10 policy coding auditor jobs found

Become a part of our caring community The 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 Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

Inpatient Medical Coder Company Overview Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG is bidding on a federal contract for several coding positions. You would be a W-2 employee with HPMG, not a government employee. Summary Responsible for assigning accurate ICD codes for diagnoses and procedures. The Medical Severity - Diagnostic Related Group (MS-DRG) is automatically assigned by the grouper software for inpatient stays. Inpatient coders may also assign accurate ICD diagnoses, CPT and HCPCS codes, modifiers, and quantities from medical record documentation for professional services (rounds or IBWA encounters). They train and educate military staff on coding issues and play a significant role in coding compliance activities. Mandatory Knowledge and Skills Excellent computer and communication skills for provider and staff interactions. Knowledge of anatomy/physiology, disease processes, medical terminology,...

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...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. RCM Medical Billing Operations Supervisor 5 days ago Requisition ID: 2002 Salary Range: $21.22 To $24.84 Hourly Work Location: Remote in SW Washington, NW Oregon Responsible To: Revenue Cycle Manager Major Duties The RCM Medical Billing Operations Supervisor position works under the supervision of the RCM Manager. This position oversees the front end of the medical billing cycle, namely timely and accurate claim submission processes and supervises the Coding and Claim Review Specialists, and Medical Billing Assistant. They also ensure acceptable resolution of failed claims in the EHR to promote timely submission of claims and in EPIC Charges/invoices, monitors unbilled claims and upfront rejections. The incumbent is responsible for coding and mapping in the EHR, maintaining payer information, billing configurations, fee...

Job Summary The Coding Supervisor is responsible for overseeing the daily operations of the coding team, ensuring accurate and compliant coding practices across all clinical departments. This role provides leadership, training, and quality assurance for coding staff, supports provider education, and collaborates with Revenue Cycle and Compliance teams to optimize reimbursement and maintain regulatory compliance. Job Specific Competencies Team Leadership & Oversight Supervises coding staff including Coder I and Coder II. b. Monitors productivity and quality metrics, ensuring standards are met or exceeded. c. Conducts regular team meetings and one-on-one check-ins to support performance and development. Quality Assurance & Compliance Oversees internal/external audits and reviews coding accuracy, documentation, and billing compliance. b. Ensures adherence to federal, state, and payer-specific coding guidelines. c. Coordinates with Compliance and Revenue...

Lifeline Connections is a community-based behavioral health organization that specializes in providing confidential and compassionate care to individuals who experience substance use and/or mental health conditions. Our Vision - As the premier provider of substance use and mental health services in the Pacific Northwest, we are respected and the most trusted resource for behavioral health treatment and whole-person care. We provide a comprehensive continuum of coordinated quality services, foster enduring relationships, and empower our communities to truly thrive. Our Mission - Through superior customer service, high quality programs, and well-trained and dedicated staff, we inspire hope and support lifesaving changes for people affected by substance use and mental health conditions. POSITON TITLE: RCM Medical Billing Operations Supervisor Non-Exempt Position RESPONSIBLE TO: Revenue Cycle Manager Work Location: Remote in SW Washington, NW Oregon MAJOR...

CLOSING DATE: Open Until filled with Bi-weekly reviewsPOSITION: Medical Billing Specialist (2 positions)SALARY: $23.08 to $28.12 per hour DOEREPORTS TO: Revenue Cycle SupervisorLOCATION: Nespelem Health Center, 6 month training in Nespelem, WA, with possibility of working in other districts upon completion of training.Basic Functions: This is a Non-Exempt position. Performs clerical standard and procedures of the Medical Billing Office through direct contact with eligible programs using computer-aided data entry screens.MINIMUM QUALIFICATIONS:Education and Training:Requires a High School Deploma or GEDRequires 12 months billing and coding experience with Anatomy and Pathophysiology trainingWilling to obtain a Certified Professional Coder (CPC) certificate or Certified Professional Biller (CPB) certificate from the American Academy of Professional Coders (AAPC) within 36 months of hire and maintain certification throughout employment.May require valid driver’s license and be...

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

CTHCA Medical Billing Specialist Hot Job Reservation Wide - WA Overview Salary Range $23.08 - $28.12 Hourly Description Closing Date: Open Until Filled with Bi-weekly Reviews Position: CTHCA Medical Billing Specialist (2 Positions) Salary: $23.08 to $28.12 per hour DOE Reports To: Revenue Cycle Supervisor Location: Nespelem Health Center, 6 Month Training in Nespelem, WA, with Possibility of Working in Other Districts Upon Completion of Training. Basic Functions: This is a Non-Exempt Position. Performs Clerical Standard and Procedures of the Medical Billing Office Through Direct Contact with Eligible Programs Using Computer-Aided Data Entry Screens. Qualifications Minimum Qualifications: Education and Training: Requires a High School Diploma or GED Requires 12 Months Billing and Coding Experience with Anatomy and Pathophysiology Training Willing to Obtain a Certified Professional Coder (CPC) Certificate or Certified Professional Biller (CPB)...