11 outpatient coding auditor jobs found

DRG Coding Auditor Principal Virtual: This role enables associates to work virtually full-time, with the exception of 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. Work Location Policy 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 an accommodation is granted as required by law. Job Overview 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...

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.,...

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...

Occupational Therapist Occupational Therapists are responsible for providing patients with treatment to help them develop and improve their ability to complete everyday tasks related to their job and daily life. They perform patient evaluations and re-evaluations, establish patient treatment plans based on the referral from the physician/referral source (if required), and document the patients' care and direct supportive staff regarding treatment process. This may involve outpatients, inpatients, pediatrics and off-site locations. Essential Job Functions Reviews physician referral, patients condition and medical history to determine occupational therapy treatment needs. Performs and documents patient evaluation, re-evaluation and develops treatment and discharge plans per department policies and procedures/protocols Plans and administers medically prescribed occupational therapy treatments to patients. Designs and constructs special equipment for adaptation of individuals...

Occupational Therapist At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Up to $40K Sign On Bonus Full Time Days Primary Function/General Purpose of Position Occupational Therapists are responsible for providing patients with treatment to help them develop and improve their ability to complete everyday tasks related to their job and daily life. They perform patient evaluations and re-evaluations, establish patient treatment plans based on the referral from the physician/referral source (if required), and document the patients' care and direct supportive staff regarding treatment process. This may involve outpatients, inpatients, pediatrics and off-site locations. Essential Job Functions Reviews physician referral, patient's condition and medical history to determine occupational therapy...

Claims Resolution Coder- Remote Responsible for reviewing medical documentation to assign modifiers to insurance claims with issues identified by the National Correct Coding Initiative (NCCI), Medicare Outpatient Code Editor (OCE),or other party payer specific claims processing guidelines. Works with Coding, Billing and Reimbursement staff to resolve edits. Is additionally responsible for trending errors, supporting identification of root causes, and effective communication with coding and training staff to improve coding accuracy and clean claims processing. Researches regulations to ensure accuracy of CPT codes and documentation. Associates degree in Health Information Technology or Medical Billing preferred. 2 years direct application of coding, medical billing or reimbursement in health care setting, hospital or physician office required. CPC or CCS coding certification required at time of hire. Thorough knowledge of lab, radiology and other ancillary, CPT, HCPCS related...

Claims Resolution Coder- Remote page is loaded## Claims Resolution Coder- Remoteremote type: Remotelocations: Norfolk, VAtime type: Full timeposted on: Posted Todayjob requisition id: JR-91627**City/State**Norfolk, VA**Work Shift**First (Days)**Overview:**# **Claims Resolution Coder- Remote**Responsible for reviewing medical documentation to assign modifiers to insurance claims with issues identified by the National Correct Coding Initiative (NCCI), Medicare Outpatient Code Editor (OCE),or other third party payer specific claims processing guidelines.Works with Coding, Billing and Reimbursement staff to resolve edits. Is additionally responsible for trending errors, supporting identification of root causes, and effective communication with coding and training staff to improve coding accuracy and clean claims processing.Researches regulations to ensure accuracy of CPT codes and documentation.* Associates degree in Health Information Technology or Medical Billing...

This service is set to disconnect automatically after {0} minutes of inactivity. Your session will end in {1} minutes. Click OK to reset the timer to {0} minutes. You have been signed out. This service is set to sign out after {0} minutes of inactivity. POSITION OVERVIEW Under the direction of the Health Information Management Director, the Outpatient Coder I accurately determines ICD-10-CM diagnosis codes and ICD-10-CM, CPT and HCPCS procedure codes for outpatient medical records that may include Emergency Department (ED), outpatient laboratory, diagnostic imaging, minor outpatient procedures, infusion and injections, outpatient labor and delivery, recurring accounts and observation stays. POSITION RESPONSIBILITIES: Abstract pertinent information from patient records within various outpatient types. Assign ICD-10-CM / ICD-10-PCS codes or HCPCS codes, creating ambulatory payment classification (APC). Monitor and manage the discharged not final billed (DNFB) accounts within...

Overview Job Description - Coder II (7454-1498) Wythe County Community Hospital Description POSITION SUMMARY: Under the direction of the Health Information Management Director, the coder II accurately determines ICD-10-CM diagnosis codes, ICD-10-CM, CPT and HCPCS procedure codes for all patient types including inpatient, observation, surgical day care, Emergency Department (ED) outpatient and recurring patients. Responsibilities Abstract pertinent information from patient records within various inpatient and outpatient types. Assign ICD-10-CM/ ICD-10-PCS codes or HCPCS codes, creating ambulatory payment classification (APC) or diagnosis related group (DRG). Monitor and manage the discharged not final billed (DNFB) accounts within assigned patient types daily to meet financial goals and expectations. Meet coding productivity standards and accuracy rate determined by company policy. (See Coding Productivity and Quality Standards.) Query clinical staff to achieve accuracy in...

At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. PRN - as needed including 1 weekend per month Primary Occupational Therapists are responsible for providing patients with treatment to help them develop and improve their ability to complete everyday tasks related to their job and daily life. They perform patient evaluations and re-evaluations, establish patient treatment plans based on the referral from the physician/referral source (if required), and document the patients' care and direct supportive staff regarding treatment process. This may involve outpatients, inpatients, pediatrics and off-site locations. Essential Job Functions ? Reviews physician referral, patient's condition and medical history to determine occupational therapy treatment needs. Performs and documents patient...

Description The Medical Coder III position plays a critical role in ensuring accurate medical coding and documentation. This involves handling complex case scenarios, applying a combination of facility coding and professional coding, and aligning with industry standards like ICD-10-CM, CPT, and HCPCS codes. The coders will code inpatient facility and inpatient professional rounds and facilitate proper documentation and communication with medical staff to enhance compliance and coding accuracy. Accurately assigns Evaluation and Management (E&M) codes, International Classification of Diseases, Clinical Modification (ICD-CM) diagnoses, ICD-10 Procedure Coding System (ICD-10-PCS), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities derived from medical record documentation (paper or electronic) for the professional and institutional (facility) components of inpatient facility discharges (stays); inpatient...