120 inpatient coding auditor virtual jobs found

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...

Seeking a New York Licensed RN Coding Auditor, the full-time remote position will validate acute inpatient coded charts, ensuring diagnostic information aligns with medical record documentation, while leveraging clinical expertise to identify DRG code assignments. Key responsibilities Conduct comprehensive reviews of CDI suggested code changes and perform coding audits for optimization Audit Medicare and non-Medicare charts to ensure compliance with federal and state regulations Communicate DRG changes and rationale to coding and CDI staff, identifying necessary coding adjustments Required qualifications Graduate from an accredited School of Nursing Bachelor's Degree in Nursing or equivalent combination of education and experience Current License to practice as a Registered Professional Nurse in New York State Specialized certifications such as HCS-D and COS-C are required Prior CHHA Nursing experience is strongly preferred

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Working remotely on a full-time basis, the Certified Inpatient Coding Auditor will perform inpatient coding audits and review services for client sites, identify trends, and provide educational support to clients. Key responsibilities Conduct coding audits and review services on various inpatient facility record types Identify trends from audit findings and recommend corrective action plans Provide in-service education and assist in developing educational seminars for clients and staff Required qualifications RHIA, RHIT, or CCS certification 2-5 years of experience in performing inpatient facility audits and coding Strong initiative for research to maintain knowledge and skills Ability to remain impartial and objective in audit findings Proficient in using audit software and secure file transfer in compliance with HIPAA policies

Coding Compliance Auditor Conducts coding compliance audits of inpatient and outpatient encounters to validate code assignment. Follows the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. Job Requirements Minimum Education Associates degree in relevant field preferred or combination of equivalent of education and experience Minimum Work Experience Five (5) years coding experience including; but not limited to; hospital inpatient and outpatient encounters Required Licenses/Certifications AHIMA and/or AAPC Coding Credential; CCS preferred Required Skills; Knowledge; and Abilities Ability to consistently and accurately audit coding of inpatient and outpatient encounters Ability to create clear and concise audit reports and maintain productivity standards Must successfully pass pre-hire coding assessment Knowledge of medical...

Seeking a full-time New York Licensed RN Coding Auditor with HCS-D and COS-C certifications to validate inpatient coded charts and ensure compliance with coding guidelines in a remote capacity. Key responsibilities Leverages clinical expertise to identify and validate DRG code assignments and performs coding audits for optimization Conducts comprehensive reviews of Medicare and non-Medicare charts to maintain compliance with Federal and State regulations Communicates coding changes and rationale to coding and CDI staff, ensuring accurate documentation practices Required qualifications Graduate from an accredited School of Nursing Bachelor's Degree in Nursing or equivalent combination of education and related experience Current License to practice as a Registered Professional Nurse in New York State Specialized certifications in HCS-D and COS-C required Prior CHHA Nursing experience strongly preferred

Job Description Job Description Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc.   Job Responsibilities/Duties: · Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or...

To ensure compliance and quality in coding practices, the full-time remote Missouri Licensed Coding Auditor will conduct second-level coding audits, provide real-time education, and develop training materials to support the Coding Department's quality assurance activities. Key responsibilities Serves as a subject matter expert and participates in committees to resolve issues and improve processes Completes quality assurance coding audits in accordance with federal and state guidelines, providing actionable recommendations Develops and delivers coding education and training plans to enhance compliance and coding outcomes Required qualifications 2-5 years of inpatient coding experience in a hospital environment Certification as RHIT, RHIA, or CCS High School Diploma or GED Experience with ICD-10-CM and ICD-10 PCS Coding Classification Systems Ability to analyze audit findings and develop educational materials

Performing independent external coding audits, the full-time Medical Coding Auditor will ensure compliance with VHA Coding Guidelines and deliver evidence-based reports and education plans while working remotely. Key responsibilities Audit 80 outpatient encounters and 10 inpatient admissions monthly using VA EHR and national encoder Validate coding accuracy for ICD-10-CM/PCS, CPT, HCPCS, and E/M levels, along with DRG assignment and POA indicators Identify documentation deficiencies and provide remediation recommendations while maintaining inter-reviewer reliability through standardized audit methodology Required qualifications Minimum of 3-5 years of medical coding experience, with 2+ years in coding audit or compliance Active certification such as RHIA, RHIT, CCS, CCS-P, CPC, or equivalent Trained on VHA Coding Guidelines and applicable VHA Directives/Handbooks Prior VA/VHA coding or audit experience is strongly preferred Proficient in Microsoft Office Suite, including...

