22 professional coding auditor educator jobs found

Position Title and Code Professional Services Certified Coding Reviewer Position Code: Coder-8125 Department and Reporting Department: Health Information Management Reports to: HIM Director/Manager Safety Sensitive: YES Exempt Status: NO 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. Key Responsibilities Ensures data quality in compliance with State, Federal and regulatory requirements Evaluates medical record documentation and charge reports to ensure completeness, accuracy and compliance with the Correct Coding Initiative Edits Coded all professional charges to ensure accurate and timely billing Perform coding reviews and/or surgical coding for practices and providers Evaluates and report audit findings or reviews and reports on results to physicians and/or operations directors Provides technical guidance, training,...

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...

Physician Coding Auditor Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! 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....

Medical Coder Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting. We are seeking an experienced Medical Coder to join our healthcare consulting practice. The role is fully remote within the US, with infrequent travel to client locations for onboarding and training. We are proud of our national presence, and excited to offer great career opportunities within the organization. What you'll do: Accurately assign ICD-10 CM, E/M, ICD-10 PCS, CPT, HCPCS, modifiers and units based on documentation. Adhere to systems and standards required in multi-specialty medical coding encounters, including Outpatient, Emergency Room, Surgery, Inpatient facilities, Inpatient Professional Rounds, and others. Process encounters within required SLA on contract with deficiencies identified escalated as necessary. Review and respond to each audit within set...

Job Description Job Description Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas....

Health Plan Compliance Auditor page is loaded## Health Plan Compliance Auditorlocations: Banner Health Corp Phoenix (2901 N Central Ave)time type: Full timeposted on: Posted Yesterdayjob requisition id: R4426945**Primary City/State:**Phoenix, Arizona**Department Name:**Internal Audit**Work Shift:**Day**Job Category:**General OperationsYou have a place in the health care industry. At Banner Health, caring for people is at the core of all we do. We are committed to fostering a strong, inclusive culture where every team member feels valued and supported. If that sounds like something you want to be a part of - apply today!In this role you will support compliance oversight regarding Banner Health Plans and Networks. Key responsibilities include investigating issues, performing risk-based regulatory compliance audits, preparing audit reports, and evaluating documentation supporting remediation of compliance action plans.**This position is hybrid for candidates residing in...

A health data exchange leader is seeking an Inpatient Auditing Specialist to perform coding audits, provide coder education, and ensure regulatory compliance. This fully remote position allows for flexible scheduling, catering to professionals with over 5 years of inpatient coding experience. Candidates should hold certifications like CCS, RHIA, or RHIT and have experience with software such as Epic and Cerner. #J-18808-Ljbffr

Healthcare Coder – Southwest Network This position requires a candidate who can accurately code healthcare services in compliance with government and insurance regulations, maintain confidentiality, and work efficiently with electronic medical record systems. Essential Functions Assigns codes correctly and sequences them according to regulatory guidelines. Complies with all medical coding guidelines. Follows up and clarifies any unclear information with providers. Conducts ad‑hoc audits to ensure fidelity to coding guidelines. Serves as a subject‑matter expert for accurate and efficient coding practices. Analyzes medical records and identifies documentation deficiencies. Nonessential Functions Follows policies and procedures and adheres to the Corporate Compliance Program. Maintains confidentiality of verbal and written information per HIPAA standards and Southwest Network policy. Performs other duties as assigned. Education, Experience & Certifications Associate degree...

Join to apply for the Medical Billing Specialist role at Integrated Medical Services (IMS) 3 weeks ago Be among the first 25 applicants Join to apply for the Medical Billing Specialist role at Integrated Medical Services (IMS) Get AI-powered advice on this job and more exclusive features. Headquartered in Phoenix, IMS is a team of 500 employees and a physician-led organization united through its providers’ commitment to high-quality innovative health care. Each day is a new day for ground-breaking ideas and unparalleled opportunity. Ours is a culture focused on what we can accomplish today, and where it can lead us tomorrow. IMS is searching for a professional, compassionate and knowledgeable individual to fill an approximately 6–9-month Medical Billing position. The Billing Specialist is accountable for processing medical claim information through data-entry in the Electronic Medical Record (EMR), researching, and correcting data entry errors. This position uses knowledge...

You will be able to work from your home location within the United States PURPOSE AND SCOPE: Conducts data quality audits of outpatient encounters to validate coding assignment is in compliance with the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. Provides feedback and education to coders. Escalates compliance, risk-related issues to expedite mitigation. PRINCIPAL DUTIES AND RESPONSIBILITIES: Consults facility leaders and staff on best practices, methodology, and tools for accurately coding. Chart Analysis, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA/AAPC). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to...

Risk Adjustment Coder Specialist Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for...

