16 outpatient coding auditor jobs found

University of Michigan Michigan Medicine is seeking a Coding Compliance Auditor to perform outpatient coding quality audits ensuring CPT/HCPCS, ICD-10-CM code assignments and modifiers align with CMS guidelines. You will provide ongoing feedback to the coding staff and develop educational programs for the outpatient coding department. The ideal candidate holds CPC/COC/RHIT/RHIA/CCS/CCS-P credentials, an associate degree in healthcare, and at least three years of coding/auditing experience, with #J-18808-Ljbffr

University of Michigan's Michigan Medicine is seeking an experienced Coding Quality Auditor to perform outpatient coding audits for CPT/ICD-10-CM, ensuring accuracy and CMS guideline compliance. You will develop and deliver educational programs, and act as a subject matter expert for the outpatient coding department. The role requires coordinating training, providing feedback to improve code accuracy, and contributing to departmental policies and process improvements within Revenue Cycle #J-18808-Ljbffr

Become a part of our caring community Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Outpatient Behavioral Health Coding disputes and is part of the PPI Coding Disputes Team with Humana. The Outpatient Behavioral Health Coding Auditor on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient Behavioral Health coding disputes and expertise in CPT/HCPCS...

Humana is seeking an experienced Medical Coding Auditor to handle provider disputes in a results-driven environment. This remote role focuses on outpatient Behavioral Health coding disputes and participates in the PPI Coding Disputes Team. You will audit disputes, ensure accuracy, and communicate outcomes clearly to providers. The candidate will work with the Disputes Team reporting to the Manager, collaborating across departments, and will have 3+ years of Behavioral Health coding audits #J-18808-Ljbffr

Job Description Job Description Company Description More Than Just Care, It’s Community   Imagine doing meaningful work in a place where people vacation. That’s life at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties.   If you want a career in healthcare and a lifestyle most people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be  Munson Material.  To us, that means teammates who live by our values of  excellence, teamness, positivity, creativity,  and a commitment to creating  exceptional experiences  for our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country. Invested in You   Grow:  Tuition reimbursement, in-person and online development, and access to our career hub to...

Job TitleUses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization's strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge.Note: "patients" refers to patients, clients, residents, participants, customers, membersEssential FunctionsOur Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience. Responsible for distribution of...

Become a part of our caring community 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 direction and receives guidance where needed. Follows...

Humana is seeking a Medical Coding Auditor to review medical claims against records, ensuring CPT/HCPCS coding accuracy and guideline adherence. The role supports APC/outpatient coding, uses encoders, and performs CPT/HCPCS reviews while protecting patient confidentiality. You will work remotely with potential occasional travel for training or meetings, typical hours Monday–Friday, and focus on Outpatient Facility/APC coding teams with emphasis on accuracy and compliance. #J-18808-Ljbffr

Employment Type: Full time Shift: Description: Purpose Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization’s strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge. Note: “patients” refers to patients, clients, residents, participants, customers, members Essential Functions Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency &...

Medical Billing Specialist Administration - Flint, MI 48502 Overview Position Type Full Time Education Level High School Category Health Care Description This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third-party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities. General responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks. Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days. Accurately post all insurance payments by line item. Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely* Collects...

Job Details POSITION SUMMARY : The HIM Coding Specialist, Outpatient, is responsible for the timely and accurate coding of outpatient, ambulatory surgery, observation, recurring, rehabilitation, and skilled care accounts. This role supports optimal reimbursement and regulatory compliance through the application of ICD-10-CM, CPT-4, APC assignment, NCCI edits, modifiers, and coding guidelines while maintaining productivity, quality, and turnaround standards. EMPLOYMENT TYPE: Direct- Hire WORK LOCATION : Remote SCHEDULE : Monday-Friday | 40 Hours Per Week SYSTEMS EMR, Outlook, VitalWare, Lawson, Encoder Software, Excel START DATE COMPENSATION: $22.49 - $34.25/hour, based on coding experience and years of acute care outpatient coding experience. ONSITE REQUIREMENTS (PLEASE REVIEW CAREFULLY) Although this is a remote position, limited onsite attendance is required. Candidates must attend one full week of onsite orientation and training at Covenant HealthCare at...

Coding Compliance AuditorMichigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.Perform coding quality audits on outpatient records to assure appropriateness, accuracy, and compliance for CPT/HCPCs, ICD-10-CM code assignments, and modifier assignment in accordance with Center of Medicare and Medicaid Service (CMS) Guidelines, AMA and AHA Official ICD-10-CM Coding Guidelines. Provide ongoing feedback to managers and coders. Develop and implement educational programs regarding elements of the coding compliance program and act as a subject matter expert for the outpatient coding...

Join Stout: Relentless ExcellenceAt Stout, we're dedicated to exceeding expectations in all we do – we call it Relentless Excellence. Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team.Impact You'll MakeContribute to complex healthcare consulting engagements involving coding and billing audits, disputes, claims analysis, investigations, compliance reviews, and litigation support.Deliver accurate, defensible analyses across inpatient and outpatient facilities, ambulatory surgery centers (ASCs), and professional fee services.Identify clinical documentation, coding, billing, reimbursement, contractual, regulatory, and fraud, waste, and abuse risks from provider and payor perspectives.Translate...

Health Information Management Coding Specialist Outpatient The Health Information Management Coding Specialist Outpatient provides timely and accurate clinical and administration data to ensure optimal reimbursement for facility outpatient, ambulatory surgery, observation, recurring accounts to support the facility coding needs. This may include coverage on some Rehab or Skilled Care accounts. Primary patient contact is only social. Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation. Responsibilities Contributes to organization success targets for patient satisfaction. Formulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients, and other department staff members. Adhere to...

Back-End Medical BillerFull-Time, Temp to Hire Opportunity - OnsiteHours: 8 am to 4:30 pm M-F (30-minute lunch)$19-$20 per hour DOEProfessional SummaryThis position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilitiesGeneral ResponsibilitiesAble to perform accounts receivable collection activities timely and accurately including prioritizing subtasksUtilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 daysAccurately post all insurance payments by line itemCommunicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely*Collects outstanding claims from third party...

Back-End Medical Biller Full-Time, Temp to Hire Opportunity - Onsite Hours: 8 am to 4:30 pm M-F (30-minute lunch) $19-$20 per hour DOE Professional Summary This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities General Responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days Accurately post all insurance payments by line item Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely* Collects...