12 drg coding auditor jobs found

Coding Auditor - Drg/Apc Coordinator Be a part of a world-class academic healthcare system at UChicago Medicine as a Coding Auditor - DRG/APC Coordinator for the Health Information Management department. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area. In this role, the Coding Auditor - DRG/APC Coordinator is responsible for ensuring accuracy and quality of coding assignments for all records requiring DRG and/or APC coding, and ensures optimal and timely reimbursement. Essential Job Functions Performs data quality reviews on inpatient and outpatient records to ensure proper coding guidelines have been followed and appropriate DRG or APC assignments have been made for appropriate reimbursement Provides DRG/APC and coding quality information and statistical reports to the Coding Manager Communicates with the Medical Staff and House staff as needed to discuss clinical questions with respect to the assignment of...

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 accuracy...

Medical Records Coder II At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. Occ Summary The Medical Records Coder II is a certified coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-10-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures, and appropriate/optimal reimbursement for hospital and/or professional...

About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. Occ Summary The Medical Records Coder II is a certified coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-10-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures, and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract information from medical records following established methods and procedures. Work Performed Review the complex (problematic coding that needs research and reference checking) medical...

Join to apply for the Compliance Auditor - Pharmacy role at Duke University Health System Be among the first 25 applicants At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Compliance Auditor 5119 - G1 Occupational Summary Conduct health-system wide compliance audits to ensure data integrity, compliance with federal and state regulations pertaining to but not limited to: federal healthcare program requirements, clinical trials billing, privacy, conflict of interest, and anti-kickback and physician relationships. Exercise independent decisions using analytical and problem solving skills. Provides critical analytical and support with respect to third party payer external audits (i.e. RAC, ADR/TPE, UPIC, etc.). Work Performed Interpretation of applicable federal and state law and regulations...

Compliance Auditor 5119 - G1 At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Occupational Summary Conduct health-system wide compliance audits to ensure data integrity, compliance with federal and state regulations pertaining to but not limited to: federal healthcare program requirements, clinical trials billing, privacy, conflict of interest, and anti‑kickback and physician relationships. Exercise independent decisions using analytical and problem‑solving skills. Provides critical analytical and support with respect to third‑party payer external audits (i.e. RAC, ADR/TPE, UPIC, etc.). Work Performed Interpretation of applicable federal and state law and regulations to plan audit parameters, determine department's compliance with such regulations and communicate to department necessary...

Job Title Medical Records Coder II at Duke University Health System About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. Overview The Medical Records Coder II is a certified Coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-10-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract information from medical records following established methods and procedures. Responsibilities Review complex medical...

Certified Professional Coder, Independent Contractor Join to apply for the Certified Professional Coder, Independent Contractor role at Constellation Quality Health Constellation Quality Health is a non‑profit health care quality consultancy headquartered in the North Carolina Research Triangle. We offer a range of quality improvement, clinical review, audit, technical and consulting services to improve care delivery, system performance and patient outcomes. What You’ll Do Perform coding reviews in a manner consistent with contract requirements for timeliness and accuracy. Review and compare provider service documentation to billed claims to determine compliance with clinical policies and state and federal regulations. Qualifications Associate or bachelor’s degree in a human services field or five (5) years of related experience may substitute for degree. Certified Professional Coder (CPC) certification with at least two (2) years’ experience in DRG coding in an inpatient...

Certified Professional Coder (CPC), Independent Contractor Remote, North Carolina Who we are: Constellation Quality Health, formerly CCME, is a non‑profit health care quality organization and QIO‑like Entity certified by the Centers for Medicare & Medicaid Services (CMS) founded by physicians in 1983. Headquartered in North Carolina’s Research Triangle, we offer an array of quality improvement, clinical review, audit, technical, and consulting services and solutions to improve care delivery, system performance, and patient outcomes. What you’ll do: The Certified Professional Coder (CPC) is responsible for reviewing and comparing provider service documentation to billed claims in order to determine compliance with clinical policies, state and federal regulations. Perform reviews in a manner consistent with contract requirements for timeliness and accuracy. Our requirements for this role: Associate or bachelor’s degree required in a human services field or five (5) years of...

At Duke Health, we’re driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. ABOUT DUKE HEALTH'S PATIENT REVENUE MANAGEMENT ORGANIZATION Patient Revenue Management Organization is Duke Health’s fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. OCC SUMMARY The Medical Records Coder II is a certified coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD‑10‑CM and CPT‑4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract...

Overview At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. OCC Summary The Medical Records Coder II is a certified Coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-10-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures and appropriate/optimal...

Firsthealth Of The Carolinas FirstHealth of the Carolinas is a nationally recognized health care system located in central North Carolina. Comprised of four hospitals with more than 600 beds, the system also offers leading-edge heart care in the Reid Heart Center, the area's only dedicated heart and vascular center. Our growing health system has more than 6,200 employees serving in more than 75 locations throughout a 15-county service area. In addition, FirstHealth has received numerous accolades for its patient care and outcomes, including recognitions from Healthgrades, U.S. News & World Report, and Becker's Healthcare. At FirstHealth of the Carolinas, we believe in supporting our employees' professional growth and personal well-being. That is why we offer a comprehensive benefit package that is designed to help you thrive. Enjoy a free gym-membership to one of our 7 FirstHealth Fitness Centers to stay active and prioritize your health, take advantage of our educational...