18 e m coder auditor jobs found

1.0 FTE Full time Day - 08 Hour R2658919 Remote USA 108610021 Admin Compliance Business & Administration Day - 08 Hour (United States of America) This is a Stanford Health Care job. A Brief Overview Billing and Coding Compliance Auditors conduct audits and monitoring activities to identify and address compliance risks related to billing and coding practices. They review and evaluate healthcare regulatory compliance, focusing on the detection of documentation, coding, and billing errors. Responsibilities include assessing the adequacy and accuracy of documentation supporting billed services, including ICD, CPT, HCPCS, and other third-party payer codes, as well as adherence to Teaching Physician guidelines, Evaluation & Management criteria, DRG and APC assignments, medical necessity, and reimbursement accuracy. Auditors serve as a communication channel, partnering with Billing and Coding Compliance Educators to address compliance issues. They are responsible for conducting...

In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments – and accuracy and completeness of all ICD-10-CM, CPT, and HCPCS codes assigned by professional revenue coders and providers. All assigned codes must be supported by professional documentation contained within the medical record and must be in compliance with federal coding compliance regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics re: coding accuracy rates, compliance rates, denial analytics, etc. Recommend education topics based on audit findings and assist in the continuing education of professional coders and providers. Understands coding/billing computer systems such as Cerner, MediTech,...

In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments and accuracy and completeness of all codes assigned by professional revenue coders and providers. All assigned codes must be supported by professional documentation contained within the medical record and must be in compliance with federal coding compliance regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics regarding coding accuracy rates, compliance rates, denial analytics, etc. The auditor recommends education topics based on audit findings and assists in the continuing education of professional coders and providers. They understand coding/billing computer systems such as Cerner, MediTech, Epic,...

Coding Compliance Auditor - Coding Services - Full Time 8 Hour Days (Non-Exempt) (Non-Union) Los Angeles, CA Job ID REQ20168803 Category Keck Medicine of USC Helpful Information for Applicants External Applicants Internal Applicants (Current USC Employees) In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments – and accuracy and completeness of all ICD-10-CM, CPT, and HCPCS codes assigned by professional revenue coders and providers. All assigned codes must be supported by professional documentation contained within the medical record and must be in compliance with federal coding compliance regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also, provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics Re:...

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

Summary Join the Indian Health Service and make a meaningful impact in Native communities. In this role, you will support vital healthcare operations that ensure patients receive timely, high-quality care. If you're looking for a rewarding career where your work directly supports patient services and community well-being, we encourage you to apply. Duties Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final diagnoses accurately reflect care provided. Reviews provider documentation to ensure appropriate Evaluation and Management (E/M) levels and correct CPT code assignment. Assigns and sequences ICD, CPT, HCPCS, CDT, and DSM codes based on documented diagnoses and procedures. Ensures diagnostic and procedural terminology aligns with current medical nomenclature and...

Summary Join the Indian Health Service and make a meaningful impact in Native communities. In this role, you will support vital healthcare operations that ensure patients receive timely, high-quality care. If you're looking for a rewarding career where your work directly supports patient services and community well-being, we encourage you to apply. Duties Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final diagnoses accurately reflect care provided. Reviews provider documentation to ensure appropriate Evaluation and Management (E/M) levels and correct CPT code assignment. Assigns and sequences ICD, CPT, HCPCS, CDT, and DSM codes based on documented diagnoses and procedures. Ensures diagnostic and procedural terminology aligns with current medical nomenclature and...

San Mateo County Health is seeking an experienced Medical Records Coder II/III to join Correctional Health and support the coding of CalAIM billable services, including clinic visits and ancillary services. This position plays an important role in ensuring accurate reimbursement while supporting continuity of care for justice‑involved individuals. The successful candidate will perform billing functions related to the Department of Health Care Services (DHCS) Justice‑Involved CalAIM Initiative. This initiative allows eligible incarcerated individuals to enroll in Medi‑Cal prior to their release and enables reimbursement for covered healthcare services provided during the 90 days before reentry, helping support successful transitions back into the community. This position requires independent proficiency in ICD‑10 and CPT coding, coding audits, physician education on coding practices, Evaluation and Management (E/M) coding, and identifying and resolving billing edits. This assignment...

Job Description Employment Duration: 3 months Department: Faculty Practice Revenue Management Operations (FPRMO) The Patient Record Abstractor fulfills a role as a Medical Coder for UCSF's physician practices. The position reviews patient records, discharge summaries, operative reports, and other clinical documentation to assign standardized codes for diagnoses, procedures, and services. The role applies national and international coding classifications to ensure records reflect the care delivered, supporting accurate reimbursement and reliable clinical data. It requires knowledge of Current Procedural Terminology (CPT), International Classification of Diseases, 10th Edition, Clinical Modification (ICD-10-CM), and Healthcare Common Procedure Coding System (HCPCS). The position operates within a healthcare records or billing team and requires close liaison with clinicians, clinical coders, and administrative staff to resolve documentation queries. The coder must maintain currency...

