19 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...

Overview Coding Educator, Clinical Document Integrity Full Time, 80 Hours Per Pay Period, Day Shift Must be located in East TN. Position is remote and onsite. 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 office...

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...

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...

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...

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g., ICD‑10‑CM, CPT, HCPCS). The role requires interpretation and independent determination of the appropriate courses of action, contributing to overall cost reduction by increasing the accuracy of provider contract payments in our payer systems and ensuring correct claims payment for appropriate CPT/HCPCS code assignments. The Auditor analyzes, enters and manipulates database data, responds to or clarifies internal requests for medical information, understands departmental, segment and organizational strategy and operating objectives, and follows established guidelines and procedures while making decisions in ambiguous situations. Where you come in The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g.,...

A leading health insurance company seeks a Medical Coding Auditor to review claims and ensure coding accuracy. This remote role requires a minimum of 3 years post-certification experience and knowledge of coding guidelines. Responsibilities include verifying procedure codes, analyzing medical documentation, and conducting compliance reviews. The company offers competitive benefits, including health insurance and retirement plans, with a salary range of $59,300 to $80,900 annually. Flexible work hours available. #J-18808-Ljbffr

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...

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...

Category: Admin Support City: Jackson State: Tennessee Shift: 8 - Day (United States of America) Job Description Summary: Under the direct supervision of the Coding Supervisor/Clinical Manager, responsible for assigned 8 hour shift, 5 days a week with possibility as needed of overtime. ESSENTIAL JOB FUNCTIONS: Reviews electronic medical records and paper records to identify all treated diagnosis and significant procedures performed. Sequences diagnoses and procedures according to definition of principal diagnosis, other co-morbid conditions and complications, and according to definition of principal procedure and other procedures and using appropriate modifiers. Uses 3M Encoder to assign ICD- 9 diagnosis and CPT procedure codes and modifiers when indicated to ensure coding accuracy. Uses compliance advisor to determine medical necessity. Utilizes online coding references, Local Coding Determinations and National Coding Determinations, Medicare Part B...

Coding Educator, 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: 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 office staff. Serves as a resource to coders, CDI staff, Quality and Case...

Coder Analyst Specialist, Clinical Document Integrity 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 initiatives. Abstracts and enters data from the medical records in order to maintain a database for statistics and reporting. Assists the Billing Department in timely billing and rebilling of patient information. Responsibilities Reviews documentation in the medical record to determine ICD-10 CM and CPT-4 coding that is needed to comply with billing and reimbursement guidelines set forth by government entities. Verifies data in the medical record and accurately abstracts pertinent information for charge entry. Appropriately utilizes CPT-4 and ICD-10 current procedural coding standards in assisting the provider with proper selection and assignment of the principal...

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...

A Brief Overview Leads the maintenance of medical records and medical information including charting, coding and abstracting diagnoses, treatments and other information from patient records. Ensures that systems for acquiring, analyzing, storing, retrieving and release of information is provided in an orderly manner when needed. In conjunction with LTACH leadership, assists in the development of policies and procedures in compliance with Federal, State and local government, CMS, and/or state rules/guidelines, medical bylaws, administrative, ethical and other legal regulations and requirements. What you will do Apprises Administrator of all activities, pertinent changes in internal/external market, threats, and opportunities in a timely and anticipatory manner and presents action plans for immediate implementation/approval. Leads functions and practices of Medical Records including chart completion, tumor registry, coding, record retention/retrieval, transcription and...

OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. Our team is bringing together leaders to the market place to help drive OneOncology's mission and vision. Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of community oncologists and the patients they serve. Job Description: Under general supervision, the Medical Coding Specialist performs daily charge review of visits, diagnosis, radiation oncology or surgeries for accurate level and coding. Responsible for input charges into practice management system or EMR. The...

Job Description Job Description About the company Steadfast Health was founded to establish a new standard of substance use disorder (SUD) care. Recognizing that traditional treatment methods often fall short of reaching patients when they're most in need, Steadfast is relentlessly focused on making low-barrier, high quality care accessible to all. We know that the journey to recovery is unique for every individual, and our patient-centered approach ensures we meet patients where they are, providing evidence-based therapies with unwavering support in a compassionate environment that fosters healing and growth. We are growing rapidly and building a dedicated team of professionals who are committed to fulfilling our mission – join us! Position Summary We are seeking an experienced Certified Medical Coder with a strong background in Behavioral Health and Substance Use Disorder (SUD) coding. The ideal candidate will have 3–5+ years of hands-on experience coding both inpatient...

Experienced Multi-Specialty Surgery Coder The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours: Monday - Friday, working 40 hours a week Location: Fully Remote - U.S You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Provide coding and abstraction of physician or professional records Provide communications to Coordinator, Supervisors and Managers Complete RAI's, denials, charge hold reports, and coding edits Assist on special coding projects as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear...

Erlanger Health hires employees for telecommuting/remote positions in the following states: AL, AZ, GA, FL, IN, KY, LA, MD, MI, MS, MO, NC, NV, OH, PA, SC, TN, TX, VA, WI, WY Job Summary Position is responsible for coding of physician and/or mid-level provider professional services. Recognize and complete a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follow set procedures to achieve goals. Display professional office skills and ability to navigate a practice management system. Good written and oral communication skills, ability to handle multiple tasks, and work with and train other employees. Ability to serve as liaison between management, the physician practices, and employees working within physician practices. This position is involved in a team-based approach to care. Team members are trained to meet the highest level of function for their role as per the State of Tennessee/Georgia guidelines. Coder will provide CPT, HCPCS and...

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,...