24 outpatient coding auditor jobs found

divh2Medical Coder Auditor/h2pRevenue Cycle Management is looking for a Medical Coder Auditor to join our team. Remote opportunity after 30-90 day in-person training./ppSUMMARY: The Medical Coder Auditor is responsible for reviewing coded encounters to ensure accuracy, compliance, and alignment with coding guidelines, payer rules, and organizational policies. This role provides feedback to coders, identifies trends in errors, and supports coding education and process improvement initiatives./ppESSENTIAL FUNCTIONS:/pulliConduct retrospective and prospective coding audits to ensure coding accuracy and compliance with regulations./liliReview coded documentation for completeness, accuracy, and adherence to ICD-10-CM, CPT, HCPCS, and/or ICD-10-PCS guidelines./liliIdentify coding trends, error patterns, and compliance risks and develop corrective action plans./liliProvide feedback and education to coders to improve accuracy and consistency./liliCollaborate with providers and clinical...

Compliance Coding Auditor Hours: Variable Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $48.140 - $62.110 - $76.080 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit...

Job Description Job Description THIS IS NOT A REMOTE POSITION We are hiring a Medical Records Clerk/Coder to assign procedure, and diagnosis codes for insurance billing, review claims data, research, and correspond with insurance companies to obtain accurate reimbursement for healthcare claims. This person will also be responsible for analyzing, abstracting, compiling data, and generating reports. This position must provide customer service excellence when dealing with internal and external contacts. Duties include but are not limited to: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place before submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims...

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...

Summary Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs, including but not limited to Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is an on-site position with a remote option. Responsibilities Perform Medical Record reviews and audits based on organizational priorities. These can include both prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk adjustment. Perform code abstraction...

Job Description The Compliance Auditor, Billing and Coding Compliance is responsible for the oversight and management of auditing and monitoring billing and coding compliance activities, assist with internal compliance policies and procedures, completing compliance risk assessments, and developing risk-based educational materials to ensure compliance with federal/state laws and regulations, and UT Health San Antonio policies. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Responsibilities Provide oversight on billing compliance auditing, monitoring, and educational activities within the compliance department. Performs audits of electronic and manual documentation, coding, and billing systems. Conducts close-out meetings with senior management of audited departments. Maintain current knowledge of changes in federal and state coding and billing regulations/guidelines...

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g., ICD‑10‑CM, CPT, HCPCS). The role requires interpretation and independent determination of the appropriate courses of action, contributing to overall cost reduction by increasing the accuracy of provider contract payments in our payer systems and ensuring correct claims payment for appropriate CPT/HCPCS code assignments. The Auditor analyzes, enters and manipulates database data, responds to or clarifies internal requests for medical information, understands departmental, segment and organizational strategy and operating objectives, and follows established guidelines and procedures while making decisions in ambiguous situations. Where you come in The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g.,...

Embedded Medical Coder We are seeking a detail-oriented and certified Embedded Medical Coder to join our healthcare team. This role involves working directly within a clinical or administrative unit to ensure accurate and compliant coding of medical procedures, diagnoses, and services. The ideal candidate will be embedded in day-to-day operations, collaborating closely with physicians, nurses, and billing staff to support efficient documentation and reimbursement processes. Key Responsibilities: Review and analyze patient medical records to assign appropriate ICD-10, CPT, and HCPCS codes. Ensure coding accuracy and compliance with federal regulations, payer policies, and internal standards. Collaborate with healthcare providers to clarify documentation and resolve coding discrepancies. Submit coded data to billing systems to initiate insurance claims and support reimbursement. Maintain and update patient data for long-term tracking and reporting. Participate in audits and...

