15 compliance coding auditor jobs found

Him Coding/Compliance Auditor 2 Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of medical excellence and community care for more than a century. Throughout its rich and storied history, Jackson Memorial - located in the heart of the City of Miami - has been ground zero for some of the world's greatest medical breakthroughs and important moments in South Florida. We've grown into one of the nation's largest public hospitals, and one of the few that is also a world-class academic medical center with a proud mission and proven success. Jackson Memorial is an accredited, tertiary teaching hospital with 1,500 licensed beds, where nearly every medical specialty is provided by some of the world's most skilled and highly regarded multidisciplinary team of healthcare professionals. The HIM Coding/Compliance Auditor 2 analyzes abstracted, coded data for the purpose of ensuring coding accuracy. Serves as a resource for expert knowledge...

Summary Who We Are: LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to "improve the health of people in the communities we serve." Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care. The Health Information Management Department supports the mission and goals of Sinai Hospital, Northwest Hospital, Carroll Hospital, Levindale and Grace Medical Center by providing appropriate and timely access to health information for continuity of patient care and other authorized requests. REMOTE WORK OPPORTUNITY Acceptable remote locations: District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia, Reviews medical records for coding accuracy (I10 and CPT) and DRG (CMS or APR) assignment. Develops and provides a structured reporting and education process for HIM...

Company Description The University of Maryland Medical System is a 14-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women's and children's health and physical rehabilitation. UMMS is the fourth largest private employer in the Baltimore metropolitan area and one of the top 20 employers in the state of Maryland. No organization will give you the clinical variety, the support, or the opportunities for professional growth that you'll enjoy as a member of our team. Job Description I. General Summary Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification...

Company Description The University of Maryland Medical System is a 14-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women's and children's health and physical rehabilitation. UMMS is the fourth largest private employer in the Baltimore metropolitan area and one of the top 20 employers in the state of Maryland. No organization will give you the clinical variety, the support, or the opportunities for professional growth that you'll enjoy as a member of our team. Job Description I. General Summary Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems....

The Coding Auditor demonstrates expertise in coding and billing compliance while performing audits to determine billing integrity of professional and facility/technical fees including detection and correction of documentation, coding and billing errors and/or medical necessity of services billed. Audits consist of evaluation of the adequacy and accuracy of documentation in support of services billed including ICD-10/CPT/HCPCS and other third party payor codes, DRG and EAPG assignments, medical necessity of the services, reimbursement overpayments and underpayments, and compliance with other documentation, coding and billing standards. The Coding Auditor applies standardized audit scoring methodology to consistently evaluate documentation and coding, and standardized audit findings methodology to report audit results. Qualifications: Minimum Education Associate's Degree Candidates with 3 years of coding experience in lieu of the degree requirement will be considered. ....

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 direction and...

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...

Summary Who We Are: LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to "improve the health of people in the communities we serve." Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care. This position is located on the campus of Carroll Hospital in Westminster, MD. Consideration will be given for a potential hybrid work model after 6 months of successful employment. About the Role: Supports the LifeBridge Health Institutional Compliance. The auditor works under the under general direction of the Director of Institutional Compliance to perform institutional (e.g., hospital, post-acute care (DME, Home Health, etc.) compliance related audit activities to ensure compliance with federal health care program requirements and federal and state laws and regulations. Responsible...

Candidate should ideally be located in Baltimore, MD Monro’s family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach.  Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company’s regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color.  Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto service in the industry.  Do you have what it takes to shape a...

Introduction OPEN TO ALL QUALIFIED APPLICANTS This is a position specific recruitment. The resulting certified eligible list may be used to staff several current and future vacancies for this position/function only. This recruitment will be closed once all positions have been filled. GRADE 16 (*Please note, state salary guidelines may apply for current state employees) LOCATION OF POSITION Baltimore, Maryland POSITION DUTIES The Comptroller of Maryland's Compliance Division is looking to add new tax auditors to their Business Tax Audit and Individual Tax Audit teams. We offer flexible work schedules that include telework options and opportunities to work from the field (outside of the office) for certain audit assignments. If you're interested in tax auditing and want to join our team, please consider applying. We look forward to meeting you! Business Tax Audit : The main purpose of this position is to audit business entities for compliance with the...

Lead Coding Specialist Adventist HealthCare seeks to hire an experienced Lead Coding Specialist for our Medical Coding Department who will embrace our mission to extend God's care through the ministry of physical, mental, and spiritual healing. As a Lead Coding Specialist, you will: Conduct reviews to validate I-10-CM diagnosis codes and PCS procedure codes for inpatient bill hold related to PSI, PPC & other reimbursement conventions to be resolved prior to final coded data. Manages daily DNFB and DNFC reports and work queues for un-coded or outstanding records. Under the direction of the coding manager, the coding specialist lead should be proficient in communicating with the coding team. Oversees coding corrections, abstracts elements for HSCRC submissions, and ensures coding compliance with coding standards. Liaison between coding and other departments, managing coding-related tasks and denials. Provides mentoring support to coders on coding questions/reviews and...

A healthcare solutions provider is seeking a Senior Medical Coder to support Medicare Part C Risk Adjustment initiatives. Candidates should have at least five years of coding experience in ICD-9-CM/ICD-10-CM standards and the necessary certifications. Responsibilities include diagnosis coding, medical record audits, and providing subject matter expertise during appeals processes. The role ensures compliance with healthcare regulations and promotes efficient data management within the organization. Competitive salary between $60,000 and $80,000, with additional benefits offered. #J-18808-Ljbffr

Job Description Job Description About Company: Since 1984, Professional Performance Development Group (PPDG) has been proudly Serving Heroes by connecting exceptional healthcare professionals with rewarding opportunities across military, federal, and commercial healthcare facilities. Guided by our core principles of excellence, integrity, and collaboration , we are dedicated to delivering high-quality staffing solutions that strengthen the delivery of patient care nationwide. Rooted in a culture of Linked Prosperity , PPDG values the success of our clients, employees, and partners alike—offering competitive compensation, comprehensive benefits, professional growth, and a cooperative workplace built on trust, respect, and service. As a proud Department of Defense Partner Employer and participant in the Military Spouse Employment Partnership (MSEP) , PPDG remains committed to supporting our Nation’s Finest through meaningful careers that make a lasting impact....

Orthopedic and Plastic Surgery Medical Coding Specialist Orthopedic and Plastic Surgery Medical Coding Specialist 1 day ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. We have an immediate opening for a part-time Orthopedic and Plastic Surgery Medical Coder. Candidate will be a highly skilled and detailed-oriented Certified Medical Coder with specialized experience in Ambulatory Orthopedic and Plastic Surgery Coding for Same-Day Surgeries (outpatient procedures). The idealcandidate will possess extensive knowledge of CPT, ICD-10-CM and HCPCS coding systems, along with a strong understanding of outpatient surgical documentation and regulatory compliance. Preference will be given to candidates with same-day surgery coding and ASC coding specialties. Purpose The Medical Coding Specialist plays a key part in ensuring accurate coding for optimal reimbursement and compliance with all coding and billing guidelines. Organizational...