote role offers a flexible schedule, enabling you to make a significant impact in healthcare from the comfort of your workspace. In this position, you will play an essential role in addressing consulting and educational needs concerning coding quality, compliance assessments, external payer reviews, and more. Your Responsibilities Will Include: Conducting inpatient coding audits on medical records, ensuring...

Company: Allegheny Health Network Job Description: GENERAL OVERVIEW: Join our innovative team as a Medical Coding Auditor Instructor, where you'll play a vital role in ensuring the accuracy and compliance of coding, billing, and medical documentation. Conduct thorough audits on medical records regarding DRGs, APCs, CPTs, and HCPCS Level II codes. Your expertise will be key in optimizing reimbursement strategies and enhancing data quality while adhering to all regulatory standards. ESSENTIAL RESPONSIBILITIES: Lead comprehensive audits and evaluate documentation, coding, and billing practices across various AHN entities. Develop and implement focused training programs to address any deficiencies identified during audits, ensuring compliance with regulatory standards. Collaborate closely with management on external audit findings and engage in strategic discussions to resolve issues. (20%) Create detailed audit reports to highlight the impacts of coding,...

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

Datavant is the data collaboration platform trusted for healthcare. Our mission is to make the world’s health data secure, accessible, and actionable, offering essential data solutions for a diverse array of healthcare entities, including providers, health plans, researchers, and life sciences companies. Whether fulfilling a single patient's request for their medical records or energizing the AI revolution in healthcare, our team at Datavant is dedicated to reshaping the future of health data connectivity and utilization. By joining Datavant, you will be part of a dynamic and collaborative team that is passionate about creating meaningful change in the healthcare landscape. As an Inpatient Coding Auditor, your expertise will be crucial in addressing various consulting and educational needs pertaining to coding quality, compliance assessments, external payer reviews, and coding education. This fully remote role offers you the flexibility to contribute to healthcare...

Overview Coding Educator, Clinical Document Integrity Full Time, 80 Hours Per Pay Period, Day Shift Must be located in East TN. Remote with onsite requirements.. Covenant Medical Group is Covenant Health’s employed and managed medical practice organization, with more than 300 top Physicians and providers spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include cardiology, cardiothoracic surgery, cardiovascular surgery, endocrinology, gastroenterology, general surgery, infectious disease, neurology, neurosurgery, obstetrics and gynecology, occupational medicine, orthopedic surgery, physical medicine and rehabilitation, primary care, pulmonology, reproductive medicine, rheumatology, sleep medicine and urology. Position Summary: Provides consulting services to the organization’s management and staff and may coordinate requested coding investigations. Responsible for education and training for all Covenant coders, CDI, and/or physician...

Overview Job Description - Director, Coding Auditor & Educator (7410-2297) LifePoint Health Support Center Description The Director, Coding Auditor and Educator is responsible for reviewing and auditing hospital medical records for coding completeness and accuracy. This position identifies potential coding and DRG error and researches appropriate coding guidelines to support recommended changes. This position will communicate these changes in a timely manner. This position will provide coding education and expert coding advice to the coding staff. The Director, Coding Auditor and Educator will develop education/training materials including the development of coding guidelines, policies and procedures. This individual would demonstrate proficiency in auditing principles (including re-auditing). This individual communicates with IRM, Group Leadership, Ethics and Compliance Department members, hospital HIM coding and DI regarding coding audit issues, current coding regulations...

Surgical Coder The Surgical Coder in an Ambulatory Surgery Center (ASC) is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS Level II codes to surgical and procedural services based on thorough review of patient medical records. This role ensures coding compliance with current healthcare regulations and supports timely, accurate billing and data reporting. The ideal candidate has strong knowledge of surgical procedures, anatomy, and medical terminology, and is comfortable collaborating with clinical and administrative teams. This is a non-exempt position. Key Responsibilities: Assign appropriate diagnosis and procedure codes (ICD-10-CM, CPT, HCPCS) in accordance with documentation and regulatory requirements Analyze patient medical records, operative reports, and other clinical documentation to ensure completeness and accuracy in coding. Work closely with surgeons, nurses, and billing staff to clarify documentation and resolve coding discrepancies. Follow...