Job Description A client of Innova Solutions is immediately hiring for a HIM Coder . Position type: Full-time, Contract Duration: 5+ Months Location: Remote (looking for candidates based out in HI, CA, WA or OR) As a HIM Coder, you will: Review inpatient and outpatient medical records daily to identify and assign accurate diagnosis and procedure codes. Abstract clinical data and ensure coding is completed within required productivity and compliance timelines. Apply ICD-10-CM, CPT, and HCPCS Level II guidelines to ensure proper code selection and sequencing. Communicate with physicians and internal teams to clarify documentation, diagnoses, and procedures when needed. Monitor coding accuracy, resolve discrepancies (including DRG‑related issues), and maintain adherence to coding standards and policies. Required Skills & Qualifications 2+ years of recent hospital coding/abstracting experience within the last 5 years (inpatient and/or outpatient). Certified Coding...

You will be able to work from your home location within the United States PURPOSE AND SCOPE: Conducts data quality audits of outpatient encounters to validate coding assignment is in compliance with the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. Provides feedback and education to coders. Escalates compliance, risk-related issues to expedite mitigation. PRINCIPAL DUTIES AND RESPONSIBILITIES: Consults facility leaders and staff on best practices, methodology, and tools for accurately coding. Chart Analysis, 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/AAPC). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from...

divh2Coding Specialist/h2pResponsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment./ppstrongMinimum Qualifications:/strong/pp1. Graduate of Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience./pp2. Certification in one of the following: RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), COC (Certified Outpatient Coder), CCS...

HIM Coder Analyst III page is loaded## HIM Coder Analyst IIIlocations: Fort Worth, TXtime type: Full timeposted on: Posted Todayjob requisition id: JR-112592**Location:**Medical Center - Fort Worth**Department:**HIM-Coding**Shift:**First Shift (United States of America)**Standard Weekly Hours:**40**Summary:**The HIM Coder Analyst III requires superior knowledge of and skill in applying International Classification of Diseases and Procedures (ICD), and Current Procedural Terminology (CPT) code sets and associated Medicare/Medicaid rules and guidelines. Reviews and interprets patient medical record documentation to identify pertinent diagnoses and procedures and assigns ICD-9-CM, ICD-10-CM/PCS and CPT 4 codes accurately and timely to the highest level of specificity based upon physician documentation for inpatient, observation and outpatient ambulatory procedures/treatment room records. Validates the coded data to one or more Diagnosis Related Groupers (DRG) validates the...

divh2Medical Coder Lead/h2pRevenue Cycle Management is looking for a Medical Coder Lead to join our team! Remote opportunity after 30-90 day in-person training SUMMARY The Medical Coder Lead is responsible for serving as a subject matter expert in coding processes providing advanced technical guidance and ensuring coding accuracy compliance and productivity standards are met. The position supports coders and auditors through consultation mentoring and expertise on complex coding scenarios./ppESSENTIAL FUNCTIONS:/pulliServe as a resource and consultant for coders on complex or specialty coding scenarios./liliReview and provide guidance on challenging cases to ensure coding accuracy and compliance./liliPartner with auditors to resolve discrepancies and identify trends in coding errors./liliProvide mentoring and technical support to coders promoting knowledge sharing and best practices./liliAssist in developing and updating coding procedures guidelines and reference...

Description Summary: Responsible for maintaining current and high-quality ICD-10-CM and CPT coding for all Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. The coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM Guidelines for Coding and Reporting and CPT Guidelines. Outpatient coding is applicable towards clinical, provider office visits, therapeutic, laboratory, recurring, emergency department, outpatient observation, and ambulatory surgery patient encounters. Coder will work collaboratively with various CHRISTUS Health departments (Admitting, Charging, Patient Financial Services, HIM, etc.) to resolve charging issues, denials, and physician documentation clarifications, to ensure accurate billing...