Working remotely on a full-time basis, the Inpatient Coding Auditor will perform inpatient coding audits and review services for client sites, identify trends, and provide educational support based on audit findings. Key responsibilities Conduct coding audits and reviews on various inpatient facility record types for clients Identify trends from audit findings and develop corrective action plans Provide in-service education and assist in designing educational seminars for clients and staff Required qualifications RHIA, RHIT, or CCS certification 2-5 years of experience in inpatient facility audits and coding Strong research skills to maintain knowledge and support audit findings Ability to present findings impartially and objectively Proficient in using audit software and secure file transfer in compliance with HIPAA

Working remotely full-time, a Certified Medical Auditor (NC) will perform validation reviews of Diagnosis Related Groups (DRG), Ambulatory Procedure Codes (APC), and Never Events, while coordinating rate adjustments and providing reports on trends in medical records management. Key responsibilities Conducts validation reviews and coordinates rate adjustments with claims areas, creating reports on outcomes and trends Manages records retrieval, release, and HIPAA compliance, overseeing all aspects of document management Acts as an expert resource for medical records and coding issues, providing guidance on methodology and procedures Required qualifications Associate's degree in a job-related field or equivalent experience (2 years of job-related work experience) 3 years of experience in medical record management, including coding and validation review Registered health information administrator (RHIA), Registered health information technician (RHIT), Certified Professional Coder...

Performing independent external coding audits, the full-time Medical Coding Auditor will ensure compliance with VHA Coding Guidelines and deliver evidence-based reports and education plans while working remotely. Key responsibilities Audit 80 outpatient encounters and 10 inpatient admissions monthly using VA EHR and national encoder Validate coding accuracy for ICD-10-CM/PCS, CPT, HCPCS, and E/M levels, along with DRG assignment and POA indicators Identify documentation deficiencies and provide remediation recommendations while maintaining inter-reviewer reliability through standardized audit methodology Required qualifications Minimum of 3-5 years of medical coding experience, with 2+ years in coding audit or compliance Active certification such as RHIA, RHIT, CCS, CCS-P, CPC, or equivalent Trained on VHA Coding Guidelines and applicable VHA Directives/Handbooks Prior VA/VHA coding or audit experience is strongly preferred Proficient in Microsoft Office Suite, including Excel,...

To support coding and auditing functions, the remote CPC Certified Coding Auditor will perform inpatient and outpatient coding audits, prepare reports, and present audit findings to stakeholders. Key responsibilities Conduct coding and compliance audits for providers, preparing and presenting detailed reports Ensure accurate application of coding guidelines and provide education to physicians on audit findings Evaluate and report on the quality of physician documentation related to coding and medical necessity Required qualifications High School diploma or equivalent required CPC or CCS coding certification required from AHIMA or AAPC Minimum 5 years of coding experience with at least 2 years in auditing in a multi-specialty setting Proficiency in Microsoft Office Suite and job-related software Strong interpersonal skills with the ability to communicate effectively at all organizational levels

Working remotely full-time, a Certified Medical Auditor (NC) will perform validation reviews of Diagnosis Related Groups (DRG), Ambulatory Procedure Codes (APC), and Never Events, while coordinating rate adjustments and providing reports on trends in medical records management. Key responsibilities Conducts validation reviews and coordinates rate adjustments with claims areas, creating reports on outcomes and trends Manages records retrieval, release, and HIPAA compliance, overseeing all aspects of document management Acts as an expert resource for medical records and coding issues, providing guidance on methodology and procedures Required qualifications Associate's degree in a job-related field or equivalent experience (2 years of job-related work experience) 3 years of experience in medical record management, including coding and validation review Registered health information administrator (RHIA), Registered health information technician (RHIT), Certified Professional...

