16 hcc auditor coder jobs found

Job Description Job Description Education and/or Experience :   Must have these requirements under the umbrella of the HCC industry: Requires knowledge in HCC Coding documentation guidelines. Requires technical expertise in ICD-9-CM or ICD-10-CM. Strong skills in medical record audit and review. Regulatory requirements for coded data. Medical record documentation requirements. Understanding of healthcare data systems. Proficiency in MS Outlook and Word. Strong proficiency with Excel--must have ability to prepare spreadsheets. Excellent written and verbal communication skills. Certification is a plus with HCC. AHA coding clinic is a plus. Certification required in CPC and/or CCS, and CRC is a plus. Hybrid Schedule Requirements Part A Monday - Wednesday onsite / Thursday - Friday Remote Part B Wednesday - Friday Onsite / Monday - Tuesday Remote   We are looking for HCC Risk Adjustment Auditors/Coders to join our team!   Position...

. Remote Coding Auditor - Risk Adjustment Are you a risk adjustment coder that is wanting to expand into an auditing role?Do you have 3 years or more of risk adjustment coding experience? Perks: Flexible, full time schedule Stable and ongoing consulting position $30-40 an hour! Equipment provided World-class training and technology Job Description The Risk Adjustment Coding Auditor will be responsible for conducting documentation reviews to assess the accuracy, completeness, and highest ICD-10 specificity related to risk adjustment and HCC coding guidelines, and assist educating in medical necessity coverage of diagnostic studies.Responsible for performing quality review audits of medical records coded by Risk Adjustment coding team to ensure the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance...

Job Description Job Description Job Title: Medical Biller I, II, III Department: Patient Accounting Reports To: Business Office Manager FLSA Status: Non-Exempt Wage Range that the Company Expects to Pay: Medical Biller I: $25.00 - $27.56 per hour Medical Biller II: $27.00 - $29.77 per hour Medical Biller III: $30.00 - $33.08 per hour SUMMARY Under the direct supervision of the Director of Business Office, the Medical Biller is responsible for utilizing both practice management systems; Athena and NextGen. The employee is responsible for preparing and posting fee tickets for various sites and programs. The Medical Biller will post and balance payments received, handle all incoming billing calls, and work aging for various programs and payers. The employee will send patient statements, run month end reports, and submit third party claims electronically and/or manually. The employee will ensure that all providers and facilities are paneled with the various...

Physician Coding Compliance Auditor Align 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. We provide an outstanding benefit package that includes paid vacation, wellness initiatives and a 403(b). Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals. What you be doing in this role: The Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges to ensure compliance with applicable documentation, coding, and billing requirements. Works closely with providers and staff to educate and train or provide audit results feedback through the use of Teams or other remote meeting platforms. The Physician Compliance Auditor identifies issues and/or risks...

Job Description Job Description Description We are currently seeking a highly motivated Risk Adjustment Coding Specialist. This role will report to a Sr. Manager - Risk Adjustment and enable us to continue to scale in the healthcare industry. * Requires travel to provider sites in San Gabriel Valley Area *May be open to considering Level I Specialists based on experience and skills Our Values:  Put Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team What You'll Do Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company Review medical record information on both a retroactive and prospective basis...

Job Description Job Description South Los Angeles based FQHC looking for onsite Certified HCC coder . *This is not a remote position Conduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare Risk Adjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding. Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records audit HEDIS coding and record collection...

Job DescriptionJob DescriptionSouth Los Angeles based FQHC looking for onsite Certified HCC coder . This is not a remote positionConduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare RiskAdjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding.Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records auditHEDIS coding and record collectionReport Coding...

Job Description Job Description Benefits: 401(k) 401(k) matching Company parties Dental insurance Health insurance Opportunity for advancement Paid time off Training & development Vision insurance Position Overview The ICD-10 Home Health & Hospice Medical Coder is responsible for accurately reviewing, analyzing, and assigning ICD-10-CM diagnosis codes to clinical documentation for home health and hospice services. This role ensures compliance with CMS guidelines, OASIS requirements, and agency policies to support precise reimbursement, high-quality patient care, and regulatory compliance. The ideal candidate has demonstrated experience in Home Health ICD-10 coding , strong knowledge of OASIS/Evaluation criteria, and a thorough understanding of PDGM (Patient-Driven Groupings Model). Key Responsibilities Coding & Documentation Review Review clinical documentation to identify appropriate and accurate ICD-10-CM codes for home health and hospice...

Job Description Align 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. We provide an outstanding benefit package that includes paid vacation, wellness initiatives and a 403(b). Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals. What you be doing in this role: The Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges to ensure compliance with applicable documentation, coding, and billing requirements. Works closely with providers and staff to educate and train or provide audit results feedback through the use of Teams or other remote meeting platforms. The Physician Compliance Auditor identifies issues and/or risks associated with...

