8 credentialed coder jobs found

Position Summary At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare.  As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. Under the direction of the DRG Operations Department leaders, the DRG Reviewer will conduct reviews of inpatient claims for both coding accuracy as well as perform screening referrals for clinical support of coded diagnoses. Responsibilities: Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing. Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides. Collaborates with physician reviewers, as needed. Ability to prioritize and organize workload and complete tasks independently....

Accountable for conversion of outpatient diagnoses and treatment procedures into codes using an international classification of diseases, and HCPCS codes based on documentation in the patient’s record, are coded accurately and in a timely manner. Complies with government, insurance regulations and with medical coding guidelines and polices that all records are coded accurately and in a timely manner. CORE FUNCTIONS 1. Reviews and validates all diagnoses/procedures stated by physician and other healthcare providers. Ensures that records are coded within 48 business hours of discharge. Notifies director whenever work is more than 48 hours behind work deadline. Meets productivity standard of assigning codes to a minimum of 25 charts per hour. 2. Partners with charting physician if diagnosis is not transcribed to assure all required documentation is presented to meet compliance accuracy in coding and severity of illness is charted and coded. 3. Codes diagnoses and...

CNY Family Care's commitment to excellence sets us apart and guides us as we provide care for our community. The Medical Coder and Auditor will be responsible to conduct prospective audits of coding and billing; analyze physician and provider documentation in outpatient office health records; correct evaluation and management (E/M) service levels, appropriate procedure codes, and any necessary modifiers.  Medical Coder and Auditor Responsibilities: Navigate the patient health record, office visit notes, and procedure reports in the determination of diagnoses, reason for visit, procedures, and modifiers to be coded. Code outpatient records utilizing coding books, online tools, and references, in the assignment of ICD, CPT, and HCPCS codes and modifiers. Document individual encounter audit findings and communicates results to providers. Access charge work queues to validate and assign charges. Perform all required EMR functions as efficiently as possible and according...

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...

Job Summary Assigns appropriate ICD and CPT codes for reimbursement and statistical purposes. Follows ICD, CPT, CMS, and other regulatory coding guidelines. Abstracts clinical information from medical records for complete and accurate statistical documentation. Minimum Qualifications Minimum Education:   High School Diploma or Equivalent Minimum Years of Experience:   3 Years of Professional Coding Experience Covering Multiple Clinical and/or Surgical Specialties (Combination of Surgical, E/M, or other coding experience as approved by Director), which they Successfully Met Quality and Productivity Standards Substitutable Education & Experience (Optional):   None. Required Certifications/Licensure:   Active AAPC or AHIMA Coding Credential Required Training:   Experience working with CPT, ICD diagnosis coding; Experience with CCI edits; Experience with Medicare LCDs and NCDs; Understanding of state and federal regulations as well as payor...

Help safeguard accuracy, integrity, and regulatory compliance across our organization. We are seeking a skilled Compliance & Coding Audit Specialist to support the Corporate Compliance Program through detailed auditing, monitoring, and provider education related to coding, billing, and clinical documentation practices. What You’ll Do Conduct ongoing coding, billing, and documentation audits to ensure compliance with hospital policies and federal and state regulations Interpret medical records and related documentation using advanced coding knowledge to assess accuracy and risk Execute compliance audit assignments with a high degree of independence, confidentiality, and professional judgment Analyze findings, prepare audit documentation, and identify trends or improvement opportunities Present audit results directly to physicians and providers, delivering clear feedback and education on documentation and coding best practices...

Supporting the Vice President & Chief Compliance Officer, the Compliance Specialist assists in carrying out the activities of the Frederick Health Compliance Program, including risk assessment, training & education, audits, policy development and internal investigations. Requirements: BA/BS required. MBA/MHA preferred. 5-10 years' experience in healthcare compliance and internal auditing. Certification preferred. Knowledge of laws, regulations, policies and procedures of governmental authorities and payers. Experience in developing and carrying out training and education of staff. Excellent oral and written communication skills. Strong organizational skills and ability to prioritize and manage multiple tasks. Ability to maintain a high level of confidentiality. The following experience & credentials are strongly preferred: Experience in healthcare revenue cycle or patient accounting (coding and/or billing) internal auditing and compliance....