10 drg coding auditor jobs found

DRG Coding Auditor Principal _Virtual: _ _ ​_ 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...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

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: The HIM Hospital Inpatient & Same Day Surgery Coding Analyst deciphers and interprets provider documentation in the health record and assigns diagnostic information using ICD-10-CM/PCS and CPT codes for a complex range of acute care services for Intermountain Health. The caregiver provides specific coding expertise in the various fields of NCCI edits, Drugs and Biologicals, Revenue Codes, Current Procedural Terminology (CPT) codes, ICD-10 & CPT codes, DRGs, anatomy and physiology, pharmacology. The analyst also performs audits, provides feedback, and advanced training to clinical teams and physicians on ICD-10 and CPT coding best practices. Essential Functions Reviews and analyzes inpatient medical records for completeness, accuracy, and compliance for Same Day Surgery, Observation and Inpatient acute services at Intermountain Health. Performs coding at an advanced level of complexity for inpatient hospitals including governmental and/or...

At Virtua Health we exist for one reason to better serve you.That means being here for you in all the moments that matter striving each day to connect you to the care you need.Whether thats wellness and prevention experienced specialists life-changing care or something in-between we are your partner in health devoted to building a healthier community.If you live or work in South Jersey exceptional care is all around.Our medical and surgical experts are among the best in the country.We assembled more than 14000 colleagues including over 2850 skilled and compassionate doctors physician assistants and nurse practitioners equipped with the latest technologies treatments and techniques to provide exceptional care close to home.A Magnet-recognized health system ranked by U.S.News and World Report weve received multiple awards for quality safety and outstanding work environment.In addition to five hospitals seven emergency departments seven urgent care centers and more than 280 other...

About UsAt Cooper University Health Care , our commitment to providing extraordinary health care begins with our team.Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols.We have a commitment to our employees to provide competitive rates and compensation programs.Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement.We also provide attractive working conditions and opportunities for career growth through professional development.Discover why Cooper University Health Care is the employer of choice in South Jersey.Short DescriptionThe auditor reviews professional fee billing, coding and documentation.Reviews to be performed are identified based on the then-current OIG Workplan and compliance risk analyses.Customers include employed providers, senior leadership,...

Datavant is a leading data platform company dedicated to health data exchange, with a vision that every healthcare decision is powered by accurate data at the right time. Our network is one of the largest and most diverse in the U.S., ensuring that data remains secure and accessible to enhance health decisions. Our clients include prominent life sciences firms, government agencies, and healthcare providers. Joining Datavant means becoming part of a high-performing, values-driven team that is committed to solving the intricate challenges of healthcare through technological innovations. Our diverse team members bring a rich array of professional, educational, and personal experiences to support our ambitious vision for the future of healthcare. Your Role: We are seeking credentialed inpatient coders who possess meticulous attention to detail and a solid understanding of medical terminology to join our dynamic team. This position offers the flexibility of fully remote work,...

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...

Position Summary The Certified Inpatient Coder is responsible for the accurate diagnostic and procedural coding of medical records. The Coder is also responsible for the accurate abstracting of medical, financial and demographic information, in addition to performing other events. Core Duties and Responsibilities • Per standard process reviews and evaluates designated medical records to identify diagnoses and procedures and accurately assigns and sequences ICD CM, ICD PCS and/or CPT codes • Reviews medical record for proper assignment of diagnosis and procedure codes according to AHA coding guidelines • Contacts Physicians and Other Healthcare Providers to clarify diagnoses and procedures • Sequence codes appropriately for accurate DRG • Abstracts required data from the medical record, including, but not limited to, Attending Physician, Discharge Disposition, ICD-9-CM , ICD-10-CM, CPT diagnosis and/or procedure codes, and Physician Consultation • Completes medical...

POSITION SUMMARY: Position Summary The Inpatient Senior Coder is responsible for accurate, compliant, and timely coding and abstracting of inpatient medical records, including the assignment of ICD-10-CM/PCS codes and validation of MS-DRG and APR-DRG groupings. This position ensures proper reimbursement, adherence to regulatory and coding guidelines, and supports overall clinical documentation accuracy for inpatient services. This is a remote position with onsite availability required as needed. EDUCATION: High school diploma or equivalent. CCS (Certified Coding Specialist) Required . EXPERIENCE: * Three to five years of inpatient hospital coding experience * Proficient in ICD-10-CM and ICD-10-PCS coding * In-depth knowledge of MS-DRG and APR-DRG reimbursement systems * Familiarity with coding audits and clinical documentation review * Experience with Observation or complex outpatient cases is a plus * Prior mentoring or training experience preferred...