30 documentation coding auditor jobs found

Inpatient Drg Coding Auditor Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs...and more! Job Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. Reviews discrepancies...

Description WHAT IT'S LIKE AT SGMC HEALTH Purpose . No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place. Excellence . We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service. Team Spirit. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. Award Winning Performance. We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides. WHY YOU WILL LOVE SGMC HEALTH SGMC has great benefit options, depending on the role that you are going into- including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities...

Professional Coding Auditor & Educator The Professional Coding Auditor & Educator works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Responsibilities: Responsible for reviewing and analyzing all aspects of the department clinical documentation and care to ensure timely, accurate, and compliant charge capture and submission Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges Collaborates with Coding Supervisor to ensure clinical documentation in high-risk areas is consistent and complete Identifies...

Professional Coding Auditor & Educator The Professional Coding Auditor & Educator works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Responsibilities: Responsible for reviewing and analyzing all aspects of the department clinical documentation and care to ensure timely, accurate, and compliant charge capture and submission Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges Collaborates with Coding Supervisor to ensure clinical documentation in high-risk areas is consistent and complete Identifies...

Professional Coding Auditor/Education Specialist Job Location: SGMC Patient Financial Services Department: Revenue Cycle Medical Group Schedule: Full Time, 8 HR Day Shift, 8-5 on site Position Summary This position requires on-site presence at SGMC Health Main Campus. Remote work is not available for this role. The ideal candidate for the Professional Coding Auditor/Education Specialist role will be a Certified Professional Coder (CPC), with preference given to those holding a Certified Professional Medical Auditor (CPMA) or Certified Documentation Expert Outpatient (CDEO) certifications, although relevant experience may substitute for these credentials. The candidate must have a strong foundation in medical coding, including extensive knowledge of ICD-10, HCPCS, and CPT, along with expertise in multispecialty and complex coding, and experience in abstracting E/M and CPT codes. Proficiency in anatomy and physiology, medical terminology, and regulatory compliance related to...

Lead Medical Coder and Auditor [PR0001D] Full‑time ProSidian is looking for “Great People Who Lead” at all levels in the organization. Are you a talented professional ready to deliver real value to clients in a fast‑paced, challenging environment? ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. Linking strategy to execution, ProSidian assists client leaders in maximizing company return on investment capital through design and execution of operations core to delivering value to customers. Visit www.ProSidian.com or follow the company on Twitter at www.twitter.com/prosidian for more information. ProSidian Seeks a Lead...

Inpatient Drg Coding Auditor Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs...and more! Job Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. Reviews...

Overview At Piedmont Healthcare, you’ll love a shared purpose, be motivated to be your best, and be recognized for your contributions. Piedmont Healthcare leaders are in your corner and invested in your success. Our wellness programs and comprehensive total benefits and rewards will meet your needs for today and help you plan for the future. Responsibilities This position is responsible for conducting risk-based audits focused on documentation integrity, medical necessity, and regulatory compliance for home health and hospice services. This role also supports the Piedmont’s Compliance Program by identifying areas of risk, leading investigations, and delivering targeted education to mitigate future compliance vulnerabilities. Qualifications Education Bachelor’s Degree Work Experience 3 years of experience in healthcare auditing or coding, with a focus on home health and hospice. Required Licenses and Certifications RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL...

Emory Healthcare is seeking an experienced Inpatient DRG Coding Auditor in Atlanta, Georgia. The role involves reviewing inpatient medical records for coding accuracy and completeness, conducting audits, and coordinating with clinical staff to improve documentation. Candidates should have a Certified Coding Specialist (CCS) certification and a minimum of five years of experience in ICD-10 coding within an acute care setting. The position offers comprehensive health benefits and additional support programs to ensure your professional growth. #J-18808-Ljbffr

Become a part of our caring community 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 receives guidance where needed....

DEPARTMENT: Physician Practice Management FACILITY: Medical Office Building WORK TYPE: Full Time SHIFT: Daytime SUMMARY: Assess the educational needs of coding specialists and providers regarding coding and documentation and direct development of effective regularly scheduled educational programs that meet the needs of the health system. Serve as the primary resource to physicians for documentation and coding issues. Conduct ongoing coding and billing training programs for billing and coding specialists and providers. Creates presentations, develops learning material, handbook, and other training materials. Conducts coding and data quality reviews and prepares complex reports as required. Ensures all education activities comply with clinical billing standards and government regulation with concentration on hospital inpatient procedures, ambulatory, and specialty physician services. RESPONSIBILITIES: * Keeps abreast of pertinent federal, and state regulations...

Lead Medical Coder and Auditor ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. ProSidian Seeks a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on athe medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land dominance, across the full range of military...

Compliance Audit And Analysis Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more Description Reporting to the Manager, Compliance Audit and Analysis, develops and executes audit, monitoring, and education for inpatient hospital billing, coding and documentation programs that ensure compliance with regulatory standards. Continuously evaluates inpatient hospital/clinical billing compliance activities to assess compliance with the Compliance Audit and Analysis Program and...

