25 professional coding auditor and educator jobs found

Join to apply for the Professional Billing Coder II role at Onvida Health 2 days ago Be among the first 25 applicants Join to apply for the Professional Billing Coder II role at Onvida Health Get AI-powered advice on this job and more exclusive features. Job Description Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Job Description Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Days Pay Rate Type: Hourly Location: Remote Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $22.62 Mid = $28.28 Max = $33.93 Summary The Professional Billing Coder II is an intermediate-level coding professional responsible for independently reviewing medical documentation and...

ED / Observation Coder (Full Time) Unlock your potential for professional development! We are hiring an ED / Observation Coder to join our Imaging Services Team! Located in northwest Arizona, Kingman has a mild climate with stunning Arizona sunsets! In the shadows of beautiful mountain ranges and nearby lakes, Kingman is an outdoor enthusiasts' paradise with abundant sunshine and is a great community to live, work and play! Position Purpose: All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI's vision to be among the kindest, highest quality health systems in the country. The ED / Observation Coder oversees assigned departments' charging through software systems. Benefits (Full Time Employees): We offer you an excellent total compensation package, including a competitive salary, comprehensive benefits, and growth opportunities: Exceptional Colleagues Join us and you'll be a part of a culture where we support...

Lead Medical CoderThe Lead Medical Coder serves as a certified professional coder and assists the Medical Coding Office Manager with oversight of daily coding operations. Performs the full range of coding, assigns ICD, CPT, HCPCS, and medical inpatient codes; abstracts data from the record; performs chart analysis, research coding issues; peer reviews; and serves as a medical documentation and coding technical expert to TONHC providers.Scope of Work: This position is located within Tohono O'odham Nation Health Care (TONHC). The work involves performing specialized medical record tasks and resolving problems using established processes, coding conventions, and guidelines. Performance of duties reflects directly on patient care by recording services performed on the patient. The incumbent works independently under the general supervision of the Supervisor or designee.Essential Duties and Responsibilities: (Depending on the area of assignment, an incumbent may not be required to...

Clinical Fraud Audit Specialist - Remote Arizona HealthCare Support is actively seeking a Clinical Fraud Audit Specialist - Remote Arizona to fill an opening in Phoenix , Arizona . Daily Responsibilities for Clinical Fraud Audit Specialist - Remote Arizona: Conduct in-depth clinical and claims reviews using benefit plans, medical policies, claims systems, member enrollment information, provider contracts, and other relevant resources. Analyze claims and determine appropriate resolution in accordance with department policies and applicable state and federal requirements. Identify and monitor claims trends that may indicate educational opportunities, policy or guideline updates, referrals, or potential fraud, waste, and abuse. Monday to Friday 8AM - 5PM Required Qualifications for Clinical Fraud Audit Specialist - Remote Arizona: 1-2 years of related medical coding, auditing, or clinical experience. Associate degree, post-high-school nursing...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Surgery HIM CoderWe are seeking a highly detail-oriented and experienced Surgery HIM Coder to join our Health Information Management team. This position is responsible for reviewing, analyzing, and accurately assigning ICD-10-CM, CPT, and HCPCS codes for surgical procedures based on clinical documentation in the patient medical record. The Surgery Coder ensures coding compliance with federal regulations and internal policies to optimize reimbursement and ensure data integrity.This is a remote position with a 4 day on-site work rotation, every 6-7 weeks.Essential Job DutiesReview operative reports, physician documentation, and other clinical records to assign accurate and complete ICD-10-CM, CPT, and HCPCS codes.Abstract relevant information from medical records into the health information system.Ensure compliance with all coding guidelines (AAPC, AHIMA, CMS, and payer-specific).Query physicians when documentation is unclear, conflicting, or incomplete.Meet productivity and accuracy...

Medical Coding SupervisorWickenburg Community Hospital is a beautiful and sophisticated rural-access hospital located in Wickenburg, Arizona. WCH is a 8-bed Emergency Department, 19-bed Acute department and many ancillary services. We also have 3 Primary Care Clinics. Here at WCH, we strive to maintain the highest standards of professionalism and care. Join us today and let us be part of your success story.We offer:Full BenefitsPTO/Sick LeaveWellness BenefitsWickenburg Community Hospital is a non-profit organization and qualifies for the Public Service Loan Forgiveness (PSLF) program.General DescriptionThe Medical Coding Supervisor oversees daily operations of the coding staff in the HIM Dept which includes coding, auditing, peer review, chart review, charge capture, documentation improvement and compliance. Ensures efficient and effective department operations by managing employee relations as well as guiding and coaching staff to achieve operational goals in all areas of the...

LOCATION: WICKENBURG, AZ Wickenburg Community Hospital is a beautiful and sophisticated rural-access hospital located in Wickenburg, Arizona. WCH is a 8-bed Emergency Department, 19-bed Acute department and many ancillary services. We also have 3 Primary Care Clinics. Here at WCH, we strive to maintain the highest standards of professionalism and care. Join us today and let us be part of your success story. We offer: Full Benefits PTO/Sick Leave Wellness Benefits Wickenburg Community Hospital is a non-profit organization and qualifies for the Public Service Loan Forgiveness (PSLF) program. GENERAL DESCRIPTION The Medical Coding Supervisor oversees daily operations of the coding staff in the HIM Dept which includes coding, auditing, peer review, chart review, charge capture, documentation improvement and compliance. Ensures efficient and effective department operations by managing employee relations as well as guiding and coaching staff to achieve...

