29 drg coding auditor jobs found

divh2Inpatient/DRG Validation Coding Auditor/h2pThe Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations./ppHas an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems./ppConducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding,...

A leading health services company is seeking an experienced Inpatient Medical Coding Auditor to perform coding audits and ensure accurate provider reimbursements. This remote position requires certifications such as RHIA, RHIT, or CCS, and proficiency in MS-DRG coding, claims interpretation, and Microsoft Office. Strong communication and detail orientation are essential for success in our supportive, flexible work environment, where candidates will also enjoy competitive benefits and potential bonuses. #J-18808-Ljbffr

A leading healthcare consulting firm is seeking a Clinical Coding Auditor & Trainer to lead DRG and medical record auditing while delivering staff training programs. The role emphasizes quality improvement and compliance across clinical and coding teams. Candidates should have a relevant license and an associate’s degree in nursing, coupled with 4+ years in auditing and at least 1 year of clinical experience. This primarily remote position offers competitive benefits and workplace flexibility. #J-18808-Ljbffr

A leading health data exchange company is seeking an Inpatient Auditing Specialist to conduct coding audits and ensure compliance with quality standards. This fully remote position requires significant coding experience, especially in MS-DRG and APR-DRG coding. Candidates will also engage in coder education and client interaction, contributing meaningfully to healthcare decisions. Join a high-performing team committed to innovative healthcare solutions. #J-18808-Ljbffr

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...

Benefits: 401(k) Competitive salary Employee discounts Paid time off Overview: We are seeking a Clinical Coding Auditor & Trainer to lead DRG and medical record auditing and deliver staff training programs. This role supports quality improvement, compliance, and education across clinical and coding teams. Responsibilities: Conduct audits of staff work; report findings and improvement recommendations. Develop and deliver coding and DRG training programs. Revise policies and procedures to improve audit accuracy. Maintain training and audit records and track staff progress. Ensure compliance with company policies and healthcare standards. Requirements: RN, PA, MD, APRN, DO, or MBBS license. Associate's degree in Nursing or equivalent experience. 4+ years of DRG and/or medical record audit experience. 1 year of clinical experience in a hospital setting. Strong written communication skills. Preferred: Inpatient coding experience....

Clinical Coding Auditor & Trainer Location: Remote (U.S.) Must be willing to travel to New York twice annually Position Type: Full Time The Clinical Coding Auditor & Trainer is responsible for conducting clinical documentation and coding audits to ensure compliance with federal regulations, payer requirements, and company policies. This position focuses on DRG validation, inpatient...

Location Miramar, Florida Summary Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. For physician billing, collaborates with billing department to ensure all bills are satisfied. For hospital, routes to billing charge entry errors and/or account edits preventing completion of coding and/or billing. Makes appropriate coding corrections, when advised, and follows procedure to notify billing. Reviews and validates the accuracy of data in the Admission, Discharge Transfer (ADT) fields following HIM...

Clinical Coding Auditor & Trainer Location: Remote (U.S.) – Must be willing to travel to New York twice a year for onsite meetings or training sessions. Position Type: Full Time This role is responsible for conducting clinical documentation and coding audits to ensure compliance with federal regulations, payer requirements, and company policies. The focus is on DRG validation, inpatient medical record auditing, and education/training for clinical and coding teams. Key Responsibilities Conduct DRG validation and inpatient coding audits to ensure medical record accuracy and compliance. Provide training and education to clinical, coding, and quality staff on coding guidelines, audit findings, and process improvements. Review clinical documentation and coding practices for adherence to federal and payer standards (CMS, AHIMA, AAPC, etc.). Evaluate and recommend process improvements to enhance coding accuracy and quality of medical record documentation. Collaborate with...

6 days ago Be among the first 25 applicants This range is provided by TalentPlug LLC. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $55,100.00/yr - $99,000.00/yr Direct message the job poster from TalentPlug LLC Job Title Clinical Coding Auditor & Trainer Job Location Remote (Candidates must be residents of New York) Summary The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Position Purpose Responsible for developing and conducting training and quality auditing programs for the Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care. Applicants must be willing to travel to New York twice a year. Responsibilities Conducts auditing of work performed by staff and present findings and recommendation for areas...

