21 inpatient coding auditor jobs found

A leading health insurance company is seeking an Inpatient Medical Coding Auditor to work remotely. This role involves reviewing inpatient hospital claims and ensuring accurate coding and reimbursement. Candidates should hold an RHIA, RHIT, or CCS certification with substantial experience in coding audits. Strong attention to detail, excellent communication skills, and the ability to manage multiple priorities are essential. The job offers competitive compensation and various benefits to support overall well-being. #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. 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...

Are you an experienced Medical Coder seeking a career growth? Are you a Certified Auditor interested in a new work opportunity? If so, then we want to connect with you! MAHEC is now accepting candidates for Medical Auditor. This integral role supports MAHEC's mission of educating the next generation of healthcare professionals by completing internal quality assessment reviews on Care Provider coding and effectively builds relationships with MAHEC Care Providers to educate and foster complete, accurate, timely, and consistent coding. The Auditor/Provider Educator is responsible for documentation to ensure compliance with national coding guidelines and MAHEC policies. We welcome experienced Medical Coders interested in becoming a Certified Professional Medical Auditor, and MAHEC offers an employer-sponsored pathway to CPMA certification if hired for the position! This is a hybrid work opportunity, with roughly 50-60% onsite work to support in-person collaboration and...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

Coding Auditor - Drg/Apc Coordinator Be a part of a world-class academic healthcare system at UChicago Medicine as a Coding Auditor - DRG/APC Coordinator for the Health Information Management department. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area. In this role, the Coding Auditor - DRG/APC Coordinator is responsible for ensuring accuracy and quality of coding assignments for all records requiring DRG and/or APC coding, and ensures optimal and timely reimbursement. Essential Job Functions Performs data quality reviews on inpatient and outpatient records to ensure proper coding guidelines have been followed and appropriate DRG or APC assignments have been made for appropriate reimbursement Provides DRG/APC and coding quality information and statistical reports to the Coding Manager Communicates with the Medical Staff and House staff as needed to discuss clinical questions with respect to the assignment of...

Job Description Job Description Description: Full Time, Remote Exempt / Salary Organization High Country Community Health (HCCH) is a federally funded Community and Migrant Health Center with medical locations in Watauga, Avery, Burke, and Surry Counties. The mission of HCCH is to provide comprehensive and culturally sensitive primary health care services that may include dental, mental and substance abuse services to the medically under-served population of Watauga, Avery, Burke, and Surry Counties and the surrounding rural communities. Supervisory Relationship: Reports to: Deputy CFO Job Summary and Responsibilities Provides thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and patient complexity of care. Utilizes knowledge of official coding guidelines, HCC standards, Risk Adjustment Factor (RAF)...

Why Join First Choice Community Health Centers Nestled in the heart of North Carolina, Harnett County offers a unique blend of small-town charm and convenient access to big-city amenities. Located less than an hour from both Raleigh and Fayetteville, residents enjoy the tranquility of rural living with the benefit of nearby urban excitement. At First Choice, we’re proud to offer employment opportunities in this beautiful area, giving you the chance to work in a close-knit community while staying connected to the vibrant Triangle region. With a perfect balance of peaceful + affordable living and easy access to cultural and career opportunities, Harnett County is an ideal place to call home. Position Summary The Medical Billing Specialist will be responsible for billing and collections for Medicare, Medicaid, Insurance, and Self Pay patients for all Medical and Dental clinics. Responsibilities of individual Billing Specialist will vary depending on assignment of responsibilities...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Compliance Auditor 5119 - G1 Occupational Summary Conduct health-system wide compliance audits to ensure data integrity, compliance with federal and state regulations pertaining to but not limited to: federal healthcare program requirements, clinical trials billing, privacy, conflict of interest, and anti-kickback and physician relationships. Exercise independent decisions using analytical and problem solving skills. Provides critical analytical and support with respect to third party payer external audits (i.e. RAC, ADR/TPE, UPIC, etc.). Work Performed Interpretation of applicable federal and state law and regulations to plan audit parameters, determine department's compliance with such regulations and communicate to department...

Medical Records Coder II At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. Occ Summary The Medical Records Coder II is a certified coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-10-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures, and appropriate/optimal reimbursement for hospital and/or professional...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

Certified Professional Coder, Independent Contractor Constellation Quality Health is a non‑profit health care quality consultancy and QIO‑like Entity certified by Centers for Medicare and Medicaid Services (CMS) founded by physicians in 1983. Headquartered in North Carolina’s Research Triangle, we offer an array of quality improvement, clinical review, audit, technical, and consulting services and solutions to improve care delivery, system performance, and patient outcomes. What You’ll Do The Certified Professional Coder (CPC) is responsible for reviewing and comparing provider service documentation to billed claims in order to determine compliance with clinical policies, state and federal regulations. Perform reviews in a manner consistent with contract requirements for timeliness and accuracy. Our requirement for this role: Associate or bachelor’s degree required in a human services field or five (5) years of related experience may substitute for degree. Certified...