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions. At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements: Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week Hybrid 2 (Operational Roles such as but not limited to: Customer Service,...

ED / Observation Coder (Full Time)Unlock your potential for professional development! We are hiring an ED / Observation Coder to join our Imaging Services Team!Located in northwest Arizona, Kingman has a mild climate with stunning Arizona sunsets! In the shadows of beautiful mountain ranges and nearby lakes, Kingman is an outdoor enthusiasts' paradise with abundant sunshine and is a great community to live, work and play!Position Purpose:All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI's vision to be among the kindest, highest quality health systems in the country. The ED / Observation Coder oversees assigned departments' charging through software systems.Benefits (Full Time Employees):We offer you an excellent total compensation package, including a competitive salary, comprehensive benefits, and growth opportunities:Exceptional Colleagues Join us and you'll be a part of a culture where we support each other and celebrate...

Specialist - Concurrent Coding / Inpatient Coder Full-time Company Description Accounting and Finance/Healthcare Job Description Specialist-Concurrent Coding/Inpatient Scottsdale Arizona 85258 Exp 2-5 Degree Associates Job Summary: The Concurrent Coding Specialist performs and facilitates concurrent inpatient coding in order to establish a working DRG. Ensures high quality documentation that is thorough, accurate and complete to ensure accurate reimbursement capture. He or she will concurrently reviews health records, identifies key clinical data elements within the record, and translate this data from verbal description of disease, injuries and procedures into numerical designations, applying ICD coding systems. Audits for documentation opportunities and queries clinical staff with CDI to fill in any gaps, clarify confusing, incomplete or conflicting information and obtain any needed additional documentation in real time. Ensures coding compliance and acts as...

Specialist - Concurrent Coding / Inpatient CoderFull-timeCompany DescriptionAccounting and Finance/HealthcareJob DescriptionSpecialist-Concurrent Coding/Inpatient Scottsdale Arizona 85258Exp 2-5Degree AssociatesJob Summary: The Concurrent Coding Specialist performs and facilitates concurrent inpatient coding in order to establish a working DRG. Ensures high quality documentation that is thorough, accurate and complete to ensure accurate reimbursement capture. He or she will concurrently reviews health records, identifies key clinical data elements within the record, and translate this data from verbal description of disease, injuries and procedures into numerical designations, applying ICD coding systems. Audits for documentation opportunities and queries clinical staff with CDI to fill in any gaps, clarify confusing, incomplete or conflicting information and obtain any needed additional documentation in real time. Ensures coding compliance and acts as technical resource, resolves...

Surgery HIM Coder We are seeking a highly detail-oriented and experienced Surgery HIM Coder to join our Health Information Management team. This position is responsible for reviewing, analyzing, and accurately assigning ICD-10-CM, CPT, and HCPCS codes for surgical procedures based on clinical documentation in the patient medical record. The Surgery Coder ensures coding compliance with federal regulations and internal policies to optimize reimbursement and ensure data integrity. This is a remote position with a 4 day on-site work rotation, every 6-7 weeks. Essential Job Duties Review operative reports, physician documentation, and other clinical records to assign accurate and complete ICD-10-CM, CPT, and HCPCS codes. Abstract relevant information from medical records into the health information system. Ensure compliance with all coding guidelines (AAPC, AHIMA, CMS, and payer-specific). Query physicians when documentation is unclear, conflicting, or incomplete....

*Risk Adjustment Coding Auditor* Overview We are seeking a detail-oriented *Risk Adjustment Coding Auditor* to support the accuracy, integrity, and compliance of clinical coding data across risk adjustment programs. In this role, you will conduct audits, review medical record documentation, identify coding opportunities, and provide guidance on coding accuracy to help support compliant reporting and appropriate reimbursement. The ideal candidate will bring extensive HCC coding and risk adjustment auditing experience, strong analytical skills, and a thorough understanding of Medicare, Medicaid, and ACA risk adjustment models. Key Responsibilities * Perform retrospective and prospective chart reviews to evaluate risk adjustment diagnosis coding accuracy. * Audit medical records to verify the completeness, specificity, and appropriateness of reported diagnoses. * Review clinical documentation to ensure accurate HCC capture and risk adjustment reporting. * Evaluate coding practices...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level. Job...

