28 inpatient coding auditor jobs found

Humana Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review hospital inpatient claims, assign ICD-10-CM/PCS and DRG codes, and ensure accurate reimbursements. The role supports cost reduction through precise coding, requires 4+ years in MSDRG auditing and RHIA/RHIT/CCS certification, and offers a remote-friendly schedule with potential travel for training. #J-18808-Ljbffr

Become a part of our caring community 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 increasing the accuracy of...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Location: This role enables associates to work virtually full-time, except for 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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 accommodation is granted as required by law. The Patient Safety 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...

Job Description The Patient Safety 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. The role generates highly complex audit findings recoverable claims for the benefit of the Company across all lines of business. The position focuses on very complex coding cases paid through various DRG methodologies such as APS-DRG, APR-DRG, AP-DRG, MS-DRG, or TRICARE, with findings that may be reviewed only by other DRG Coding Audit Principals or Executives. Responsibilities Analyzes and audits claims by integrating advanced medical chart coding principles found in Official Coding Guidelines, Coding Clinics, and the ICD-10 Alphabetic and Tabular Indices, as well as complex clinical guidelines, maintaining objectivity in audit activities. Draws on extremely advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate sophisticated...

The Elevance Health Companies, Inc. is seeking a Patient Safety DRG Coding Auditor Principal responsible for auditing inpatient medical records based on DRG methodology. This role is critical for generating complex audit findings and supporting claims recovery for various business lines. Candidates must have extensive experience in claims auditing and relevant certifications. The position is primarily independent, with responsibilities that include analyzing claims and suggesting process improvements. The company offers a competitive salary range of $116,128 to $210,864 and a robust benefits program. #J-18808-Ljbffr

Elevance Health is seeking a Patient Safety DRG Coding Auditor Principal to work remotely with some in-person training. The role involves auditing inpatient medical records, ensuring compliance with DRG methodologies, and identifying new claim types for recoveries. This position requires a minimum of 15 years in claims auditing and extensive expertise in ICD-9/10CM. Benefits include comprehensive packages and equity stock purchase options. #J-18808-Ljbffr

Location: This role enables associates to work virtually full-time, except for 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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 accommodation is granted as required by law. The Patient Safety 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...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

SUMMARY/OBJECTIVESThe Certified Medical Coder is responsible for the timely, accurate, and compliant review, abstraction, and coding of professional healthcare services provided by Edgewater Health clinicians. This position ensures that medical documentation supports the assignment of appropriate ICD-10-CM, CPT, and HCPCS Level II codes to facilitate accurate reimbursement while maintaining compliance with federal and state regulations, payer requirements, and organizational policies.The Certified Medical Coder works collaboratively with providers, clinical leadership, billing staff, and the Revenue Cycle Department to optimize documentation quality, improve coding accuracy, reduce claim denials, and maximize reimbursement. This position plays an integral role in supporting Edgewater Health's behavioral health, primary care, substance use treatment, and Federally Qualified Health Center (FQHC) billing operations.ESSENTIAL DUTIES AND RESPONSIBILITIESThe essential functions include,...

Job Description Job Description The PB Coder is responsible for reviewing, analyzing, and accurately coding ambulatory and/or hospital-based encounters. This role performs initial charge review for E/M visits, diagnostic tests, and procedures across multiple specialty departments to determine the appropriate assignment of CPT, ICD-10, HCPCS codes, and modifiers for reporting physician services to third-party payers. The PB Coder ensures all coding aligns with established coding standards, regulatory requirements, and reimbursement policies. Essential Duties and Responsibilities: Analyzes provider documentation to assure appropriate Evaluation & Management (E/M) levels are assigned using the correct CPT and current Evaluation and Management Guidelines Analyzes provider documentation to assure that appropriate CPT codes are assigned for surgeries and other diagnostic procedures. Ensures that all coding aligns with coding standards, regulatory requirements and other...