Phoebe Putney Health System in Albany, GA, is seeking a Medical Coder to audit medical record documentation, ensuring compliance with coding standards. The role requires expertise in ICD-10-CM/PCS and HCPCS coding, and the candidate must educate staff on documentation practices to support accurate billing. Candidates must have a Bachelor's degree in Health Information Management or equivalent experience, along with a CCS certification. Strong organizational, communication, and analytical skills are essential for success in this role. #J-18808-Ljbffr

Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more Description Reporting to the Manager, Compliance Audit and Analysis, develops and executes audit, monitoring, and education for inpatient hospital billing, coding and documentation programs that ensure compliance with regulatory standards. Continuously evaluates inpatient hospital/clinical billing compliance activities to assess compliance with the Compliance Audit and Analysis Program and appropriate focus on risk...

Surgical Coder - PHYS Overview At Piedmont Healthcare, you’ll love a shared purpose, be motivated to be your best, and be recognized for your contributions. Piedmont Healthcare leaders are in your corner and invested in your success. Our wellness programs and comprehensive total benefits and rewards will meet your needs for today and help you plan for the future. Responsibilities Reviews, analyzes, and codes medical record documentation to include, but not limited to, medical diagnostic and complex procedural information for general surgical specialties for the correct ICD‑10, CPT and/or HCPCS codes to the greatest specificity. Abstracts demographic and coding information into the information system accurately and completely. Reviews documentation for medical necessity. Audits orders and claims before submission for entirety and accuracy and to minimize claim denials. Assesses records and prepares reports. Provides technical guidance to physicians and other departmental staff in...

The Supervisor, Claims Audit – A&H Core Team, is responsible for leading a team of claims auditors focused on reviewing and rendering decisions on liability for claims made under Medical Stop Loss policies issued to Skyward non captive insurance clients. This role oversees the claims audit process for accident and health captive programs, ensuring claims are handled accurately, efficiently, and in accordance with company standards and client expectations. The manager will guide and support staff, ensure compliance with audit protocols, and partner with stakeholders to drive quality results and client satisfaction. This position will work a hybrid schedule in our Kennesaw, GA office. Essential Duties and Responsibilities Supervise, train, and mentor the Claims Audit team, ensuring adherence to claims audit standards and achievement of performance goals Oversee audits of medical claims across Skyward insurance programs (monitoring over/under payments, duplicate payments, contract...

The Supervisor, Claims Audit - A&H Core Team, is responsible for leading a team of claims auditors focused on reviewing and rendering decisions on liability for claims made under Medical Stop Loss policies issued to Skyward non captive insurance clients. This role oversees the claims audit process for accident and health captive programs, ensuring claims are handled accurately, efficiently, and in accordance with company standards and client expectations. The manager will guide and support staff, ensure compliance with audit protocols, and partner with stakeholders to drive quality results and client satisfaction. This position will work a hybrid schedule in our Kennesaw, GA office. Essential Duties and Responsibilities • Supervise, train, and mentor the Claims Audit team, ensuring adherence to claims audit standards and achievement of performance goals • Oversee audits of medical claims across Skyward insurance programs (monitoring over/under payments, duplicate...

JOB SUMMARY Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and compliance with the Official Coding Guidelines for Coding and Reporting, payer regulations, and hospital policy. Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure compliant coding and billing practices. Educates and trains coders to ensure both a working knowledge of coding and reimbursement guidelines and successful career ladder completion, including the development of training materials and reference documents. Researches audit results, error reports, and denials and resolves by successful appeal, staff education, and correction of discrepancies. GENERAL REQUIREMENTS Adheres to the hospital and departmental attendance and punctuality guidelines Performs all job...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

BayCare is currently in search of our newest Team Member who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area. Position Details Location: Remote (must reside in the state of Florida, Georgia, North Carolina, or South Carolina) Status: Full time (non-exempt) Shift: 8:00am - 4:30pm Days: Monday through Friday This Specialty Coder II opportunity is a full-time remote position. This team member must reside in the state of Florida, Georgia, North Carolina, or South Carolina. Sign on bonuses available! Responsibilities The Specialty Coder II is a Certified Professional Coder who assigns diagnosis and procedural codes using ICD-10 CM and CPT-4 coding systems. The Specialty Coder audits physician documentation to assign appropriate CPT codes, diagnosis codes, and modifiers. Mentors and training of other Specialty Coders. Serves as...

Are you seeking a career with a growing company, a place where you can make an impact in the community? Then Positive Impact Health Centers is the company for you. What makes us different? We offer our employees the following: • 1 Health Wellness day per quarter • Parental Leave • Free parking at our locations/bus line accessibility • Competitive Salary & Benefits • Automatic 3% Safe Harbor & 2% Profit Sharing (Retirement Program) • 100% allotted for benefit elections for employees, 50% allotted for benefit elections for employees' spouse/dependents • Credit Union Positive Impact Health Centers (PIHC) is a community leader in providing HIV prevention, care and treatment services. The PIHC model of care assures that persons with HIV have access to medical, pharmacy, dental, behavioral health and social services, providing the best opportunity for patients to achieve high-quality health outcomes. Job Summary : The Medical Billing &...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...