12 payment integrity coder jobs found

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Outpatient Coder 2 To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. Under the general direction of the OP Coding Supervisor, the Outpatient Coder 2 is responsible for a comprehensive review of medical record documentation and performs a variety of coding related activities in two complex outpatient coding service line. Work may include, but is not limited to: coding cases, prioritizing assigned coding tasks, resolving claim edits, handling individual coding workload, working stop bills (if assigned), and sending queries, as needed, to clinical staff. Responsibilities: Reviews medical record documentation to determine appropriate ICD-10-CM codes in accordance with official coding guidelines. Reviews medical record documentation and...

Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. Reporting to the Supervisor of Outpatient Coding, The OP Senior Coder is a vital multifaceted role within the Outpatient Coding Department. This position provides support to the Outpatient Coding Department as a OP coding subject matter expert, educator, QA reviewer, and also focuses daily efforts on A/R management and oversight. Additionally, this person works with partner departments to problem solve issues and streamline processes. The OP Senior Coder is also required to mentor other team members and also prepare them for the role of OP Senior Coder. The OP Senior Coder possesses a strong level of OP clinical coding expertise, and has the ability to handle multiple priorities....

Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. Under the general direction of the OP Coding Supervisor, the Outpatient Coder 1 is responsible for a comprehensive review of medical record documentation and performs a variety of coding related activities in one complex outpatient coding service line. Work may include, but is not limited to: coding cases, prioritizing assigned coding tasks , resolving claim edits, handling individual coding workload, working stop bills (if assigned), and sending queries, as needed, to clinical staff. EEO/AA/Disability/Veteran Responsibilities 1. Reviews medical record documentation to determine appropriate ICD-10-CM codes in accordance with official coding guidelines. 2. Reviews...

Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. Under the general direction of the OP Coding Supervisor, the Outpatient Coder 2 is responsible for a comprehensive review of medical record documentation and performs a variety of coding related activities in two complex outpatient coding service line. Work may include, but is not limited to: coding cases, prioritizing assigned coding tasks , resolving claim edits, handling individual coding workload, working stop bills (if assigned), and sending queries, as needed, to clinical staff. EEO/AA/Disability/Veteran Responsibilities 1. Reviews medical record documentation to determine appropriate ICD-10-CM codes in accordance with official coding guidelines. 2. Reviews medical...

Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. Under the general direction of the OP Coding Supervisor, the Outpatient Coder 3 is responsible for a comprehensive review of medical record documentation and performs a variety of coding related activities in three (3) complex outpatient coding service line. Work may include, but is not limited to: coding cases, prioritizing assigned coding tasks, resolving claim edits, handling individual coding workload, working stop bills/DNBs, conducting QA reviews and sending queries, as needed, to clinical staff. Mentors Coder 1 and Coder 2 coders, and participates in cross-training initiatives such as the coder buddy program and learning circle initiatives. Acts as an expert coding resource...

Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values – integrity, patient-centered, respect, accountability, and compassion – must guide what we do, as individuals and professionals, every day. The Inpatient Coder 3 performs activities involving expert level inpatient coding of medical records as a mechanism for indexing clinical information used for research, utilization, appropriateness of care, compilation of statistics for hospital, regional and government reporting, and accurate reimbursement. This level of coding is expected to completely code cases of any complexity/length of stay. They also support the department through a variety of project work and support the department through a variety of project work. EEO/AA/Disability/Veteran Responsibilities 1. Coding Expectations - Coders are expected to perform coding functions within departmental guidelines. Departmental...

W ork where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network. The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system. Position Summary: Reviews and validates outpatient and professional clinical documentation and diagnostic results. Extracts data and assigns alpha numeric codes for billing, internal and external statistical...

Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system. Position Summary: Reviews and validates outpatient and professional clinical documentation and diagnostic results. Extracts data and assigns alpha numeric codes for billing, internal and external statistical reporting,...

Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. Under the general direction of the OP Coding Supervisor, the Outpatient Coder 3 is responsible for a comprehensive review of medical record documentation and performs a variety of coding related activities in three (3) complex outpatient coding service lines. Work may include, but is not limited to: coding cases, prioritizing assigned coding tasks, resolving claim edits, handling individual coding workload, working stop bills/DNBs, conducting QA reviews and sending queries, as needed, to clinical staff. Mentors Coder 1 and Coder 2 coders, and participates in cross-training initiatives such as the coder buddy program and learning circle initiatives. Acts as an expert coding resource to...

Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. The Inpatient Coder 2 performs activities involving moderate level inpatient coding of medical records as a mechanism for indexing clinical information used for research, utilization, appropriateness of care, compilation of statistics for hospital, regional and government reporting, and accurate reimbursement. This level of coding is expected to completely code cases of moderate complexity with lengths of stay greater than six days and continue to challenge themselves to code more complex cases with longer lengths of stay. They also support the department through a variety of project work and support the department through a variety of project work. EEO/AA/Disability/Veteran...

Job Description About the Role: We are seeking a highly skilled and experienced Senior Inpatient HIM Coder to join our dynamic healthcare information management team. This role is crucial in bridging the gap between clinical data and technology, as we aim to develop cutting-edge AI solutions for medical coding and billing processes. The successful candidate will play a pivotal role in providing valuable insights and expertise to enhance our product development efforts. Requirements and Qualifications: A minimum of 3 years of hands-on experience as an acute HIM inpatient medical coder in a hospital environment. Proficiency in identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and associated modifiers from patient records. In-depth understanding of supporting evidence requirements for accurate coding. Practical experience using grouper software for MS-DRG and APR-DRG assignment. Strong communication skills to interact...