57 drg validation coding auditor jobs found

Ensemble Health Partners is hiring an Inpatient/DRG Validation Coding Auditor in Blue Ash, Ohio. This remote role conducts coding audits for acute inpatient services, ensuring compliance with coding standards and optimizing reimbursement. Requires 5+ years of coding experience and proficiency in multiple EMR systems. The position offers a salary ranging from $69,400 to $104,100 annually, along with bonuses, paid certifications, and comprehensive benefits. #J-18808-Ljbffr

Thank you for considering a career at Ensemble!Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!O.N.E Purpose:Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.Striving for...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and...

Inpatient Facility Medical Coder (OR; WA) Candidates must reside either in Washington or Oregon to be considered for this position. Essential Responsibilities Proficient in medical record review and translating clinical information into coded data. Identify and assign appropriate codes for diagnoses, procedures and other services rendered, while also validating any Computer Assisted Coded (CAC) assignments for dual coding. Utilizing the Code Base Charge Trigger system (CBCT) and OPTUM 360 EncoderPRO software system for professional surgical services, analyzing and maintaining systems accuracy, validity and meaningfulness for both professional and facility services. Utilizes electronic patient data system and clinical information system (EpicCare) to access patient encounter information. Abstracts and enters clinical data elements as defined by the needs of the organization. Identifies and assigns principal diagnosis and procedure codes, sequencing them as needed for proper...

Clinical Coding Auditor & TrainerLocation:Remote (U.S.) Must be willing to travel to New York twice annuallyPosition Type:Full TimeThe 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 prospective payment system (IPPS) compliance, and ICD-10-CM/PCS coding accuracy.

Coding Auditor (ICD-10)A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas:Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.Job DescriptionPosition:Coding Auditor (ICD-10)Duration:Full-TimeLocation:Newark/Wall NJJob Summary:This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on ICD9-...

DRG auditor Location: Maplewood Mn Pay Rate: Negotiable Duration: 12 months potential for extension Summary We are seeking two experienced inpatient DRG Auditors for an as‑needed role offering flexible hours (8–40 hours per week). Candidates may already have full‑time jobs, and the position is open to applicants on either the East or West Coast. The role will likely include two interviews. Qualifications 5–7+ years of inpatient hospital coding/auditing experience Experience working in acute care hospitals, large hospital systems, or academic medical centers Strong expertise with ICD‑10‑CM/PCS, MS‑DRG and APR‑DRG methodologies Understanding of Elixhauser scoring, HACs, PSIs, and clinical validation Prior exposure to Clinical Documentation Improvement (CDI) preferred Ability to independently perform DRG audits with high accuracy Strong analytical, communication, and documentation skills Responsibilities Perform inpatient DRG audits to validate the accuracy of coded...

DRG auditor Location: Maplewood Mn Pay Rate: Negotiable Duration: 12 months potential for extension Summary: We are seeking two experienced inpatient DRG Auditors for an asneeded role offering flexible hours (8-40 hours per week). Candidates may already have fulltime jobs, and the position is open to applicants on either the East or West Coast. The role will likely include two interviews . Ideal candidates will have: 5-7+ years of inpatient hospital coding/auditing experience Experience working in acute care hospitals, large hospital systems, or academic medical centers Strong expertise with ICD10CM/PCS , MSDRG and APRDRG methodologies Understanding of Elixhauser scoring , HACs , PSIs , and clinical validation Prior exposure to Clinical Documentation Improvement (CDI) preferred Ability to independently perform DRG audits with high accuracy Strong analytical, communication, and documentation skills Role Responsibilities: Perform...

Registered Nurse - Diagnosis Related Group Coding Auditor Principal – Carelon Payment Integrity Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. 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 rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients. Specializes in review of DRG coding via medical records and attending physician’s statements provided by acute care hospitals on paid DRG,...

Responsibilities Participate in the inpatient coding training program, as needed, which is well-established. In times of light training responsibilities, this position will perform retrospective inpatient coding reviews for DRG validation and compliance reviews. If you are an inpatient coder with a proven track record of excellent quality, this is an opportunity to advance your career as a retrospective inpatient coding auditor, possibly to include coder training. Qualifications Requirements are at least three years of inpatient coding experience in a high complexity facility or organization, with a certification of a CCS (or CPC and CCS eligible), RHIT, or RHIA. #J-18808-Ljbffr

Stryker Corporation is seeking an inpatient coding auditor in Plymouth, Minnesota. This role involves participating in a well-established inpatient coding training program and performing retrospective coding reviews for DRG validation and compliance. The ideal candidate will have at least three years of inpatient coding experience in a high complexity facility and possess CCS, RHIT, or RHIA certification. This is a great opportunity for career advancement in coding. #J-18808-Ljbffr

Vālenz® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible. About This Opportunity As a Certified Medical Coding Auditor (Clinical Bill Review Analyst), you’ll review claims upfront and take a deeper dive to catch billing discrepancies, unbundled charges, and other errors based on standard billing practices and coding guidelines. You’ll...