Job Description: The HIM Hospital Inpatient & Same Day Surgery Coding Analyst deciphers and interprets provider documentation in the health record and assigns diagnostic information using ICD-10-CM/PCS and CPT codes for a complex range of acute care services for Intermountain Health. The caregiver provides specific coding expertise in the various fields of NCCI edits, Drugs and Biologicals, Revenue Codes, Current Procedural Terminology (CPT) codes, ICD-10 & CPT codes, DRGs, anatomy and physiology, pharmacology. The analyst also performs audits, provides feedback, and advanced training to clinical teams and physicians on ICD-10 and CPT coding best practices. Essential Functions Reviews and analyzes inpatient medical records for completeness, accuracy, and compliance for Same Day Surgery, Observation and Inpatient acute services at Intermountain Health. Performs coding at an advanced level of complexity for inpatient hospitals including governmental and/or...

Discover Vanderbilt University Medical Center Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. EOE/Vets/Disabled. Job Summary Applies specialized skills and training independently to evaluate and advise whether professional, outpatient and inpatient hospital documentation meets applicable standards for coverage, accuracy, and completeness as well as coding and general compliance, with the goals of identifying and preventing compliance risk and providing timely and effective education and remediation. Provides hands-on training and day-to-day productivity and...

Overview Coder Analyst Specialist, Clinical Document Integrity Full Time, 80 Hours Per Pay Period, Day Shift Covenant Medical Group is Covenant Health’s employed and managed medical practice organization, with more than 300 top Physicians and providers spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include cardiology, cardiothoracic surgery, cardiovascular surgery, endocrinology, gastroenterology, general surgery, infectious disease, neurology, neurosurgery, obstetrics and gynecology, occupational medicine, orthopedic surgery, physical medicine and rehabilitation, primary care, pulmonology, reproductive medicine, rheumatology, sleep medicine and urology. Position Summary: Analyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding...

Position Summary: The Surgical Coder in an Ambulatory Surgery Center (ASC) is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS Level II codes to surgical and procedural services based on thorough review of patient medical records. This role ensures coding compliance with current healthcare regulations and supports timely, accurate billing and data reporting. The ideal candidate has strong knowledge of surgical procedures, anatomy, and medical terminology, and is comfortable collaborating with clinical and administrative teams. This is a non-exempt position. Key Responsibilities: Assign appropriate diagnosis and procedure codes (ICD-10-CM, CPT, HCPCS) in accordance with documentation and regulatory requirements Analyze patient medical records, operative reports, and other clinical documentation to ensure completeness and accuracy in coding. Work closely with surgeons, nurses, and billing staff to clarify documentation and resolve coding...

Discover Vanderbilt University Medical Center : Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research. Organization: Compliance Operations - VUH Job Summary: Applies specialized skills and training independently to evaluate and advise whether professional,...

Join to apply for the Physician Coder III, Remote role at Erlanger 3 days ago Be among the first 25 applicants Join to apply for the Physician Coder III, Remote role at Erlanger Erlanger Health hires employees for telecommuting/remote positions in the following states: AL, AZ, GA, FL, IN, KY, LA, MD, M I, MS, MO, NC, NV, OH, SC, TN, TX, VA, WI, WY REMOTE Job Summary: The Physician Coder III is responsible for coding of physician and/or mid-level provider professional services. Recognizes and completes a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follows set procedures to achieve goals. Displays professional office skills and ability to navigate a practice management system. Functions as liaison between management, the physician practices and employees working within physician practices. Coder will provide CPT, HCPCS and ICD-10-CM coding a minimum of 1-4 specialties. Specialties could include UR, Podiatry, Plastics,...