About the job Clinical Coding Auditor & Trainer We are looking for a Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Position Purpose: Responsible for developing and conducting training and quality auditing programs for the Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care. Responsibilities: Conducts auditing of work performed by staff and present findings and recommendation for areas of improvement to management Under minimal supervision responsible for all aspects of auditing projects that are broad in nature and require originality and/or ingenuity Assists with revisions to Policy and Procedure and/or work process development Conducts training needed analysis to determine specific training needs for clinical and coding staff Identifies, selects, or develops appropriate training...

Overview We are seeking a Clinical Coding Auditor & Trainer to lead DRG and medical record auditing and deliver staff training programs. This role supports quality improvement, compliance, and education across clinical and coding teams. Responsibilities Conduct audits of staff work; report findings and improvement recommendations. Develop and deliver coding and DRG training programs. Revise policies and procedures to improve audit accuracy. Maintain training and audit records and track staff progress. Ensure compliance with company policies and healthcare standards. Requirements RN, PA, MD, APRN, DO, or MBBS license. Associate’s degree in Nursing or equivalent experience. 4+ years of DRG and/or medical record audit experience. 1 year of clinical experience in a hospital setting. Preferred Valid/current CPC or CIC Certification (AAPC) or CCS (AHIMA). RHIA/RHIT credentials. Prior training or auditing experience in managed care. Notes Primarily remote position...

A healthcare solutions company is seeking a Clinical Coding Auditor & Trainer to work remotely. This role requires professional licensing (RN, PA, MD, etc.) and at least 4 years of experience in DRG and Medical Record Audits. The position involves occasional travel to New York. The salary ranges from $55,100 to $99,000 annually, providing a competitive compensation package for qualified candidates. #J-18808-Ljbffr

Job Overview Clinical Coding Auditor & Trainer – Remote, NY, US. The position is primarily remote with a small travel expectation (twice a year to New York). Full‑time, permanent, salary $55,100–$99,000 / yr. Required Qualifications RN, PA, MD, APRN, DO, or MBBS license Associate’s degree in Nursing or equivalent experience 4+ years of DRG and/or Medical Record Audit experience 1 year of clinical experience in a hospital setting Valid/Current CPC or CIC Certification, or CCS through AHIMA Inpatient coding experience preferred Preferred or Nice-to-­Have Skills RHIA/RHIT credentials Training or auditing experience in a managed care or healthcare setting Years of Experience 4+ years in DRG/Medical Record Audit; 1 year in hospital clinical setting. Industry Experience Healthcare, specifically in a hospital or managed care setting. This is a remote position. Compensation: $55,100 – $99,000 per year. I was referred to this position by a current employee. #J-18808-Ljbffr

Req Number 176729 Job Description Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Seeking RN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Remote position Job Responsibility 1.Leverages clinical expertise to identify and validate DRG code assignment. 2.Full review of CDI suggested code changes 3.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. 4.Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules and regulations to the validation review process. 6.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to the coding and CDI...

Position Overview The Inpatient Coder Level 3 is a senior-level position responsible for coding high-complexity inpatient records with accuracy and efficiency. This role requires expert-level knowledge of ICD-10-CM and ICD-10-PCS coding systems, MS-DRG and APR-DRG assignment, and comprehensive understanding of clinical documentation. The Level 3 coder ensures coding compliance, supports training and mentoring of junior staff, and contributes to audit and quality improvement efforts within the HIM department. Primary Department, Division, or Unit: Coding Support Services, UHS Revenue Cycle Operations Primary Work Shift: Day Compensation Range: $33.63 - $50.45 per hour, depending on experience You will be eligible for benefits if you are hired into a regular position with at least 24 scheduled weekly hours. Key Responsibilities Demonstrate proficient understanding of complex clinical scenarios, including comorbidities and complications. Analyze...