Audits charts and revies clinical records ensuring all diagnostic and procedural codes and modifiers strictly adhere Identifies trends in improper coding or other communication shortcomings that may lead to claim denials or audits Complies with all medical coding guidelines and monitors evolving regulatory and industry changes Provides targeted education, direct coaching, and facilitates training programs tailored to each medica specialty upon translating audit findings Follows up and clarifies any information that i s not clear with the rendering provider Collaborates with IT and EHR teams to improve charge automation and optimize workflows Conducts ad-hoc audits to ensure fidelity to coding guidelines Relevant expert for Southwest Network on accurate and efficient coding practices Analyze medical records and identify documentation deficiencies Nonessential Functions Follows policies and procedures and adheres to the requirements of the Corporate Compliance Program Ensures...

Quality Assurance Coder/AuditorThe Quality Assurance Coder/Auditor will develop a risk mitigation and provider education program. On a regular basis, Coder/Auditor will educate primary care providers and their staff on their historical diagnoses/coding error trends, accurate completion of medical record documentation, and at-risk code identification and risk mitigation. This includes the review, analysis, and recommended coding based on medical and clinical diagnoses, procedures, injuries, or illnesses contained in medical records and supporting documentation.The Quality Assurance Coder/Auditor will perform risk mitigation analysis using available vendor tools to identify at-risk single occurrence of HCCs and OIG targets. Deletions will be submitted for unsupported/invalid diagnoses. This analysis combined with QA findings and EDPS claims errors will drive the content and audience for provider education.The Quality Assurance Coder/Auditor will perform medical record reviews and...

Under general supervision of the HIM Director, the Certified Inpatient Coder is responsible for reviewing inpatient medical records and accurately assigning ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and MS-DRGs in accordance with official coding guidelines, federal regulations, and Tribal 638 facility policies. Upholds the principles of WIHCC's Vision, Mission, and Value Statements. Maintains confidentiality of all privileged information at all times. This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all-inclusive. Essential Duties & Responsibilities: Maintains regular attendance and punctuality. Review inpatient medical records to identify all diagnoses and procedures relevant to each patient encounter. Assign ICD-10-CM and ICD-10-PCS codes according to official coding guidelines. Determine and assign the appropriate MS-DRG. Ensure coding reflects the highest level of specificity...

Job Title Essential Functions: Audits charts and reviews clinical records ensuring all diagnostic and procedural codes and modifiers strictly adhere Identifies trends in improper coding or other communication shortcomings that may lead to claim denials or audits Complies with all medical coding guidelines and monitors evolving regulatory and industry changes Provides targeted education, direct coaching, and facilitates training programs tailored to each medical specialty upon translating audit findings Follows up and clarifies any information that is not clear with the rendering provider Collaborates with IT and EHR teams to improve charge automation and optimize workflows Conducts ad-hoc audits to ensure fidelity to coding guidelines Relevant expert for Southwest Network on accurate and efficient coding practices Analyze medical records and identify documentation deficiencies Nonessential Functions: Follows policies and procedures and adheres to the...

Datavant, the data collaboration platform trusted for healthcare, is hiring a Profee Auditing & Education Specialist to lead professional fee coding audits, provide rationale for changes, and deliver coder education programs remotely. You will organize multiple cases, identify coding trends, develop educational content, and collaborate with leadership and clients to maintain reference tools while upholding coding ethics. #J-18808-Ljbffr

Audits charts and revies clinical records ensuring all diagnostic and procedural codes and modifiers strictly adhere Identifies trends in improper coding or other communication shortcomings that may lead to claim denials or audits Complies with all medical coding guidelines and monitors evolving regulatory and industry changes Provides targeted education, direct coaching, and facilitates training programs tailored to each medica specialty upon translating audit findings Follows up and clarifies any information that i s not clear with the rendering provider Collaborates with IT and EHR teams to improve charge automation and optimize workflows Conducts ad-hoc audits to ensure fidelity to coding guidelines Relevant expert for Southwest Network on accurate and efficient coding practices Analyze medical records and identify documentation deficiencies Nonessential Functions Follows policies and procedures and adheres to the requirements of the Corporate Compliance Program Ensures...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2814 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced...

Blue Cross Blue Shield of Arizona is seeking a Quality Assurance Coder/Auditor to develop risk mitigation and provider education programs. On a regular basis, you will educate primary care providers and their staff on diagnoses, coding accuracy, and risk mitigation based on medical records and documentation. The role requires in-depth knowledge of HCC coding, Medicare guidelines, and the ability to perform QA audits and deliver corrective actions. #J-18808-Ljbffr

Specialist - Concurrent Coding / Inpatient CoderAccounting and Finance/HealthcareJob DescriptionSpecialist-Concurrent Coding/Inpatient Scottsdale Arizona 85258Exp 2-5Degree AssociatesJob Summary:The Concurrent Coding Specialist performs and facilitates concurrent inpatient coding in order to establish a working DRG. Ensures high quality documentation that is thorough, accurate and complete to ensure accurate reimbursement capture. He or she will concurrently reviews health records, identifies key clinical data elements within the record, and translate this data from verbal description of disease, injuries and procedures into numerical designations, applying ICD coding systems. Audits for documentation opportunities and queries clinical staff with CDI to fill in any gaps, clarify confusing, incomplete or conflicting information and obtain any needed additional documentation in real time. Ensures coding compliance and acts as technical resource, resolves issues, educates and works...