14 professional coding auditor jobs found

Professional Medical Coder II CCG Talent Management is not only a business solutions company but a company that believes success starts with the individual. CCG Business Solutions has been consulting and providing talent placement services since 2007. Our team understands the principles of connecting purpose to business. We are currently recruiting for a Professional Medical Coder II. Job Description Remote Role - Must be located in the Portland, OR Metro Area. The Professional Medical Coder II will focus on review of documentation and coding. The Professional Medical Coder II will ensure accurate coding and claim submission and conformity to applicable guidelines and regulations. Responsibilities: Perform documentation and coding reviews within work queues across various specialties as assigned. Utilize available coding tools and knowledge to assist in appropriate assignment of coding. Maintain current knowledge to ensure that coding and documentation meets regulatory...

A leading health data exchange company is seeking an Auditor for HCC Risk Adjustment Coder. You will be responsible for reviewing medical records and coding diagnoses using a standardized system. This role demands a minimum of 3 years coding experience, along with strong communication skills. The company offers comprehensive benefits, including health insurance and paid time off, with flexible work arrangements available. Join a team committed to tackling healthcare challenges with technology-forward solutions. #J-18808-Ljbffr

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...

Overview Join to apply for the Revenue Compliance Auditor role at Hartford HealthCare . Location: 100 Pearl Street Hartford (10484) Shift: Monday-Friday 8:00am-4:30pm Work Location Type: In Person Work where every moment matters. Hartford HealthCare is Connecticut’s most comprehensive healthcare network. Responsibilities Conducts audits in accordance with the approved Revenue Compliance Work Plan or as requested by the Manager or Director. Maintains organized files to support audit observations and drafts related audit reports in accordance with agreed-upon standards in a timely manner. Collaborates with business owner to develop agreed-upon action plans to address findings identified during an audit. Communicates audit results and corrective action plans to audit stakeholders. Monitors progress of corrective actions and provides status reports to leadership. Independently validates that corrective action plans are implemented as intended. Stays up to date on...

Work where every moment matters. Every day, more than 30,000 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 Revenue Compliance Auditor contributes to the success of the Office of Compliance and Integrity (OCI) by executing clinical documentation, coding and billing audits as assigned or scheduled. The Revenue Compliance Auditor performs independent reviews to assess compliance with federal, state and private payor regulations, guidelines and requirements. Documentation and coding audits may include professional, facility (inpatient and outpatient), home health and skilled nursing facilities. The Revenue Compliance Auditor may be asked to assist in other compliance audits from time to time at the direction of his/her manage OCI leadership. Responsibilities include but, are not limited to the following: •...

Work where every moment matters. Every day, more than 30,000 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 Revenue Compliance Auditor contributes to the success of the Office of Compliance and Integrity (OCI) by executing clinical documentation, coding and billing audits as assigned or scheduled. The Revenue Compliance Auditor performs independent reviews to assess compliance with federal, state and private payor regulations, guidelines and requirements. Documentation and coding audits may include professional, facility (inpatient and outpatient), home health and skilled nursing facilities. The Revenue Compliance Auditor may be asked to assist in other compliance audits from time to time at the direction of his/her manage OCI leadership.Responsibilities include but, are not limited to the following: · Conducts...

Job Title: Lead Inpatient Coder How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. The Lead Inpatient Coder serves as a key expert in ICD-10-CM, ICD-10-PCS, and DRG assignment, providing specialized knowledge and guidance to the Inpatient Coding team. This role is responsible for addressing complex coding questions, reviewing, and resolving external audit findings, and contributing to coding improvement initiatives. Additionally, the Lead Inpatient Coder plays a critical role in delivering ongoing education and training to the coding team, helping to minimize...

Risk Adjustment Coder It's rewarding to be on a team of people that truly believe in making an impact! We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us. Job Summary The Risk Adjustment coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations. Duties & Responsibilities Essential Duties & Responsibilities Review medical record information to identify all appropriate coding based on CMS HCC categories Prepare the medical charts and track patient information via Excel spreadsheets. Complete...

Op Senior Coder 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 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....

Job Description Job Description Join our Culture of Caring! Mission: With every action we take, Advanced Radiology Consultants is committed to building and maintaining the trust of our referring physicians and providing our patients with exceptional care. Advanced Radiology is one of the largest independent radiology practices in the tri-state area with the most experienced radiologists. We look for team members who want to grow and be professionally challenged, while enjoying a rewarding, caring, and friendly environment. We are looking for a Revenue Cycle Coding Specialist to join our team. The pay range for this role will depend on experience and qualifications. Position Summary: Under the direction of the Senior Revenue Cycle Manager, provide assistance with practice education on insurance and billing criteria with CPT and ICD-10. Chart review for proper coding and/or denial follow up or for clinical information and/or study confirmation as requested...

Overview Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We’re Looking For We’re looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate...

Revenue Cycle Specialist Apply the appropriate diagnostic and procedural code to patient health records for purposes of document retrieval, analysis and claim processing. 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) or Diagnosis-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 with and keep abreast of coding guidelines and reimbursement reporting requirements. Conduct chart audits for physician documentation requirements & internal coding. Provides associate/physician &...

Contract Assignment Healthcare System (Epic Ehr) This is a remote position. We're seeking a Certified Professional Coder (CPC) with hands-on front-end Epic operational experience to support a health system's day-to-day coding workflows. This contractor will perform professional coding activities directly within Epic's end-user workflows (e.g., encounter completion, charge entry, charge review workqueues) to ensure accurate, timely, and compliant coding and charge capture. Responsibilities: Review clinical documentation and assign CPT/HCPCS, ICD-10-CM codes within Epic at the point of coding (front end), ensuring compliance with payer guidelines and health system policies. Work in Epic workqueues (e.g., Charge Review, Claim Edit, Coding WQs) to resolve edits, denials, and holds; clear daily queues to meet turnaround goals. Validate medical necessity and modifier usage; correct charge router/charge session issues before billing. Collaborate with revenue cycle, clinic...

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...