Datavant is a leading data platform company revolutionizing health data exchange. Our mission is to ensure that every healthcare decision is made with the right data, delivered timely and in the appropriate format. Powered by the most extensive health data network in the U.S., our platform guarantees secure, accessible, and usable data to enhance health decisions. We are proud to be trusted by the foremost life sciences organizations, government bodies, and healthcare providers. By joining our team, you will be part of a high-performing and values-driven culture. Together, we are addressing some of healthcare's most challenging issues with innovative technology solutions. We embrace a diverse array of professional and personal experiences among our team members as we pursue our ambitious goals for healthcare. What We're Seeking We are on the lookout for seasoned and certified inpatient coders to join our team. The perfect candidate will have exceptional attention to...

Medical Coding Auditor Become a part of our caring community and help us put health first. 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...

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 assigning accurate diagnostic and...

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 assigning accurate diagnostic and procedural codes for outpatient and professional services. This role requires advanced knowledge of coding guidelines and payer‑specific requirements to support correct billing, compliance, and optimal reimbursement. The PB Coder II works with minimal supervision and may assist with training or mentoring entry‑level coders. Responsibilities Review and interpret...

As a member of the care team, the Certified Coder is responsible for working collaboratively with other team members to assure the safe, timely and accurate delivery of patient care. The Certified Coder is responsible for accurate and timely coding of surgeries, consults and E&M visits. Customer Service Operates within the concept of patient focused care Delivers caring, timely service with positive body language Presents good telephone skills Greets patients at every stage of the visit Responds promptly to patient needs requests Responds promptly to Physician and team member requests and inquiries Participates as an active, positive member of the TOI team Certified CoderDuties Reviews all surgery charge slips Works with physicians on procedures and charges Knows how to use ICD-10, CPT, CCI and coding companion books to assign appropriate codes and modifiers Assigns appropriate codes using ICD-10 and CPT Requests details from clinical staff when information is not recorded...

Medix - 3003 North Central [Medical Records Clerk] As a Coder at Medix, you'll: Analyze medical records to assign appropriate codes for billing and insurance purposes; Ensure accuracy and compliance with coding guidelines and regulations; Collaborate with healthcare professionals to clarify diagnoses and procedures; Maintain confidentiality of patient information; Update coding knowledge through continuous education and training; Assist in audits and reviews to improve coding processes and accuracy...Hiring Immediately >>

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.,...

Essential Functions Ensures that codes are assigned correctly and sequenced appropriately as per government and insurance regulations Complies with all medical coding guidelines Follows up and clarifies any information that is not clear with the rendering provider Conducts ad-hoc audits to ensure fidelity to coding guidelines Serves as a relevant expert for Southwest Network on accurate and efficient coding practices Analyzes medical records and identifies documentation deficiencies Nonessential Functions Follows policies and procedures and adheres to the requirements of the Corporate Compliance Program Ensures confidentiality of verbal and written information in accordance with HIPAA standards and Southwest Network policy, and adheres to the legal, ethical, and professional guidelines adopted by Southwest Network Other duties as assigned Working Conditions and Driving Travel between Southwest Network sites as well as in the community is required; must have a registered...

PLEASE NOTE - This position may require temporarily relocation to other TONHC Facilities: Sells Hospital, Santa Rosa Health Center, San Simon Health Center, and San Xavier Health Center. Position Summary: Under general supervision, this position serves as a certified professional coder; performs the full range of coding, assigns ICD, CPT, HCPCS, and medical inpatient codes; abstracts data from the record; perform chart analysis; peer review; 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....

Navajo Preference Employment Act TCRHCC is located within the Navajo Nation and, in accordance with Navajo Nation law and applicable federal law, has implemented a Navajo/Indian Preference in Employment Policy. Pursuant to this Policy, applicants who are enrolled members of the Navajo Nation, Hopi Tribe, and San Juan Southern Paiute Tribe and who meet the necessary qualifications for this position will be given preference in hiring and employment for this position. Applicants who are legally married to an enrolled member of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe, who have resided within the territorial jurisdiction of the Navajo Nation or other federally-recognized American Indian Tribe for at least one continuous year immediately preceding the date of application, and who meet the necessary qualifications for this position will be given secondary preference. Applicants who are enrolled members of any other federally-recognized American Indian Tribe and...

ESSENTIAL FUNCTIONS FOR THIS POSITION • Ensures that codes are assigned correctly and sequenced appropriately as per government and insurance regulations • Complies with all medical coding guidelines • Follows up and clarifies any information that is not clear with the rendering provider • 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 confidentiality of verbal and written information in accordance with HIPAA standards and Southwest Network policy, and adheres to the legal, ethical, and professional guidelines adopted by Southwest Network. • Other duties as assigned. EDUCATION and/or EXPERIENCE, LICENSURE and CERTIFICATION • Associate degree in medical coding or...