889 hospital coding auditor jobs found

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The LPS (Learning & Performance Solutions) QA Inpatient Coding Auditor will provide expert coding audit services across various acute hospital organizations for inpatient services. Review medical record documentation and related coding of inpatient encounters utilizing the ICD-10-CM/PCS classification and CMS MS-DRG system. Verify coding accuracy and that coders base code assignment in a manner consistent with relevant laws, regulations, official coding guidelines and industry standards. This...

LPS (Learning & Performance Solutions) QA Inpatient Coding Auditor Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The LPS (Learning & Performance Solutions) QA Inpatient Coding Auditor will provide expert coding audit services across various acute hospital organizations for inpatient services. Review medical record documentation and related coding of inpatient encounters utilizing the ICD-10-CM/PCS classification and CMS MS-DRG system. Verify coding accuracy and that coders base code assignment in a manner consistent with relevant laws,...

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The LPS (Learning & Performance Solutions) QA Inpatient Coding Auditor will provide expert coding audit services across various acute hospital organizations for inpatient services. Review medical record documentation and related coding of inpatient encounters utilizing the ICD-10-CM/PCS classification and CMS MS-DRG system. Verify coding accuracy and that coders base code assignment in a manner consistent with relevant laws, regulations, official coding guidelines and industry standards. This individual...

Responsibilities Evaluates coding based on Coding Guidelines. Reviews records for all care settings. Identifies high volume, high risk coding, and reimbursement and quality problems. Responsible for accurate assessment, analysis and summary of findings for coding validation. Provide auditing and feedback that is incorporated into training education programs. **This position offers a fully remote work opportunity. Employees in this role must reside in one of the following states to be considered for fully remote positions: Kentucky, Indiana, Missouri, Ohio, Tennessee, Alabama, Virginia, Mississippi, North Carolina, South Carolina** Qualifications Required: One year coding in healthcare setting One of: CCA or CCS or CPC Desired: Diploma Certified Coding Associate OR Certified Coding Specialist OR Certified Professional Coder

Summary: Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. 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. Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts...

Be Part of an Extraordinary Team 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. Build the Possibilities. Make an Extraordinary Impact. Title : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **Virtual: ** _ _ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates...

Position Summary The Revenue Cycle Auditor - Credentialed Coder is responsible for end to end auditing of professional and facility claims to ensure accurate, complete, and compliant coding and billing. This role partners closely with revenue cycle leadership, coding teams, and clinical providers to identify root causes of denials, drive best practices in claims resolution, and deliver targeted education that improves documentation quality and reimbursement accuracy. The ideal candidate brings deep working knowledge of ICD 10 CM/PCS, CPT®, and HCPCS Level II, along with hands on experience using NCCI/CCI edits, MUEs, and payer policies across inpatient, outpatient, and professional settings. Key Responsibilities Audit & Compliance • Perform prospective and retrospective audits of medical records and associated charges to validate code selection, modifiers, medical necessity, and documentation sufficiency across inpatient, outpatient, ED, and professional services. •...

About the Job Position Highlights: Compliance Auditors conduct Compliance Department audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including detection and correction of documentation, coding, and billing errors. The Compliance Auditor evaluates the adequacy and effectiveness of controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to professional or hospital documentation, coding and billing, and federal and state regulations and guidelines. The Compliance Auditor communicates audit results to physicians, physician leadership, senior management, management, and staff and provides physician and coder education. The Compliance Auditor will act as a liaison with assigned faculty members, developing relationships and functioning as a resource to all providers and their staffs and will serve as an...

GENESIS HEALTHCARE SYSTEM In order to fill our Mission of serving our community by helping each person achieve optimal health and well-being by providing compassionate, exceptional, and affordable healthcare services, all employees of Genesis HealthCare System must be committed to living the Genesis Mission and Genesis values of Compassion, Excellence, Integrity, Team, and Innovation. All employees must regard themselves as an 'owner' of Genesis and keep our patients at the center of everything we do - always. Position Details: Work Shift: Varied Shift (United States of America) Scheduled Weekly Hours: 40 Department: Physician Coding Overview of Position: Works day-to-day on assigned charge review WQ's to review Physicians, Nurse Practitioners and Physician Assistants documentation thoroughly, assigns the appropriate Evaluation and Management code, CPT procedure codes, HCPCS procedure codes, modifiers, and ICD-10 diagnosis code(s) to ensure optimal, correct,...