Radiology Medical Coder Radiology Medical Coder Job Description Client Profile - An Indiana based Independent Physician-Owned radiology practices founded in 1967. Job Summary - The Radiology Coder is responsible for coding and charge submission activities, including abstracting CPT Professional Fee Coding and inpatient/outpatient coding and billing. This involves reviewing medical records and assigning appropriate ICD, CPT, and HCPCS codes. Job Duties Review and analyze medical records ensuring the correct assignment of ICD-10, CPT and HCPCS codes. Accurately code diagnostics imaging, interventional radiology procedures and other radiological services Ensure that documentation supports the assigned codes and matches physician orders and radiology reports Abstract relevant data such as procedural dates, providers, and patient demographics for billing and reporting. Collaborate with radiologists and other medical professionals to clarify diagnoses and procedures when...

Perm - Remote - Hospital Inpatient Coder As a permanent, remote Hospital Inpatient Coder, you will be responsible for accurately coding inpatient medical records, ensuring compliance with coding guidelines, and collaborating with healthcare professionals to maintain data integrity, all while working from home. Essential Job Functions: Assign ICD10CM and PCS codes to hospital inpatient visits Reviews and analyzes the content of medical records and the autosuggested computer assisted codes (CAC) for the appropriate assignment of ICD diagnosis/procedure codes, present on admission indicators, hierarchical condition categories, complication and comorbidities in the proper sequence in accordance with official coding resources resulting in an accurate DRG assignment. Meets 95% accuracy rate in audits Maintains productivity of 2.75 charts per hour after release from training period. Data Analysis- Hospital Inpatient Coding Accurately reviews and codes patient records in the...

JOB RESPONSIBILITIES: Abstracts pertinent information from patient records for provider services. Reviews the International Classification of Diseases, Clinical Modification (ICD), Current Procedural Terminology (CPT), or Healthcare Common Procedure Coding System (HCPCS) codes, including modifiers, assigned by providers. Works with providers to correct any codes or charges when errors are identified. Reviews medical records for diagnoses that meet medical necessity according to the CMS Local Coverage Determination (LCD) and/or National Coverage Determination (NDC) guidelines. Reviews and interprets provider notes using CPT and ICD coding books and/or software. Ensures codes are accurate and sequenced correctly in accordance with government and insurance regulations. Works with providers to correct any identified errors. Conducts chart audits for provider documentation and recognizes when it is necessary to obtain further clarification from providers when documentation is...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We’re Looking For We’re looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to...

Overview Responsible for ensuring accuracy and quality coding assignments for all records requiring DRG and/or APC coding; ensures optimal and timely reimbursement. Responsibilities Principal Duties and Responsibilities (*Essential Functions) Performs comprehensive pre-billing coding audits, through the use of eValuator , to ensure claims are accurately coded and charged in compliance with coding and regulatory standards. Performs comprehensive pre-billing coding data quality reviews on inpatient and/or outpatient records to ensure proper coding guidelines have been followed and appropriate DRG (MS/APR) or APC assignments have been made for appropriate reimbursement. Responsible for completion of reviews within 72 hrs of import date to include new reviews of up to or exceeding 12 to 15 per day for inpatients and/or completion of reviews within 48 hrs of import date including up to or exceeding 50 per day for outpatient accounts. Maintains an audit response...

Coder – Clinic Location: St. John Outpatient Center, St. John, IN 46373; Remote availability Job Summary: Under general supervision and according to industry standards, identifies and assigns diagnostic and procedure codes for distinct patient encounters from source documentation using current ICD and CPT recommendations. Performs charge entry, review, reconciliation, and error correction tasks to ensure full and accurate charge capture. Performs regular manual and electronic charge and coding audits. Possesses a thorough knowledge of the coding process, coding resource material, coding rules and guidelines and applicable classification systems. Education/ Experience Requirements: • High School graduate (or GED equivalent) required. • Completion of college course work in health information degree or certificate program preferred. • 1-2 years professional billing/coding experience. Physician practice setting preferred. Previous use of EPIC preferred. •...