To support coding and auditing functions, the remote CPC Certified Coding Auditor will perform inpatient and outpatient coding audits, prepare reports, and present audit findings to stakeholders. Key responsibilities Conduct coding and compliance audits for providers, preparing and presenting detailed reports Ensure accurate application of coding guidelines and provide education to physicians on audit findings Evaluate and report on the quality of physician documentation related to coding and medical necessity Required qualifications High School diploma or equivalent required CPC or CCS coding certification required from AHIMA or AAPC Minimum 5 years of coding experience with at least 2 years in auditing in a multi-specialty setting Proficiency in Microsoft Office Suite and job-related software Strong interpersonal skills with the ability to communicate effectively at all organizational levels

Registered Nurse - Diagnosis Related Group Coding Auditor Principal – Carelon Payment Integrity Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. 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. The 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 of DRG coding via medical records and attending physician’s statements provided by acute care hospitals on paid DRG,...

General Summary: This role focuses on the Risk Adjustment process that supports the documentation of acuity diagnoses for the Managed Care (MC) patient population and required activities for submission of records to Medicare Advantage (MA) payers under established capitated contracts. It assists with medical record reviews for HCC diagnoses, correct usage of various coding guidelines (ICD-10-CM, CPT, HCPCS) and federal and MA payor regulations, as well as clinical validation of appropriate supporting documentation.Supervisory Responsibilities: This position has no supervisory responsibilities.General Requirements: All duties performed will be done accurately and in a timely manner.Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy.Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers.Must always adhere to customer service expectations including in-person and virtual (via telephone, or...

Patient Billing Specialist Post patient charges, includes checking coding, ABN documentation, and verification of patient demographics. Posts payments. Files appeals when necessary and assists in determining final claim status. Maintains accurate count of collections received each day. Maintain daily count of physician, procedure, nursing home, hospital and nurse visits. Job Duties: Submits claims to accounts as appropriate. Submits claims to carriers and intermediaries as appropriate. Checks coding to insure accuracy and medical necessity. Insures information is appropriate for client or insurance billing. Assists in follow-up on payment and billing errors. Send medical records requested by insurance companies. Send monthly deposit reports to accounting. Fill out paperwork for patient/insurance refunds. Help answer the phone and make appointments. Perform other duties as assigned by supervision. Other duties as assigned by Director associated with clinic specialty....

Medical Biller I | On-Site | Full Time Job Category: Billing & Coding Personnel Requisition Number: MEDIC003917 Full-Time On-site Gritman Medical Center Moscow, ID 83843, USA Description Medical Billers bill all patient accounts to the appropriate insurance company or payor in an efficient, accurate and timely manner according to payor regulations, and, as appropriate, provide assistance in regard to patient bills, customer (patients, families, physician offices, review organizations, insurance companies) in polite and professional manner. The below Essential Functions are subject to change based on the organizational needs and to ensure with the ever-changing environment of healthcare. Job Summary Daily Responsibilities: Consistently demonstrates AIDET Obtains appropriate insurance and demographic information Understands EOBs, billing tickets statuses, and takes appropriate actions accordingly Understands claim Edits for claim processing and takes appropriate action...

Medical Billing (AR) Specialist At Unifeye Vision Partners (UVP) our mission is simple: to partner with leading eye care practices and support them in their quest to improve the quality of their patients' lives. We are building the leading, nationally recognized integrated eye care community in the country through these partnerships and our commitment to upholding our mission and core values. Unifeye Vision Partners is currently hiring for a full-time Medical Billing (AR) Specialist. This position can be hybrid (Bloomington) or fully remote. The Medical Billing (AR) Specialist at UVP plays a vital role in the revenue cycle process by ensuring accurate and timely submission of medical claims, working denials, and supporting the financial health of the organization. This individual will work closely with clinical and administrative teams to ensure billing accuracy and compliance with payer requirements. Starting pay for the position is $22.00-24.00/hour. Essential Duties And...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Join Our Caring Community Become a part of our caring community and help us put health first. The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS...

Become a part of our caring community Become a part of our caring community and help us put health first The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while...