Stanford Health Care seeks a Billing and Coding Compliance Auditor to conduct proactive audits, review documentation for regulatory compliance, and collaborate across departments to mitigate risks. The role involves evaluating ICD, CPT, HCPCS codes and E/M criteria, with a focus on accuracy and reimbursement integrity. Requirements include an Associate’s degree and at least four years of related experience; professional coding certifications are preferred and must be obtained within 180 days. #J-18808-Ljbffr

Certified Coder ProfessionalReporting to the Manager Physician Coding Services, the Certified Coder Professional will be responsible for reviewing and evaluating clinical documentation within medical records to ensure high quality and compliant coding. The Certified Coder Professional will provide training, consultation, and feedback to clinicians on their documentation and coding to ensure Emanate Health Medical Group receives appropriate reimbursement and conforms to applicable guidelines and regulations. Collaborates with Emanate Health's Compliance team and with all third party billing and reimbursement requirements including, but not limited to, the requirements of Medicare and Medicaid programs. Serves as the coding subject matter expert for the physicians.Minimum Education Requirement:Associate degree preferred; college degree preferred, knowledge of Medical Terminology, Anatomy & Physiology and Computer experience.Minimum Experience Requirement:Minimum of 2+ years of...

Summary Join the Indian Health Service and make a meaningful impact in Native communities. In this role, you will support vital healthcare operations that ensure patients receive timely, high-quality care. If you're looking for a rewarding career where your work directly supports patient services and community well-being, we encourage you to apply. Duties Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final diagnoses accurately reflect care provided. Reviews provider documentation to ensure appropriate Evaluation and Management (E/M) levels and correct CPT code assignment. Assigns and sequences ICD, CPT, HCPCS, CDT, and DSM codes based on documented diagnoses and procedures. Ensures diagnostic and procedural terminology aligns with current medical nomenclature and...

Summary Join the Indian Health Service and make a meaningful impact in Native communities. In this role, you will support vital healthcare operations that ensure patients receive timely, high-quality care. If you're looking for a rewarding career where your work directly supports patient services and community well-being, we encourage you to apply. Duties Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final diagnoses accurately reflect care provided. Reviews provider documentation to ensure appropriate Evaluation and Management (E/M) levels and correct CPT code assignment. Assigns and sequences ICD, CPT, HCPCS, CDT, and DSM codes based on documented diagnoses and procedures. Ensures diagnostic and procedural terminology aligns with current medical nomenclature and...

Labela is seeking certified U.S. medical coders for high-level coding and documentation consulting. You will serve as a subject matter expert to validate, refine, and audit the coding logic and documentation reasoning of frontier AI models in a flexible, remote role. Key responsibilities include auditing ICD-10-CM/PCS, CPT, and HCPCS, providing ground truth for full chart abstractions, E/M level assignment, modifiers, and identifying compliance gaps. #J-18808-Ljbffr

Overview Join the Indian Health Service and make a meaningful impact in Native communities. In this role, you will support vital healthcare operations that ensure patients receive timely, high-quality care. If you’re looking for a rewarding career where your work directly supports patient services and community well‑being, we encourage you to apply. Real ID Requirement A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021). Responsibilities Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final diagnoses accurately reflect care provided. Reviews provider documentation to ensure appropriate Evaluation and Management (E/M) levels and correct CPT code assignment. Assigns and sequences ICD, CPT, HCPCS, CDT, and DSM codes based on documented...

EH Corporate Badillo St. - Covina Full time R0014354 Current Emanate Health Employees - Please log into your Workday account to apply Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as individuals. On Glassdoor's list of "Best Places to Work" in 2021, Emanate Health was named the #1 ranked health care system in the United States, and the #19 ranked company in the country. J ob Summary Reporting to the Manager Physician Coding Services, the Certified Coder Professional will be responsible for reviewing an evaluating clinical documentation within medical records to ensure high quality and compliant coding. The Certified Coder Professional will provide training, consultation, and feedback to clinicians on their documentation and coding to...

Job Description Align yourself with an organization that has a reputation for excellence! Cedars Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company’s Workplace of the Year. This annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We provide an outstanding benefit package that includes health care, paid time off and a 403(B). Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals. What you will be doing in this role: The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. In this role, the Coder II reviews ICD-10-CM diagnosis coding and Current Procedural Terminology (CPT)...

Job DescriptionJob DescriptionMUST ATTEND ORIENTATION IN PERSON IN ARCATA, CALIFORNIASUMMARY :The primary function of this position is to review ICD, CPT and HCPCS coding for data and reimbursement.The coding function is a primary source for data and information used in health care today, and promotes quality client care, captures accurate reporting numbers and optimizes reimbursement.The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.Other duties may be assigned.Level IPerforms comprehensive review of the health record, evaluates the record for documentation, consistency, accuracy and correlation of recorded data.Ensures the final diagnosis as stated by the provider is valid, complete and accurately reflects the care and treatment rendered.Consults with provider when conflicting or ambiguous documentation is...