14 professional coding auditor jobs found

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.,...

A leading health insurance company seeks a skilled Medical Coding Auditor to ensure the accuracy and compliance of medical claims coding. This fully remote role requires at least 3 years of post-certification experience and strong knowledge of CPT/HCPCS coding. The ideal candidate will review medical documents, conduct peer reviews, and maintain compliance with coding guidelines. Benefits include competitive pay in the range of $59,300 - $80,900, comprehensive health coverage, and opportunities for professional development. #J-18808-Ljbffr

A health-focused institution in Salt Lake City is looking for a Coding Auditor to ensure accuracy and compliance in medical coding. The ideal candidate will audit inpatient medical records, enhance coding accuracy, and provide training to coders. Required qualifications include a Bachelor's degree or equivalent HIM management experience, CCS certification, and experience with ICD-10 coding. This position promotes professional growth and collaboration within a dynamic clinical environment. #J-18808-Ljbffr

Tanner Clinic has an immediate opening for a full-time Coder position. This position is not remote and is located at our Kaysville Business Office. Essential Job Responsibilities: Responsible for maintaining coding compliance for multi-specialty clinic. Audit procedure and diagnostic codes for accuracy, detail and comprehensive description of clinical procedures Responsible for maintaining current ICD-9, ICD-10, CPT and coding skills Use word processing, spreadsheet, database, and e-mail Ability to interpret and apply Medicare (CCI) and payer edits Other duties as assigned Requirements Education: High School diploma required Certified Professional Coder is required Experience: Coding experience preferred Other Requirements: Demonstrates knowledge of medical terminology Must have strong knowledge of computer and other office equipment Performance Requirements: Knowledge: Knowledge of billing practices and clinic policies...

Ambulatory Surgery Center (ASC) Cardiology Coder MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and above all excellent customer service. MedHQ, LLC, is a 2022 Becker's Top 150 Places to Work in Healthcare company. We believe our quality of service begins with our quality of team member. We offer exceptional benefits and working environments to exceptional employees. Position Summary The Ambulatory Surgery Center (ASC) Cardiology Coder is responsible for accurately reviewing,...

Job Type Part-time Description The Coder is responsible for reviewing clinical documentation and assigning accurate CPT, ICD-10, and HCPCS codes for services provided by pediatricians and other healthcare providers at Utah Valley Pediatrics. This role ensures that all coding is compliant with current guidelines and supports timely and accurate billing and reimbursement. Requirements Essential Behaviors and Characteristics: Exhibits a caring, positive, and cheerful attitude; is adaptable, positive and supportive, even during stressful situations. Treats everyone with the utmost respect and courtesy. Recognizes and supports the contributions of others, and shows patience and kindness in helping others as they learn and grow. Speaks positively and respectfully of others. Is honest in all of their dealings. Stays on task and uses time at work to benefit patients, coworkers, providers, and the company as a whole. Their actions reflect positively on Utah Valley...

Team Lead Coder Coding Validation The Team Lead Coder Coding Validation position will have responsibility for supervising a team of Coding Validation analysts or coders. Team Leaders ensure that the work of others meets productivity standards, quality and client guidelines. Primary responsibilities include queue management, work distribution, performance and production optimization, audit planning, coder interactions, training of new hires/existing staff, on appeals support while meeting SLA obligations. The Team Lead goal is to ensure the team audits client data on behalf of our clients, generating high quality payment determinations and displays professional skepticism that enhances the work performed in order to achieve success in position. Responsibilities: Oversee onshore/offshore Coder Coding Validation team(s) in reviewing claims and producing well written appeals consistent with high level of integrity and meeting metrics Provides support needed to review quality...

Coding Validation Coder I Cotiviti has multiple openings for full-time coders. These roles will focus on claims audits for appeals, checking for completeness and accuracy based on coding guidelines. Experience with EandM coding and auditing is preferred. These are full-time remote positions and can be done anywhere within the continental US and will work a traditional day time schedule. Responsibilities: Perform daily audits on provider appeals for completeness and accuracy based on specified coding guidelines to ensure appropriateness for reimbursement. Apply client specific coding guidelines when applicable. Learns new appeal categories as production need requires. Stays current on coding guidelines appropriate to the position. Uses the Cotiviti applications to processes CV appeals to meet both production and accuracy standards. Reviews quality feedback from QA. Submits questions for clarification as needed. Utilizes the 'QA Resolution' process when disagreement...

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...

Abstractor/Coder The University of Chicago Physicians Group (UCPG) team is responsible for the overall management of clinical revenue for physician billing. This includes frontend revenue capture, working of edits and conducting audits for physician education. Ensuring the workflow of charge capture through invoice creation. UCPG is seeking an Abstractor/Coder to work with providers and staff on professional billing and compliance activities. Strong knowledge of evaluation and management coding guidelines and requirements is strongly preferred. This position is eligible for a flexible work arrangement. Responsibilities: Obtain appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses, and physician visits. Analyze denial and rejection reports, and appeal wherever appropriate. Submit charges in a timely manner. Work in collaboration with the Clinical Revenue Supervisor and others, provide guidance to faculty and staff on...

Abstractor/Coder The University of Chicago Physicians Group (UCPG) team is responsible for the overall management of clinical revenue for physician billing. This includes frontend revenue capture, working of edits and conducting audits for physician education. Ensuring the workflow of charge capture through invoice creation. UCPG is seeking an Abstractor/Coder to work with providers and staff on professional billing and compliance activities. Strong knowledge of evaluation and management coding guidelines and requirements is strongly preferred. This position is eligible for a flexible work arrangement. Responsibilities: Obtain appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses, and physician visits. Analyze denial and rejection reports, and appeal wherever appropriate. Submit charges in a timely manner. Work in collaboration with the Clinical Revenue Supervisor and others, provide guidance to faculty and staff on...

A leading healthcare data platform company is seeking an Inpatient Auditing Specialist with 3-5 years of auditing experience in a Trauma Level 1 facility. This remote role involves conducting coding audits, providing coder education, and preparing audit reports. Ideal candidates will have a degree in health information management or nursing, preferably with CCS, RHIT, or RHIA credentials. Additional perks include medical benefits, paid time off, and a stipend for professional education. #J-18808-Ljbffr

A leading data platform company is seeking an Outpatient Auditing Specialist to perform coding audits and provide education. This fully remote role requires 5 or more years of experience in outpatient facility coding and auditing. The ideal candidate will be skilled in coding regulations and have experience with various EMR systems. The position offers competitive pay, benefits including medical and dental, and a supportive work environment focused on professional development. #J-18808-Ljbffr