22 compliance coding auditor jobs found

Become a part of our caring community and help us put health first The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the...

Physician Coding Auditor Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW....

Medical Coding Auditor Become a part of our caring community and help us put health first. 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...

Telecommuting Coding Auditor This position is national remote. You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. This position is full time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00 am - 6:00 pm EST. It may be necessary to attend later meetings according to physician's schedule. We offer 12 weeks of...

WelbeHealth Paced Program WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits and...

About Optima Medical :Optima Medical is an Arizona-based medical group consisting of 30 locations and over 130medical providers, who care for more than 200,000 patients statewide.Our mission is to improve the quality of life throughout Arizona by helping communities Live Better, Live Longer through personalized healthcare, with a focus on preventing the nation's top leading causes of death.We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services.We aspire to aid the growth of our company by welcoming the most qualified and deserving candidates aboard.This position requires an initial 60-day training period at our corporate office in Scottsdale, Arizona.Upon successful completion of training, the position will transition to a fully remote role.Job Responsibilities :Audit Medical Records...

AHCCCS Arizona Health Care Cost Containment System Arizona’s Medicaid agency is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is nationally acclaimed and a recipient of multiple awards for workplace effectiveness and flexibility. Employees are passionate, high-performing, and dedicated to serving the citizens of Arizona. Recognized for high employee engagement, supportive leadership, and flexible work environments, including remote opportunities. Experience pathways span seasoned professionals, entry-level positions, and internships, offering meaningful career opportunities in a competitive industry. Come join our dynamic and dedicated team. Compliance Auditor Office of Inspector General (OIG) Job Location 150 North 18th Avenue Phoenix, Arizona 85007 All AHCCCS Employees must reside within the state of Arizona. Posting Details Salary: $50,000 - $55,000 FLSA Status: Exempt Grade: 21 This position will remain open until...

Quadris Team, LLC - A Revenue Cycle Management Group, is searching for a dynamic person to join us, working with our highly skilled Medical Coding Team to fill the role of Medical Coding Auditor & Educator.We are a 100% remote team supporting our clients across the United States! See us at.The ideal applicant will be a subject matter expert in both Facility and Profee medical coding auditing.Job Focus :The Senior Coding Auditor may be responsible for a variety of duties and obligations, depending on the client and assignment.These responsibilities may include inpatient / outpatient / professional fee facility auditing, denial management, coding, implementation specialist, job aid creation, training, and specialty coding.The position may also be responsible for management of the audit team and project management.All coding and auditing are performed within the scope of regulatory and compliance law expectations.Auditing Responsibilities :May include conducting inpatient,...

Job Description Job Description PLEASE NOTE - This position may require temporarily relocation to other TONHC Facilities: Sells Hospital, Santa Rosa Health Center, San Simon Health Center, and San Xavier Health Center. Position Summary: Under general supervision, this position serves as a certified professional coder; performs the full range of coding, assigns ICD, CPT, HCPCS, and medical inpatient codes; abstracts data from the record; perform chart analysis; peer review; and serves as a medical documentation and coding technical expert to TONHC providers. Scope of Work: This position is located within Tohono O'odham Nation Health Care (TONHC). The work involves performing specialized medical record tasks and resolving problems using established processes, coding conventions, and guidelines. Performance of duties reflects directly on patient care by recording services performed on the patient. The incumbent works independently under the general supervision of the...

ESSENTIAL FUNCTIONS FOR THIS POSITION • Ensures that codes are assigned correctly and sequenced appropriately as per government and insurance regulations • Complies with all medical coding guidelines • Follows up and clarifies any information that is not clear with the rendering provider • Conducts ad-hoc audits to ensure fidelity to coding guidelines • Relevant expert for Southwest Network on accurate and efficient coding practices • Analyze medical records and identify documentation deficiencies NONESSENTIAL FUNCTIONS • Follows policies and procedures and adheres to the requirements of the Corporate Compliance Program. • Ensures confidentiality of verbal and written information in accordance with HIPAA standards and Southwest Network policy, and adheres to the legal, ethical, and professional guidelines adopted by Southwest Network. • Other duties as assigned. EDUCATION and/or EXPERIENCE, LICENSURE and CERTIFICATION • Associate degree in medical coding or...

You will be able to work from your home location within the United States PURPOSE AND SCOPE: Conducts data quality audits of outpatient encounters to validate coding assignment is in compliance with the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. Provides feedback and education to coders. Escalates compliance, risk-related issues to expedite mitigation. PRINCIPAL DUTIES AND RESPONSIBILITIES: Consults facility leaders and staff on best practices, methodology, and tools for accurately coding. Chart Analysis, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA/AAPC). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to...

Job Description Job Description About Optima Medical: Optima Medical is an Arizona-based medical group consisting of 30 locations and 130+ medical providers, who care for more than 200,000 patients statewide. Our mission is to improve the quality of life throughout Arizona by helping communities "Live Better, Live Longer" through personalized healthcare, with a focus on preventing the nation's top leading causes of death. We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services. We aspire to aid the growth of our company by welcoming the most qualified and dedicated professionals aboard. We are currently seeking a Medical Coding Specialist to join our team! This role will transition to a fully remote position after your first 60 days. To be eligible, you'll need to complete your...

