16 internal coding auditor jobs found

Thank you for considering a career at Ensemble!Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!O.N.E Purpose:Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.Striving for...

Medical Coding and Billing Compliance Auditor Location: Remote Division: Coding Compliance About the Role: The Medical Coding Auditor is a detail-oriented position responsible for reviewing medical coding accuracy, documentation integrity, ensuring compliance with federal and state regulations, payer guidelines, and internal policies. The ideal candidate will bring strong analytical skills, extensive coding knowledge, and a passion for maintaining the highest standards of quality and compliance. The candidate will demonstrate a strong background in Microsoft Office applications including PowerPoint, Word, Excel, Outlook, TEAMS, and SharePoint. The Medical Coding Auditor will have a background in physician feedback and education on documentation integrity and coding accuracy. The ideal candidate will have extensive knowledge of CPT coding, ICD-10-CM coding, E/M coding, HCC methodologies, modifiers, telehealth, and HCPCS coding. The candidate will understand and know where to access...

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...

Job Description Job Description Join Our Team We are a mission-driven behavioral health organization committed to empowering individuals on their recovery journey. We are seeking an experienced Medical Billing, Credentialing & Coding Specialist  responsible for managing the full revenue cycle, including insurance billing, provider credentialing, and accurate medical coding for a behavioral health organization. This role ensures compliance with payer requirements, supports timely reimbursement, and maintains provider enrollment through CAQH and other credentialing platforms Summary of Responsibilities: Medical Billing & Revenue Cycle ·         Submit accurate and timely claims for mental health and substance use disorder services ·         Monitor claim status, resolve denials, and follow up on unpaid claims ·         Post payments and reconcile accounts receivable ·         Verify patient insurance eligibility and benefits ·         Ensure compliance with...

Job Description Job Description Description: About Primary Health Solutions Our Mission We meet people where they are and partner with them on their journey towards wellness. Our Vision The destination for servant leaders to provide comprehensive and exceptional care. Our Values R – Respect I – Innovation S – Stewardship E – Excellence Billing and Coding Specialist Summary Responsible for entering/auditing/coding patient services to ensure encounters transfer properly for submission to insurance payers. Analyze coding related claim issues, process gaps and denials to trend feedback for providers by location and/or specialty. A Day in the Life · Review provider documentation (including hospital procedures) and translate services into correct codes. Append payer specific modifiers and claim criteria when applicable. · Review incomplete encounters and code based on available documentation in EHR systems. · Know and understand several different...

Operations Support Compliance Auditor Reporting to the Director of Operations Support, this individual will evaluate, inspect, audit, and determine the effectiveness of compliance and store operational tasks. This individual will visit store locations daily and perform regularly scheduled audits. They must effectively establish strong credibility with the Monro Field Teammates and Field Leadership. Maintaining a positive and constructive attitude is critical as this role sits at the crossroads between the Store Support Center and Field Management. Compensation: The salary range for this role is $68,000 - $85,000. This role is eligible for additional compensation and incentives. Pay will be determined based on experience level. Essential Functions: Participates in the following areas of focus, including but not limited to Monro Forward initiatives, DM onboarding, inventory subject matter expert, inventory analysis, safety compliance, building and equipment maintenance, and...

Billing Specialists Youngstown, OH | In Office | Monday-Friday Top-tier pay aligned with experience and performance Why You’ll Love This Role Meaningful impact: Your work directly supports accurate billing, compliance, and timely reimbursement. Structured problem-solving: Clear processes with enough variety to keep each day engaging. Work-life balance: Stable Monday–Friday schedule with predictable hours. Career growth: Build in-demand skills in medical billing, compliance, and accounts receivable. About All-Stat Portable All-Stat Portable has provided mobile X-ray and EKG services since 1978. We deliver high-quality bedside diagnostics to patients in skilled nursing facilities, rehab centers, and private residences. What You’ll Do Process medical claims in compliance with company and regulatory guidelines. Verify and research patient insurance eligibility and coverage. Monitor accounts for unpaid, delayed, or irregular payments and take appropriate follow-up action....