The Professional Coder provides timely and accurate clinical coding and abstraction of inpatient and outpatient services as appropriate to facilitate compliant and optimized reimbursement, research, and PI initiatives. The Professional Coder is responsible for the coding, abstraction, and charge entry (as applicable) of one or more of the following: professional and facility services which may include evaluation and management services, ancillary/diagnostic services, and behavioral health services. Essential Functions and Responsibilities Proactively contributes to Eskenazi Health’s mission: Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County; models Eskenazi Health’s values Coding and Abstracting: Identifies and assigns the appropriate diagnosis, procedure, and evaluation and management (E&M) codes in accordance with coding guidelines and departmental standards; audits notes from providers to ensure the provider is coding in a...

Powers Health Medical Group – HIM – Physician Coding Full-time , Days , 7:30am-4:00pm Hours/Pay Period: 80 FTE: 1 Position Coder – Clinic Job Summary Under general supervision and according to industry standards, identifies and assigns diagnostic and procedure codes for distinct patient encounters from source documentation using current ICD and CPT recommendations. Performs charge entry, review, reconciliation, and error correction tasks to ensure full and accurate charge capture. Performs regular manual and electronic charge and coding audits. Possesses a thorough knowledge of the coding process, coding resource material, coding rules and guidelines and applicable classification systems. Education/ Experience Requirements High School graduate (or GED equivalent) required. Completion of college coursework in health information degree or certificate program preferred. 1-2 years professional billing/coding experience. Physician practice setting preferred. Previous use of...

Ascension in Indianapolis, IN is seeking a healthcare coding specialist to translate patient charts into precise codes for claims and documentation. This full-time daytime role collaborates with providers to ensure accurate coding and compliant documentation. Responsibilities include chart audits, supporting coding accuracy, and maintaining productivity benchmarks while adhering to industry guidelines and reimbursement requirements. #J-18808-Ljbffr

Your future role at a glance Location: Indianapolis, IN Facility: Ascension Medical Group Department: Physician Support Services Schedule: Full-time | Days | Monday-Friday 7am-3:30pm Salary Range: $24.87 - $33.64 Life at Ascension: Where purpose meets opportunity Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 97,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you’ll find an inclusive and supportive environment where your contributions truly matter. Benefits that help you thrive Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options Financial security & retirement: employer‑matched 403(b), planning and hardship resources, disability and life insurance Time to...

Description Scope of Tasks & Responsibilities Analyze patient charts carefully to know the diagnosis and represent every item with specific codes. Collect health information as documented by medial provides and code appropriately. Consult with providers for further classification of items on patient charts to avoid misinterpretations. Maintain certification by staying up to date on new coding rules and regulations. Conduct audits of patient charts to verify appropriate coding was applied and review with physicians for training purposes. Review of patient medical charts to identify proper coding for denied claims. Collect and distribute coding related information and billing issues. Handle claims denial follow-up. Perform billing functions as it pertains to coding. Assist Clinic staff with patient coding and related procedures Collaborate with supervisor to increase revenue and system efficiency Communicate all outstanding billing required from Providers on a timely...

Raphael Health Center Inc in Indianapolis, Indiana is seeking a skilled medical coder with a strong background in medical terminology and claims processing. Responsibilities include analyzing patient charts for proper coding, conducting audits, and following up on claims denials. The ideal candidate will hold a CPC or HCPCS Certification and possess solid understanding of managed care, Medicaid, and Medicare billing cycles. Proficiency with MS Office and strong customer service skills are essential for this role. #J-18808-Ljbffr

Job Details Job Location: Valparaiso, IN 46383 Purpose Reporting to the Billing Team Supervisor, the professional coder is responsible for reviewing clinical documentation to abstract and/or validate CPT and ICD-10 coding for office based and outpatient professional services. Accountabilities and Job Activities Ensure that medical coders are trained, knowledgeable and consistently adhering to key responsibilities relevant to job description Train new employees Perform ongoing training and education as needed Conduct audits to ensure the accuracy of the coding team and re‑train and/or initiate coaching if necessary Monitor daily workload to ensure that claims are created in a timely manner Ensure that professional and facility service claims are created on a daily basis without interruption Responsible for alerting proper parties if any interruptions are discovered Analyze office progress notes, procedural and operative records to identify and independently assign accurate ICD and...