P osition Summary : Responsible for performing formal root cause and trend analyses of exceptions escalated from ConServe's monitoring and all other consumer-facing business activities, including consumer complaints and issues escalated to Corporate Compliance from various input channels. Responsible for performing targeted audits (control evaluations) to assess the quality and effectiveness of an individual control, a group of controls, or an entire process. Responsible for our PPMS (Professional Practices Management System) audits as well as our FISMA (Federal Information Security Management Act) audits. The Corporate Compliance Auditor is responsible for performing independent investigation on consumer complaints and issues escalated to Corporate Compliance from various input channels. The Corporate Compliance Auditor will perform Compliance Monitoring activities as assigned that ensure consumer financial regulations, Client, and ConServe's requirements are...

Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $60,367.47 - $90,551.20 The Senior Hospital Coder is responsible for performing detailed coding quality audits, scheduled and random, on staff and providing thorough education and feedback, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI. Responsible for monitoring and tracking trends of staff, bringing forward concerns to leadership regarding coding quality and productivity, completes duties as assigned by the Quality Manager. Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. Senior Hospital Coder may be asked to assist with denials work, including researching and writing appeal letters. These individuals are highly skilled and considered experts in medical coding. Essential Duties and...

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...

Medical Record Coder At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments. For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding. Submits daily productivity report to HIM manager by defined deadline. Meets and maintains HIM coding quality and...

Benefits: 401(k) Dental insurance Health insurance Paid time off Vision insurance 401(k) matching We are seeking a highly organized and detail-oriented Medical Biller to join our healthcare team. The ideal candidate will be responsible for ensuring accurate and timely billing and coding for patient services as well as oversee our billing operations. This role will include administrative patient services. This role is a crucial part of our medical office, and we are looking for someone who is passionate about providing excellent patient care while also ensuring the financial well-being of our organization. Duties: Utilize medical coding skills to assign accurate ICD-10 and CPT codes to patient records and submit claims to insurance companies. Verify patient insurance coverage and obtain necessary authorizations for services. Analyze and resolve billing discrepancies and denials in a timely and efficient manner. Maintain accurate and up-to-date medical...

Position Overview The Inpatient-Outpatient Coder is responsible for conducting coding audits and education for providers with greatest opportunity for improvement. This individual will ensure medical diagnosis and procedure codes submitted on provider claims are accurate. In addition, this person will review medical records for: physician documentation, clinical evidence that supports the diagnoses, medical necessity of procedures, appropriate setting of care and accurate use of CMS coding guidelines. Scope of Role & Responsibilities Identifies trends and inconsistencies in provider documentation and coding practices. Audits and reviews medical records to determine if the medical record is complete, accurate, and in support of individual patient risk adjustment score accuracy. Develops curriculum to improve provider coding practices. Educates providers and their practice staff in coding guidelines. Works in collaboration with other departments, develop plans...

Inpatient-Outpatient Coder Job Ref: TE0031 Category: Claims Department: CLAIMS Location: 50 Water Street, 7th Floor, New York, NY 10004 Job Type: Regular Employment Type: Full-Time Work Arrangement: Hybrid Salary Range: $76,000.00 - $86,661.00 Position Overview The Inpatient-Outpatient Coder is responsible for conducting coding audits and education for providers with greatest opportunity for improvement. This individual will ensure medical diagnosis and procedure codes submitted on provider claims are accurate. In addition, this person will review medical records for: physician documentation, clinical evidence that supports the diagnoses, medical necessity of procedures, appropriate setting of care and accurate use of CMS coding guidelines. Scope of Role & Responsibilities Identifies trends and inconsistencies in provider documentation and coding practices. Audits and reviews medical records to determine if...

Possible $5000 Sign On Bonus for External Hires! Remote Coder positions are available in all states EXCEPT CA and HI Nuvance Health has a network of convenient hospital and outpatient locations - Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care, and two urgent care offices. Non-acute care is offered through various affiliates, including the Thompson House for rehabilitation and skilled nursing services, and the Home Care organizations. Summary: Appropriately analyzes and codes complex inpatient records for facility. Position requires high-level expertise in coding and documentation guidelines, coding clinics, and knowledge of MS DRGs, CC/MCC for appropriate reimbursement and compliance....