SSM Health Dermatology's mission is to strive as a team for excellence by providing the most comprehensive, patient-centered care every day. We are looking for a Patient Scheduling Representative to contribute in their own unique way to our Company’s exceptional services and performance for our patients Objective Under the general guidance of leadership, the Medical Billing Supervisor is responsible for the daily oversight of billing and revenue cycle operations, ensuring timely and accurate submission of claims, resolution of denials, and compliance with all payer requirements. This role directly supervises billing team members, provides performance management, conducts routine employee development meetings, and monitors key performance metrics to support organizational efficiency and financial objectives. The Medical Billing Supervisor serves as an advanced resource to staff, providers, and internal departments, while maintaining a high level of accuracy, productivity, and...

Employer Industry: Healthcare Insurance Why consider this job opportunity: Salary up to $97,800 per year Eligible for a bonus incentive plan based on company and/or individual performance Comprehensive benefits package including medical, dental, vision, and 401(k) retirement savings plan Opportunities for professional development and career advancement within a Fortune 100 company Flexible remote work environment with occasional travel for training or meetings Supportive organizational culture focused on the well-being of employees and consumers What to Expect (Job Responsibilities): Review inpatient hospital claims to ensure proper reimbursement and handle provider disputes Assign appropriate procedural terminology and medical codes to patient records Analyze, enter, and manipulate databases for accurate claims payment and diagnosis-related group assignments Respond to internal requests for medical information and clarify discrepancies Make independent decisions...

Overview Looking to join and lead a dynamic team at Ohio State University Physicians where excellence meets compassion? Who we are With over 100 cutting-edge outpatient center locations, dedicated to providing exceptional patient care while fostering a collaborative work environment, our buckeye team includes more than 1,800 nurses, medical assistants, physicians, advanced practice providers, administrative support staff, IT specialists, financial specialists and leaders that all play an important part. As an employee of Ohio State University Physicians (OSUP), you'll be an integral part of a team committed to advancing healthcare, education, and professional growth. Our culture At OSUP, we foster a culture grounded in the values of inclusion, empathy, sincerity, and determination. We meet our teams where they are, coming together to serve each other and our community. Our benefits We know that having options and robust benefit plans are important to you. OSUP...

Job Summary Designs and delivers education programs on compliant documentation, coding and billing practices, regulatory requirements, and internal policies through learning experiences such as instructor-led sessions, webinars, and e-learning modules. Serves as a key resource for physicians, clinical staff, auditors, coders, and other stakeholders, ensuring understanding and adherence to applicable standards. Analyzes data and reports to identify educational needs and may conduct limited audits to support targeted training efforts. Essential Functions: Develops and delivers targeted education based on new service or program implementation, CPT/ICD-10 changes, and regulatory changes. Reviews audit data and compliance trends to identify educational gaps and address areas of risk. Designs and maintains educational content and resources, supporting accurate CPT and diagnosis coding for professional services,...

Medical Billing Specialist - Medicaid Admin Building Fulltime In Person (Monday - Friday 8:00 am - 4:30 pm) About Us Health Partners of Western Ohio is an independent, non-profit and community-directed organization. We serve low-income areas and places without access to care. We're led by a volunteer Board of Directors. Most of our board members are also patients. Our Mission is to eliminate gaps in health outcomes for all members of our community by providing access to quality, affordable, preventive and primary health care. SUMMARY: POSITION PURPOSE With knowledge of FQHC billing requirements, the Accounts Receivable Specialist prepares, submits, and follows up on insurance claims to the state Medicaid program to support an efficient and effective revenue cycle. ESSENTIAL FUNCTIONS AND BASIC DUTIES: Review insurance coverage and patient demographic information to ensure accuracy and completeness prior to billing Prepare, review, submit, and...

Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process." Department: Health Information Management Shift/schedule: Full Time (40 hrs/wk), Remote GENERAL SUMMARY Works under the supervision of the Health Information Reimbursement Manager. The primary job function of the HIM Coder Level I are to assign correct, ICD-10 and CPT codes to established diagnoses and procedures to outpatient (emergency room, same-day surgery, interventional radiology, observation and/or Urgent Care Center) and/or limited inpatient records. In some instances, may audit OP and /or IP records for charging accuracy. May be asked to add or delete charges for optimal reimbursement as well as compliance following coding and governmental guidelines. The level one coder has mastered a maximum of 2 work types. Performs other duties as assigned. QUALIFICATIONS Education: High School Diploma or successful completion of an...

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...

Candidate should ideally be located in Columbus, OH or Cleveland, OH Monro’s family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach.  Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company’s regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color.  Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto service in the industry.  Do you have what it...

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 this...