Coding Specialist In accordance with federal coding compliance regulations and guidelines, use current ICD-10-CM, CPT-4, and HCPCS code sets/systems to accurately abstract, code, and electronically record into the 3M Coding & Reimburse System (3M-CRS) & the coding abstracting system (3M-ClinTrac), all diagnoses and minor invasive and non-invasive procedures, documented by any physician in outpatient medical records (i.e. OP Ancillary visits: Laboratory, Radiology etc.; Clinic Visits; Radiation Oncology; Recurring Visits, etc.). Address OCE/NCCI edits within 3M-CRS and those returned from the Business Office. Understands PFS coding/billing processes & systems such as PBAR and nThrive/MedAssets/XClaim in a manner to assure claims drop timely with appropriate codes. Performs other coding department related duties as assigned by HIM management staff. Essential Duties: Outpatient Ancillary/Clinic Visit/Emergency Department coding of all diagnostic and procedural...

Job Description Job Description Position Purpose: The Certified Medical Coder plays a crucial role in the Billing Department by ensuring precise and compliant coding of medical services. Under the guidance of the Billing Department Supervisor, the Coder will assign appropriate diagnosis and procedural codes for services provided by JWCH physicians, adhering to industry standards and legal requirements. This position involves validating and auditing coding practices to guarantee accuracy in billing, supporting optimal reimbursement, and maintaining adherence to regulatory guidelines. Duties and Responsibilities: Serve as the primary liaison between providers and the Billing Department, effectively communicating to clarify diagnoses, procedures, coding, and documentation requirements. Recommend appropriate ICD-10-CM, CDT diagnosis codes, CPT codes, and HCPCS codes. Regularly review diagnosis and procedure coding within NextGen to ensure optimal billing accuracy....

Vista Community Clinic (VCC) At Vista Community Clinic (VCC), we believe healthcare is more than medicine, it's about hope, community, and impact. For over 50 years, we've been a leader in the community clinic movement, growing from a small volunteer-driven effort in Vista to a nationally recognized network of state-of-the-art clinics across San Diego, Orange, Los Angeles, and Riverside counties. Today VCC has 14 clinics serving over 70,000 patients annually, we continue our mission of delivering exceptional, patient-centered care where it's needed most. As a private, non-profit, multi-specialty outpatient clinic, VCC provides more than healthcare, we provide opportunity. Here your skills are celebrated, your growth is supported and your work makes a difference. We know that our success is a direct result of the exceptional talents and dedication of our employees. Benefits include: Competitive compensation & benefits Medical, dental, vision Company-paid life insurance...

Compliance Coding Auditor page is loaded## Compliance Coding Auditorlocations: System Services-Telecommutertime type: Full timeposted on: Posted 30+ Days Agojob requisition id: JR180837**Hours****:****Shift Start Time:**Variable**Shift End Time:**Variable**AWS Hours Requirement:**8/40 - 8 Hour Shift**Additional Shift Information:****Weekend Requirements:**No Weekends**On-Call Required:**No**Hourly Pay Range (Minimum - Midpoint - Maximum):**$49.700 - $64.130 - $71.820The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. \*This is a remote position\***What You Will Do** The Compliance Coding Auditor is responsible for the...

Overview Marin Community Clinics, founded in 1972, is today, a multi-clinic network with a wide array of integrated primary care, dental, behavioral, specialty and referral services. As a Federally Qualified Health Center (FQHC), we provide vital health services to almost 40,000 individuals annually in Marin County. The Clinics regularly receive national awards from the Health Resources and Services Administrations (HRSA). Our Mission is to promote health and wellness through excellent, compassionate care for all. The Compliance Auditor supports Marin Community Clinics’ compliance, risk management, and quality programs by performing independent audits, monitoring activities, and data validation to ensure adherence to federal and state regulations. This includes HRSA Health Center Program requirements, FTCA, CMS billing and documentation rules, Medi-Cal, TJC standards, HIPAA/HITECH, 42 CFR Part 2, California health laws, and internal policies. The role works closely with...

Description San Mateo County Health is seeking experienced individuals for the position of Medical Records Coder II for Correctional Health to provide coding for CalAIM billable services including ancillary services and clinic visits. Medical Records Coder II is the journey level class of this series, fully competent to independently code ICD‑10 and CPT procedural coding, perform coding audits, provide physician education on coding issues or EM levels, and analyze and resolve billing edits. 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 and receive reimbursement for health care services provided within the 90 days prior to their release, supporting their successful reentry into the community. The vacant position for coding will focus on professional fee (pro‑fee) coding. Majority of work will be...