We Are Hiring Department: Pediatric Surgery Department Schedule: Monday - Friday 8:00a - 4:30p Facility: Strictly Peds Medical Office Location: 1301 Barbara Jordan Blvd Suite 400 Austin, Texas What You Will Do Apply the appropriate diagnostic and procedural code to patient health records for purposes of document retrieval, analysis and claim processing. Responsibilities: Abstract pertinent information from patient records. Assign the International Classification of Diseases, Clinical Modification (ICD), Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes, creating Ambulatory Patient Classification (APC) orDiagnosis-Related Group (DRG) assignments. Perform complex coding. Obtain acceptable productivity/quality rates as defined per coding policy. Query physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Maintain knowledge of, comply...

Summary Selected by CHRISTUS Health Coding Leadership, to focus coding skills and expertise to foster an environment of teamwork and service excellence mentoring, training, cross training their designated Regional Inpatient or Outpatient Coding team. Coding Lead will work with Coders as a resource to maintain current and high-quality ICD-10-CM, ICD-10-PCS and/or CPT coding for the Inpatient and/or Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Coding Leads will work to ensure Coders abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding and Reporting and AMA CPT Guidelines. Coding Lead will act as a liaison for coding related questions, providing clear and concise written or verbal...

Overview At Houston Methodist, the Lead Inpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to inpatient encounters based upon documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. Houston Methodist Standard...

Description Summary: Selected by CHRISTUS Health Coding Leadership, to focus coding skills and expertise on designated Inpatient or Outpatient high dollar or specialty account types. Specialty Coder is responsible for maintaining current and high-quality ICD-10-CM, ICD-10-PCS and/or CPT coding for the Inpatient and or/ Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Specialty Coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding and Reporting and AMA CPT Guidelines. Coder will work collaboratively with various CHRISTUS Health departments, including but not limited to the HIM and Clinical Documentation Specialists, to ensure accurate and complete physician...

JOB SUMMARY This position will be functioning under minimal supervision while utilizing independent decision making. This position will assist the manager and supervisor in training new team members, coordinate inquiries from ancillary departments regarding DNFB and edit tasks. The Sr. Edit Coder will investigate and solve edit issues and communicate root cause data to management in order mitigate potential upstream and downstream impacts. Responsible for modifying and completing moderate to high complexity reviewing and resolving coding and charge edits using ICD-10-CM, CPT and HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record. Working in billing editor systems as required. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Performs claim edit...

Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care. We have a rich history at Tenet. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many different...

Outpatient Professional Medical Coder Greenberg-Larraby, Inc. (GLI) is actively seeking a skilled Outpatient Professional Medical Coder to join our dynamic healthcare team based in Temple, TX This position is onsite in Temple, TX. In this role, you will be responsible for reviewing and coding outpatient medical records, ensuring adherence to coding standards and guidelines. Your expertise will play a vital role in ensuring accurate billing and compliance, contributing to the overall quality of patient care at GLI. You'll collaborate effectively with healthcare providers to clarify clinical documentation and ensure that all coding assignments align with the latest coding practices. If you are a detail-oriented professional ready to excel in a collaborative environment, we invite you to apply! Requirements Minimum Requirements: One active coding credential required: RHIT, RHIA, CCS, CCS-P, or CPC At least three (3) years of outpatient or professional...

At Houston Methodist, the Lead Inpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to inpatient encounters based upon documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. FLSA STATUS Non-exempt...

Outpatient Professional Medical Coder Greenberg-Larraby, Inc. (GLI) is actively seeking a skilled Outpatient Professional Medical Coder to join our dynamic healthcare team based in Temple, TX This position is onsite in Temple, TX. In this role, you will be responsible for reviewing and coding outpatient medical records, ensuring adherence to coding standards and guidelines. Your expertise will play a vital role in ensuring accurate billing and compliance, contributing to the overall quality of patient care at GLI. You'll collaborate effectively with healthcare providers to clarify clinical documentation and ensure that all coding assignments align with the latest coding practices. If you are a detail-oriented professional ready to excel in a collaborative environment, we invite you to apply! Requirements Minimum Requirements: One active coding credential required: RHIT, RHIA, CCS, CCS-P, or CPC At least three (3) years of outpatient or professional...