Job Description Job Description Description: Description The Medical Coder will be responsible for accurately assigning diagnostic and procedure codes for Neonatology and NICU patient encounters , ensuring compliance with all applicable coding guidelines and regulatory requirements. This role primarily supports neonatal and newborn services , with potential crossover coding responsibilities in OB/GYN, laboratory, mammography, and women’s health services as needed. The ideal candidate will have strong expertise in ICD-10-CM and CPT coding and demonstrated experience in neonatal and critical care coding environments. Responsibilities Neonatology & NICU Coding: Review neonatal and NICU medical records, encounter forms, progress notes, and procedural documentation to accurately assign ICD-10-CM and CPT/HCPCS codes in accordance with official coding guidelines. Accurately code newborn and neonatal services, including: Initial and subsequent hospital care for...

Description The Medical Coder will be responsible for accurately assigning diagnostic and procedure codes for Neonatology and NICU patient encounters , ensuring compliance with all applicable coding guidelines and regulatory requirements. This role primarily supports neonatal and newborn services , with potential crossover coding responsibilities in OB/GYN, laboratory, mammography, and women’s health services as needed. The ideal candidate will have strong expertise in ICD-10-CM and CPT coding and demonstrated experience in neonatal and critical care coding environments. Responsibilities Neonatology & NICU Coding: Review neonatal and NICU medical records, encounter forms, progress notes, and procedural documentation to accurately assign ICD-10-CM and CPT/HCPCS codes in accordance with official coding guidelines. Accurately code newborn and neonatal services, including: Initial and subsequent hospital care for normal and sick newborns (CPT 99460–99463, 99477–99480)...

Abstractor/Coder The University of Chicago Physicians Group (UCPG) team is responsible for the overall management of clinical revenue for physician billing. This includes frontend revenue capture, working of edits and conducting audits for physician education. Ensuring the workflow of charge capture through invoice creation. UCPG is seeking an Abstractor/Coder to work with providers and staff on professional billing and compliance activities. Strong knowledge of evaluation and management coding guidelines and requirements is strongly preferred. This position is eligible for a flexible work arrangement. Responsibilities: Obtain appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses, and physician visits. Analyze denial and rejection reports, and appeal wherever appropriate. Submit charges in a timely manner. Work in collaboration with the Clinical Revenue Supervisor and others, provide guidance to faculty and staff on...

Medical Coder Trajectory RCS joined the MedHQ family in 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 integration of both business office processes and clinical documentation. MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and above all excellent...

A health data exchange leader is seeking an Inpatient Auditing Specialist to perform coding audits, provide coder education, and ensure regulatory compliance. This fully remote position allows for flexible scheduling, catering to professionals with over 5 years of inpatient coding experience. Candidates should hold certifications like CCS, RHIA, or RHIT and have experience with software such as Epic and Cerner. #J-18808-Ljbffr

Contract to Hire Job # 25030 Neonatology Coder Acclivity Healthcare - Your personable, proven partner! Since 1999, Acclivity Healthcare has served the specialized recruiting and staffing needs of leading healthcare employers nationwide. Our clients range from independent physician practices to national healthcare systems and insurance providers. We are proud of our 18,000+ successful placements with quality-oriented organizations that recognize the value of better talent. Compensation and Schedule for the Neonatology Coder Neonatology Coder – Full-time, remote, $26-$31 per hour, Monday to Friday, flexible day schedule within Arizona time zone after training. Quarterly bonuses available! Required Qualifications of the Neonatology Coder 5+ years of recent E/M coding experience required 2+ years of recent neonatology coding experience required Must provide equipment Certified Professional Coder (CPC) certification required High school diploma or GED required Must successfully...

Medix - 3003 North Central [Medical Records Clerk] As a Coder at Medix, you'll: Analyze medical records to assign appropriate codes for billing and insurance purposes; Ensure accuracy and compliance with coding guidelines and regulations; Collaborate with healthcare professionals to clarify diagnoses and procedures; Maintain confidentiality of patient information; Update coding knowledge through continuous education and training; Assist in audits and reviews to improve coding processes and accuracy...Hiring Immediately >>

Position Title and Code Professional Services Certified Coding Reviewer Position Code: Coder-8125 Department and Reporting Department: Health Information Management Reports to: HIM Director/Manager Safety Sensitive: YES Exempt Status: NO Position Purpose All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI’s vision to be among the kindest, highest quality health systems in the country. Key Responsibilities Ensures data quality in compliance with State, Federal and regulatory requirements Evaluates medical record documentation and charge reports to ensure completeness, accuracy and compliance with the Correct Coding Initiative Edits Coded all professional charges to ensure accurate and timely billing Perform coding reviews and/or surgical coding for practices and providers Evaluates and report audit findings or reviews and reports on results to physicians and/or operations directors Provides technical guidance, training,...

Join to apply for the Professional Billing Coder II role at Onvida Health 2 days ago Be among the first 25 applicants Join to apply for the Professional Billing Coder II role at Onvida Health Get AI-powered advice on this job and more exclusive features. Job Description Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Job Description Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Days Pay Rate Type: Hourly Location: Remote Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $22.62 Mid = $28.28 Max = $33.93 Summary The Professional Billing Coder II is an intermediate-level coding professional responsible for independently reviewing medical documentation and assigning accurate diagnostic and...

Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Days Pay Rate Type: Hourly Location: Remote Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $22.62 Mid = $28.28 Max = $33.93 Summary The Professional Billing Coder II is an intermediate-level coding professional responsible for independently reviewing medical documentation and assigning accurate diagnostic and procedural codes for outpatient and professional services. This role requires advanced knowledge of coding guidelines and payer‑specific requirements to support correct billing, compliance, and optimal reimbursement. The PB Coder II works with minimal supervision and may assist with training or mentoring entry‑level coders. Responsibilities Review and interpret...