Summary: Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. 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. Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts...

Be Part of an Extraordinary Team 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. Build the Possibilities. Make an Extraordinary Impact. Title : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **Virtual: ** _ _ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates...

JOB SUMMARY: This position is responsible for reviewing a patient's medical records after a Clinic visit and translating the information into codes that insurers use to process claims for patients. Duties include confirming treatments with medical staff, identifying missing information, and submitting information to insurers for reimbursement. RESPONSIBILITIES (ESSENTIAL FUNCTIONS): Accurately assigns and sequences codes (ICD-10-CM, CPT, HCPCS/modifiers as necessary) for each patient encounter, following proper coding guidelines and legal requirements to ensure compliance with federal and state regulations. Ensures professional/physician billing CPT codes/ICD-10 codes are assigned correctly and sequenced appropriately as per government and insurance regulations. Queries providers or other Clinic team members when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Assigns and enters...

Job Summary and Responsibilities You have a purpose, unique talents and now is the time to embrace it, live it and put it to work. We value incredible people with incredible skills - but your commitment to a greater cause is something we value even more. This is the heartbeat of our organization and your time will be spent in a supportive, team environment with resources to help you flourish and leaders who care about your success. The Coding Auditor-Educator is an advanced level position utilizing ICD-10-CM, ICD-10 PCS, and CPT-4 Coding Classification systems who supports the facility and Coding Service Center. Responsible for answering coding and billing questions, onboarding and training new staff, performing coding audits, and development and deployment of coding education. Works in conjunction with the Coding Service Center leadership team in planning and performing coding education and training across the system. Responsible for performing internal audits and follow up...

Coding Auditor & Educator Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 138 hospital-based locations, in addition to its home-based services and virtual care offerings. The Coding Auditor-Educator is an advanced level position utilizing ICD-10-CM, ICD-10 PCS, and CPT-4 Coding Classification systems who supports the facility and Coding Service Center. Responsible for answering coding and billing questions, onboarding and training new staff, performing coding audits, and development and deployment of coding education. Works in conjunction with the Coding Service Center leadership team in planning and performing coding education and training across the system....

Be Part of an Extraordinary Team 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. Build the Possibilities. Make an Extraordinary Impact. Title : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **Virtual: ** _ _ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates...

Mountain View Hospital is looking for a Medical Coding Auditor to join our team! JOB SUMMARY: Medical Record Auditor will be responsible for assisting/ conducting audits of medical records, coding and billing information. The auditor will look at both departments inside the hospital, outside departments and physician records and billing. Auditors will put together informational reports of finding and relay the information to the appropriate source. Reporting will be generated to help track which providers, locations or target areas need to be audited. The medical auditor will assist in putting together appeals/ rebuttals for external auditing sources. Auditor should have audits completed within a timely manner that is set up with the supervisor/ manager. Auditor will be provided as education as directed by the Auditing Integrity Department manager. Works collaboratively with the unit-specific educators, department manager, department supervisor, the DON and the compliance...

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...

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...

Job Description Position Summary The coding auditor is responsible for ensuring the integrity of inpatient and/or outpatient medical records by auditing them to confirm that clinical documentation accurately supports the diagnosis, CPT and/or DRG assigned. This position requires a detailed understanding of medical coding principles, coding guidelines, coding clinics, CPT Assistant and the ability to perform objective medical audits. The auditor will conduct audits drawing on advanced ICD-10 and CPT coding expertise, and coding guidelines to substantiate their recommendations. In this role, the auditor will review accounts flagged by Streamline, eValuator and provide recommendations if determined necessary. The auditor will also be responsible for identifying potential trends and educational opportunities. The coding auditor will also conduct focus reviews as determined by the coding manager. The auditor must be task oriented and have strong ability to work independently...

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...

A leading healthcare organization seeks an Inpatient Medical Coding Auditor to work remotely. The role involves reviewing inpatient hospital claims for correct reimbursement and managing provider disputes. Candidates should have RHIA, RHIT or CCS Certification and MS-DRG coding experience. The position offers bonuses and competitive benefits including medical and retirement plans. Exceptional communication skills and attention to detail are essential. You will contribute to cost reduction by ensuring accurate payments in the healthcare system. #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. Where you Come In 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...

Inpatient Medical Coding Auditor 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 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...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...