16 drg coding auditor jobs found

DRG Coding Auditor Principal This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case...

A leading educational institution in Ann Arbor seeks a DRG Compliance Auditor to ensure accurate coding and compliance within their records. The successful candidate will review inpatient records, train staff on coding accuracy, and handle third-party appeals. Requirements include a relevant Associate’s degree and at least three years of experience in ICD-10 coding. This role offers opportunities for professional development and contributions to patient care excellence. #J-18808-Ljbffr

A healthcare organization is seeking an ICD-10 Coding Specialist in Ann Arbor, Michigan. Your primary role will include ensuring the accuracy of coding for inpatient records, creating training programs, and supporting coding compliance. The ideal candidate will have a strong background in healthcare coding, effective communication skills, and the ability to work independently. This is an opportunity to contribute to quality patient care through effective coding practices. #J-18808-Ljbffr

Inpatient Medical Coding Auditor As an Inpatient Medical Coding Auditor, you will make an impact by auditing consultant inpatient. You will be a valued member of the Cognizant team and work collaboratively with stakeholders and teams. In this role, you will: Review ICD-10 inpatient patient records for accuracy and compliance Review physician documentation to verify diagnosis and procedures Communicate with physicians to obtain or clarify diagnosis and/or procedures via the query process Assign accurate ICD-10-CM and ICD-10-PCS codes utilizing an electronic encoder application, 3M, in accordance with practice policy and regulatory guidelines Complete reports as requested Provide ICD-10-CM and ICD-10-PCS education and mentoring to Company's clients in coding, billing and compliance Perform Peer Reviews of Company Health Information Management coding auditors and coders Assure that services provided to Clients of Company are current and up-to-date with industry standards...

About the role As an Inpatient Medical Coding Auditor, you will make an impact by auditing consultant inpatient. You will be a valued member of the Cognizant team and work collaboratively with stakeholders and teams. In this role, you will: Review ICD-10 inpatient patient records for accuracy and compliance Review physician documentation to verify diagnosis and procedures Communicate with physicians to obtain or clarify diagnosis and/or procedures via the query process Assign accurate ICD-10-CM and ICD-10-PCS codes utilizing an electronic encoder application, 3M, in accordance with practice policy and regulatory guidelines Complete reports as requested Provide ICD-10-CM and ICD-10-PCS education and mentoring to Company’s clients in coding, billing and compliance Perform Peer Reviews of Company Health Information Management coding auditors and coders Assure that services provided to Clients of Company are current and up-to-date with industry standards Conduct other...

DRG COMPLIANCE AUDITOR (DCA) University of Michigan-Flint School of Management – Michigan Medicine – Ann Arbor, MI Mission Statement Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society. Responsibilities Review inpatient records to ensure accurate ICD‑10 coding, DRG grouping, Present on Admission indicators, Severity of Illness, Risk of Mortality, Hospital‑Acquired Conditions and Patient Safety Indicators according to CMS and AHA guidelines. Provide ongoing feedback and training to Coding unit staff to improve coding accuracy and documentation completeness. Conduct chart reviews, identify missed query...

Job Summary Review and check certain inpatient records to make sure the coding is correct and follows rules for ICD-10 codes. This includes checking the DRG groups, Present on Admission indicators, Severity of Illness, Risk of Mortality, Hospital-Acquired Conditions, and Patient Safety Indicators according to guidelines set by the Centers for Medicare & Medicaid Services and the American Hospital Association. Provide ongoing feedback and training to the staff in the Coding unit. Mission Statement Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society. Responsibilities* General...

Join to apply for the Certified Professional Coder Consultant role at Yeo & Yeo CPAs & Advisors . Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever‑changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD‑10 coding. Our staff is highly trained with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes and our billing specialists receive ongoing, specialty‑specific training. We continually update our staff on insurance carrier trends and billing rule changes. At Yeo & Yeo Medical Billing & Consulting, our people are our future. We provide a venue for individuals who...

Job Description Job Description About Us: We are a busy internal medicine practice dedicated to providing exceptional patient care. We are seeking a highly skilled and detail-oriented Medical Biller & Coder to join our team and ensure accurate billing and coding processes. Key Responsibilities: Accurately code diagnoses and procedures for internal medicine patients using ICD-10-CM, CPT, and HCPCS Level II Submit insurance claims, follow up on denials, and manage appeals efficiently Post patient payments, reconcile accounts, and maintain accurate records Audit charts for coding accuracy and compliance with payer guidelines Communicate professionally with patients, providers, and insurance companies Ensure full HIPAA compliance and patient confidentiality Qualifications: 2+ years of experience in medical billing and coding, preferably in internal medicine Strong knowledge of insurance claims, prior authorizations, and payer rules...

Advanced Coding Position Positions Location: Lansing, MI Job Description General Purpose of Job: Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine Sparrow policies and procedures and maintains required quality and productivity...

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

Review and check certain inpatient records to make sure the coding is correct and follows rules for ICD-10 codes. This includes checking the DRG groups, Present on Admission indicators, Severity of Illness, Risk of Mortality, Hospital-Acquired Conditions, and Patient Safety Indicators according to guidelines set by the Centers for Medicare & Medicaid Services and the American Hospital Association. Provide ongoing feedback and training to the staff in the Coding unit. Mission Statement Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society. Responsibilities* General Characteristics: Excellent customer...

Coding Auditor We at Pine Rest believe in the power of healing and that everyone in our community has the right to expert care for mental health and substance use disorders. We are much more than just the third largest non-profit behavioral health system in the country, our 220-acre main campus, and our network of clinical sites across Michigan. We are a tight-knit community of healers who witness the impact of our life-changing work each day. Each day, we are closing the gaps in access to care. We are innovating through leading-edge research, testing, programs, and treatment modalities that others replicate across the country. Our services include a state-of-the-art psychiatric urgent care center and a soon-to-be-built pediatric behavioral health center, outpatient, inpatient, partial hospitalization (day programs), assessment and testing, residential, addiction treatment and specialty services such as crisis response, employee assistance programs, forensic psychiatry and...

Job Opportunity Job ID:49762 Positions Location: Lansing, MI Job Description General Purpose of Job: Advanced Description: Positions Location: Lansing, MI Job Description General Purpose of Job : Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows...

Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future – we provide the venue for individuals who have the desire...

Overview The Health Information Management Coder Inpatient Level 2 provides timely and accurate clinical and administration data to ensure optimal reimbursement for inpatient, rehab and/or skilled nursing coding to support the facility needs. Primary patient contact is only social. Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation. Responsibilities Contributes to organization success targets for patient satisfaction. Formulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients, and other department staff members. Adheres to current coding rules, regulations and requirements for inpatient coding, DRG/APR-DRG assignment, rehab coding, skilled care coding, CMG assignment,...