Job Description Job Description SUMMARY:  Responsible for billing team leadership, subject matter expertise and performing a variety of regular tasks to ensure timely and comprehensive billing and collections for Medical and Dental services rendered by First Choice Community Health Center (FCCHC) providers. Supervises billing specialists to ensure all tasks are completed timely and accurately. The Revenue Cycle Manager is expected to devote 50% of work time to learn leadership and subject matter expert responsibilities.  The Revenue Cycle Manager should proactively seek to further develop billing process competencies; and assist in implementation of process improvements.  ESSENTIAL DUTIES AND RESPONSIBILITIES Team Leadership Supervise and coordinate the workload of the billing staff to ensure all task are completed accurately and in a timely manner. Define and communicate current and new billing tasks and definitions of the billing team. Recommend and report billing...

Firsthealth Of The Carolinas FirstHealth of the Carolinas is a nationally recognized health care system located in central North Carolina. Comprised of four hospitals with more than 600 beds, the system also offers leading-edge heart care in the Reid Heart Center, the area's only dedicated heart and vascular center. Our growing health system has more than 6,200 employees serving in more than 75 locations throughout a 15-county service area. In addition, FirstHealth has received numerous accolades for its patient care and outcomes, including recognitions from Healthgrades, U.S. News & World Report, and Becker's Healthcare. At FirstHealth of the Carolinas, we believe in supporting our employees' professional growth and personal well-being. That is why we offer a comprehensive benefit package that is designed to help you thrive. Enjoy a free gym-membership to one of our 7 FirstHealth Fitness Centers to stay active and prioritize your health, take advantage of our educational...

# **$20,000 BONUS, PLUS RELOCATION ASSISTANCE!!****Facility**CFV Medical Group**Location**Fayetteville, North Carolina**Department**Medical Group - Clinical Administration**Job Family**Clerical, Professional**Work Shift**Days (United States of America)**Summary**Facilitate the educational development and professional growth of assigned nursing personnel. Responsibilities include development and implementation of orientation, in-service and continuing education for all nursing unit staff, including agency, which focuses upon the scope of service, emphasizing the age, psychosocial and physical needs of the patient population.# **Major Job Functions**The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time:* Provide classroom and clinical instruction for orientation for all unit nursing staff, nurse residencies and...

Select how often (in days) to receive an alert: Work Arrangement: Hybrid (On‑Site and Remote mix) Requisition Number: 263058 Regular or Temporary: Regular Location: Durham, NC, US, 27710 At Duke Health, we’re driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Compliance Auditor 5119 - G1 Occupational Summary Conduct health‑system wide compliance audits to ensure data integrity and compliance with federal and state regulations pertaining to, but not limited to: federal healthcare program requirements, clinical trials billing, privacy, conflict of interest, anti‑kickback and physician relationships. Exercise independent decisions using analytical and problem‑solving skills. Provides critical analytical and support with respect to third‑party payer external audits (i.e. RAC, ADR/TPE, UPIC, etc.). Work Performed...

Overview Job Description - IP Coder/Abstractor (7463-2997) IP Coder/Abstractor - 7463-2997 Responsibilities The Inpatient Coder/Abstractor will code all inpatient medical records, and assist with outpatient medical record coding on an as needed basis, at Harris Regional and Swain Community Hospitals. Responsibilities include the accurate coding and abstracting of inpatient records in accordance with established guidelines. Review and abstract the patient record to accurately assign diagnostic and procedural codes. Follow up with provider or Clinical Documentation Improvement (CDI) team as needed. Perform physician queries as necessary to insure accurate coding. Perform charge capture duties for injections and blood administration. Perform chart/coding data audits. Qualifications A. EDUCATION: Current RHIA, RHIT, and/or CCS required. Other coding certifications from accredited schools will be considered on a case by case basis B. EXPERIENCE: Minimum of 2 years ICD-9-CM...

About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. Occ Summary The Medical Records Coder II is a certified coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-10-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures, and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract information from medical records following established methods and procedures. Work Performed Review the complex (problematic coding that needs research and reference checking) medical...

Job Title Medical Records Coder II at Duke University Health System About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. Overview The Medical Records Coder II is a certified Coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-10-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract information from medical records following established methods and procedures. Responsibilities Review complex medical...

Certified Professional Coder, Independent Contractor Join to apply for the Certified Professional Coder, Independent Contractor role at Constellation Quality Health Constellation Quality Health is a non‑profit health care quality consultancy headquartered in the North Carolina Research Triangle. We offer a range of quality improvement, clinical review, audit, technical and consulting services to improve care delivery, system performance and patient outcomes. What You’ll Do Perform coding reviews in a manner consistent with contract requirements for timeliness and accuracy. Review and compare provider service documentation to billed claims to determine compliance with clinical policies and state and federal regulations. Qualifications Associate or bachelor’s degree in a human services field or five (5) years of related experience may substitute for degree. Certified Professional Coder (CPC) certification with at least two (2) years’ experience in DRG coding in an inpatient...

At Duke Health, we’re driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. ABOUT DUKE HEALTH'S PATIENT REVENUE MANAGEMENT ORGANIZATION Patient Revenue Management Organization is Duke Health’s fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. OCC SUMMARY The Medical Records Coder II is a certified coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD‑10‑CM and CPT‑4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract...

Overview At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. OCC Summary The Medical Records Coder II is a certified Coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-10-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures and appropriate/optimal...