Overview Department : Medical Records Schedule : Full Time, 40 Hours, Days Facility : Central Maine Medical Center Location : Lewiston, Maine, 04240 Central Maine Healthcare is an integrated healthcare delivery system serving 400,000 people living in central, western and Midcoastal Maine. CMH's hospital facilities include Central Maine Medical Center in Lewiston, Bridgton Hospital and Rumford Hospital. CMH also supports Central Maine Medical Group, a primary and specialty care practice organization. Other system services include the Central Maine Heart and Vascular Institute, a regional trauma program, LifeFlight of Maine's southern Maine base, the Central Maine Comprehensive Cancer Center and other high-quality clinical services. Responsibilities The Specialty Coder reviews and analyzes documentation present in the medical record for both inpatient and outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical...

Location :RemoteSalary :$85,000depending on experienceSkills :Auditing, Inpatient Coding, DRG Validation, Quality ReviewAbout the Company / Opportunity :Are you passionate about upholding quality standards in health information management and coding practices? Our client, an industry leader in the hospitals and health care sector, provides nationwide revenue cycle services to a vast network of hospitals and physician practices.This remote opportunity allows you to leverage your expertise in coding quality review, ensuring compliance with national guidelines and maintaining data integrity.Join a mission-driven organization focused on supporting patient outcomes and enhancing health care delivery through excellence in coding quality.Responsibilities :Lead, coordinate, and perform all functions of quality review for inpatient and outpatient coding across multiple facilities.Conduct routine, pre-bill, policy-driven, and incentive plan-driven coding quality audits to ensure compliance...

Inpatient Facility Medical Coder To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional coding...

Inpatient Facility Medical Coder (40h Day) Remote Clackamas, OR Candidates must reside either in Washington or Oregon to be considered for this position. To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative...

Company Description Job Description To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional...

divh2Coding Auditor (ICD-10)/h2pPosition: Coding Auditor (ICD-10)/ppDuration: Full-Time/ppLocation: Newark/Wall NJ/ppJob Summary:/ppThis position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on ICD9-CM, ICD-10, DRG assignment payment and auditing./ppResponsibilities:/pp Identifies and presents billing discrepancies found during audit and coordinates referral of improper claim payments through the appropriate channels./pp Identifies error trends as they relate to medical record and or billing documentation or misinterpretation of provider contract stipulations./pp Compiles statistics and other audit information to present to accounts, regulatory agencies, and internal...

Position Title: Inpatient Coding Auditor Department: HIM Coders Job Description: Ask your recruiter about our competitive wages and total rewards package! Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment. This position may be filled as levels I, II, or III, depending on individual experience, education, certification(s), and business need. ****Ideal candidate will have experience in complex inpatient coding at an academic medical center.**** General Description Ensures accurate, quality, and compliant Inpatient facility coding through prebill and retrospective audits of coder work and providing targeted education to improve consistency and documentation quality. Essential Job Duties Responsibilities listed in this section are core to the position. Inability to perform these responsibilities, with or without an accommodation, may result in disqualification from the position. · Performs all functions of coding...

Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: • Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to...

Coding Auditor (ICD-10) Position: Coding Auditor (ICD-10) Duration: Full-Time Location: Newark/Wall NJ Job Summary: This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on ICD9-CM, ICD-10, DRG assignment payment and auditing. Responsibilities: • Identifies and presents billing discrepancies found during audit and coordinates referral of improper claim payments through the appropriate channels. • Identifies error trends as they relate to medical record and or billing documentation or misinterpretation of provider contract stipulations. • Compiles statistics and other audit information to present to accounts, regulatory agencies, and internal...

Clinical Coding Auditor & Trainer 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 medical record auditing, and education/training for clinical and coding teams. The role is primarily remote, with occasional travel to New York twice a year for onsite meetings or training sessions. The ideal candidate will possess strong analytical and clinical expertise, proficiency in medical coding standards, and exceptional written communication skills to ensure audit accuracy and compliance across departments. Key Responsibilities: Conduct DRG validation and inpatient coding audits to ensure medical record accuracy and compliance. Provide training and education to clinical, coding, and...

Position Title: Inpatient Coding Auditor Department: HIM Coders Job Description: Ask your recruiter about our competitive wages and total rewards package! Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment. This position may be filled as levels I, II, or III, depending on individual experience, education, certification(s), and business need. Ideal candidate will have experience in complex inpatient coding at an academic medical center. General Description Ensures accurate, quality, and compliant Inpatient facility coding through prebill and retrospective audits of coder work and providing targeted education to improve consistency and documentation quality. Essential Job Duties Responsibilities listed in this section are core to the position. Inability to perform these responsibilities, with or without an accommodation, may result in disqualification from the position. · Performs all functions of coding quality...

Riverside University Health System (RUHS)is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience in an acute care...