16 professional coding auditor educator jobs found

Overview A Certified Professional Coder (CPC) job description generally involves reviewing patient medical records, abstracting relevant clinical information, and assigning appropriate medical codes using ICD-10, CPT, and HCPCS code sets. CPC responsibilities also include ensuring accurate documentation and coding, facilitating claims processing, and complying with regulatory requirements. Responsibilities Coding and Abstracting: Accurately translate patient encounters into standardized medical codes (ICD-10, CPT, and HCPCS). Documentation Review: Analyze patient records for completeness, accuracy, and compliance with coding guidelines. Reimbursement Analysis: Research and analyze data needs for accurate and timely reimbursement. Auditing and Compliance: Conduct chart audits, identify coding discrepancies, and implement corrective actions. Communication and Collaboration: Communicate effectively with healthcare providers to clarify coding issues and...

Outpatient Coding Compliance Auditor Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Outpatient Coding Compliance Auditor performs audits of outpatient facility (OPPS) coding to ensure accurate assignment of ICD-10-CM diagnoses, CPT/HCPCS codes, modifiers, and facility E/M levels (ACEP or client-specific). This role reviews coding for alignment with medical record documentation and established guidelines, ensuring compliance with applicable laws,...

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...

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:...

Clearview Cancer Institute is north Alabama's leading cancer treatment facility. For over 30 years Clearview Cancer Institute has provided leading-edge treatment and compassionate care to those diagnosed with cancer or blood disorders. Clearview offers every service and amenity needed in an outpatient setting and our dedication to research and involvement in Phase I-IV clinical trials gives our patients the opportunity to receive potentially life‑saving treatment options. Why Join Us? We are looking for talented and highly‑motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve. Job Purpose The purpose of the Certified Professional Coder is to input diagnostic codes for medical services rendered and ensuring that the assigned codes meet required regulations. Essential Job Functions Input appropriate diagnostic codes for various medical services. Ensure that the assigned codes meet all federal, legal,...

Certified Professional Coder Clearview Cancer Institute is north Alabama's leading cancer treatment facility. For over 30 years Clearview Cancer Institute has provided leading-edge treatment and compassionate care to those diagnosed with cancer or blood disorders. Clearview offers every service and amenity needed in an outpatient setting and our dedication to research and involvement in Phase I-IV clinical trials gives our patients the opportunity to receive potentially life-saving treatment options. Job Purpose The purpose of the Certified Professional Coder is to input diagnostic codes for medical services rendered and ensuring that the assigned codes meet required regulations. Essential Job Functions Input appropriate diagnostic codes for various medical services. Make sure the assigned codes meet all federal, legal, and insurance regulations. Assist in monthly evaluations and management audits. Understand and translate physician's diagnosis and treatment plan into...

Overview The Compliance Auditor Provider Liaison is responsible for conducting detailed audits of professional coding and provider documentation across numerous specialties, identifying compliance risks, and promoting best practices through education and feedback. The auditor partners closely with providers, coders, and revenue cycle leadership to ensure alignment with organizational policies, payer requirements, and federal regulations. Qualifications Education: High School diploma or GED required. License: Certified Coder with Auditing Certification with AAPC Experience: Minimum of 5 years of experience in a hospital or professional revenue cycle. Minimum of 5 years coding experience with CPC certification. Minimum of 3 years of coding auditing experience. Broad exposure to multiple specialties such as cardiology, general and specialized surgery, oncology, and primary care/nternal medicine strongly preferred. Deomonstrated experience educating or training providers on...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards....

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:...

Huntsville Hospital Health System is seeking a Compliance Auditor Provider Liaison to conduct detailed audits of professional coding and documentation across specialties. You will identify compliance risks and promote best practices through education and feedback. The role requires collaboration with providers, coders, and revenue cycle leadership to ensure alignment with policies, payer rules, and federal regulations. #J-18808-Ljbffr

Under general supervision of the Director, the Coder II provides consistency and efficiency in outpatient claims processing and data collection to optimize APC reimbursement and facilitate data quality in outpatient services. Reviews, audits, and reports on charge capture. Maintains patient confidentiality at all times. ESSENTIAL JOB FUNCTIONS Analyzes IP, OP, Recurring, & SDC records and appropriately codes per coding guidelines, ICD-10-CM and CPT rules and updates, creating APC or DRG group assignments. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Concurrently codes Recurring records for interim billing. Processes records for deficiencies and return for completion. Enters codes into the Abstracting Module as needed, including use of the 3M encoder. Performs data quality reviews on outpatient encounters to validate the ICD-10-CM, CPT, and HCPCS Level II code and...

Overview The Compliance Auditor Provider Liaison is responsible for conducting detailed audits of professional coding and provider documentation across numerous specialties, identifying compliance risks, and promoting best practices through education and feedback. The auditor partners closely with providers, coders, and revenue cycle leadership to ensure alignment with organizational policies, payer requirements, and federal regulations. Qualifications Education: High School diploma or GED required. License: Certified Coder with Auditing Certification with AAPC Experience: Minimum of 5 years of experience in a hospital or professional revenue cycle. Minimum of 5 years coding experience with CPC certification. Minimum of 3 years of coding auditing experience. Broad exposure to multiple specialties such as cardiology, general and specialized surgery, oncology, and primary care/nternal medicine strongly preferred. Deomonstrated experience educating or training providers on...

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...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

Overview The Compliance Auditor Provider Liaison is responsible for conducting detailed audits of professional coding and provider documentation across numerous specialties, identifying compliance risks, and promoting best practices through education and feedback. The auditor partners closely with providers, coders, and revenue cycle leadership to ensure alignment with organizational policies, payer requirements, and federal regulations. Qualifications Education: High School diploma or GED required. License: Certified Coder with Auditing Certification with AAPC Experience: Minimum of 5 years of experience in a hospital or professional revenue cycle. Minimum of 5 years coding experience with CPC certification. Minimum of 3 years of coding auditing experience. Broad exposure to multiple specialties such as cardiology, general and specialized surgery, oncology, and primary care/nternal medicine strongly preferred. Deomonstrated experience educating or training providers on...

Huntsville Hospital Health System is seeking a Compliance Auditor Provider Liaison to conduct detailed audits of professional coding and documentation across specialties. You will identify compliance risks and promote best practices through education and feedback. The role requires collaboration with providers, coders, and revenue cycle leadership to ensure alignment with policies, payer rules, and federal regulations. #J-18808-Ljbffr