22 professional coding auditor educator jobs found

Employment Type Full time Shift Day Shift Description Trinity Health IHA Medical Group is looking for a customer-focused Compliance Coding Auditor-Educator to join our team. In this role, you will serve as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services. Provides professional expertise and education in CPT, ICD and HCC coding. What You'll Do Develops and leads audit projects for medical record integrity. Repots audit results utilizing a standard reporting process. Identifies new errors while performing audits, investigates and assesses root cause. Performs one-on-one Audit meetings and providers for corrective educational guidance. Maintains complete knowledge and complies with all relevant insurance, CPT coding and diagnosis guidelines Provides training for IHA staff and providers on CPT, ICD10 and HCC coding standards and procedures. General Requirements...

POSITION DESCRIPTION :The Compliance Auditor / Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services.Provides professional expertise and education in CPT, ICD and HCC coding.The Compliance Auditor / Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations.This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution.Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance.ESSENTIAL JOB FUNCTIONS :Develops and leads audit projects for medical record integrity, service line or issues-related audits, identifies...

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...

Patient Account Representative (Medical Biller) Jackson, Michigan | Center for Family Health Make a difference in your community—every day. Join a mission-driven team dedicated to Opening the Door to Healthcare for All. What We Offer We provide a comprehensive benefits package designed to support your health, financial well-being, and work-life balance: Medical, Dental & Vision Insurance Flexible Spending Account (FSA) & Health Savings Account (HSA) Employee Assistance Program (EAP) Short-Term & Long-Term Disability Employer-Paid Life Insurance + Voluntary Life Options 403(b) Retirement Plan with 3% employer match after one year Continuing Education Fund Public Service Loan Forgiveness (PSLF) eligibility Generous Paid Time Off 9 Paid Holidays + 1 Personal Holiday Perfect Attendance Bonus (eligible hourly staff) Discounted Jackson YMCA Membership Your Day-to-Day In this role, you will: Submit and review medical and dental...

Medical Billing SpecialistAdministration - Flint, MI 48502OverviewPosition Type Full Time Education Level High School Category Health CareDescriptionThis position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third-party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities.General responsibilitiesAble to perform accounts receivable collection activities timely and accurately including prioritizing subtasks.Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days.Accurately post all insurance payments by line item.Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely*Collects on outstanding claims from...

Turn clinical work into accurate, fully supported claims — coding, audits, denials and documentation partnership. 02. Genesee County clinics About this role Turn our providers' clinical work into accurate, fully supported claims. You will code, audit, resolve denials, and partner with clinicians to close documentation gaps. We code what is documented and supported — never to a target. Assign and validate ICD-10-CM, CPT, and HCPCS Level II codes and modifiers for primary and urgent care encounters Apply current E/M documentation guidelines and CMS preventive and wellness billing rules Resolve claim edits and NCCI edits; research and appeal coding-related denials Query providers professionally and deliver documentation-improvement feedback and education What you need Active coding certification — CPC or COC (AAPC), or CCS, CCS-P, or CCA (AHIMA) Two or more years of professional-fee coding experience preferred Working knowledge of Medicare, Medicaid, and commercial payor rules EHR and...

Back-End Medical Biller Full-Time, Temp to Hire Opportunity - Onsite Hours: 8 am to 4:30 pm M-F (30-minute lunch) $19-$20 per hour DOE Professional Summary This position is responsible for billing patient services covered by Medicaid, Medicare, and other third-party payers. This position functions as a liaison between patients, third party payers, physicians, clinics, and HCHN staff regarding billing. Works under the direction of the Director of Revenue Cycle Management or designee who assigns diverse billing duties and responsibilities General Responsibilities Able to perform accounts receivable collection activities timely and accurately including prioritizing subtasks Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days Accurately post all insurance payments by line item Communicates practice management system issues with the Billing Supervisor to ensure claims are processed accurately and timely* Collects...

Certified Professional Coder Consultant Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future – we provide the...

Health Information Management Coding Specialist Outpatient The Health Information Management Coding Specialist Outpatient provides timely and accurate clinical and administration data to ensure optimal reimbursement for facility outpatient, ambulatory surgery, observation, recurring accounts to support the facility coding needs. This may include coverage on some Rehab or Skilled Care accounts. Primary patient contact is only social. Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation. Responsibilities Contributes to organization success targets for patient satisfaction. Formulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients, and other department staff members. Adhere to...

Job Opportunity Positions Location: Lansing, MI Job Description General Purpose of Job: Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine Sparrow policies and procedures and maintains required quality and productivity standards....

Positions Location: Lansing, MI Job Description General Purpose of Job :   Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine – Sparrow policies and procedures and maintains required quality and productivity standards....

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in 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 for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

Job Opportunity Job ID:54121 Positions Location: Lansing, MI Job Description General Purpose of Job: Advanced Description: Positions Location: Lansing, MI Job Description General Purpose of Job : Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows...

Description TRIARQ HEALTH Radiation Oncology Coder Location: Remote (U.S.) — we are not currently hiring in Hawaii, Alaska, California, or New York. Employment Type: Full-Time TRIARQ Health is a visionary company that partners with doctors and healthcare professionals to transform their businesses into modern patient centered independent practices. Practices that partner with TRIARQ put the patient first and deliver high-value care with less effort which results in better patient outcomes and private practices that succeed. SUMMARY The Radiation Oncology Coder is responsible for ensuring all services rendered are captured timely, coded accurately, and meet documentation requirements when processed through the EMR and Billing Systems. Demonstrates working knowledge of all facets of role, relevant regulations, and organizational and departmental policies and procedures for Radiation Oncology services. This individual works independently while also collaborating...

Job Title Employment Type: Full time Shift: Day Shift Description Purpose Work Remote Position (Pay Range: $25.0209-$37.5313) Responsible for the data capture, analysis & reporting of data information to assist the Trinity Health leadership team achieve operational efficiency. Responsible for auditing department information, producing reports, & suggesting improvements to processes. Provides knowledge & expertise in the program, services & applications. Note: "patients" refers to patients, clients, residents, participants, customers, members Essential Functions Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes...

Love God. Love People. Serve. At The Salvation Army, we are dedicated to doing the most good. We are... Passionate Our faith gives us a motivation that goes beyond simply doing good. We have a passion for Doing The Most Good for body, soul and spirit. Compassionate Caring for the poor. Feeding the hungry. Sheltering the homeless. Befriending the friendless. Uplifting The Salvation Army is a beacon of hope, a safe harbor. Our founder envisioned those in need saying, "If I could only get to The Salvation Army, they will do something for me." Brave We go into places others prefer to avoid: impoverished neighborhoods, jails/prisons, hospitals and nursing homes, gatherings of people combating addiction and the immediate scene of disasters. Trustworthy To those who want to positively affect their world, The Salvation Army is the charity that maximizes their contributions by using 88 cents of every dollar donated to provide direct services. Our Mission The Salvation Army is a...

Join Stout: Relentless ExcellenceAt Stout, we're dedicated to exceeding expectations in all we do – we call it Relentless Excellence. Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team.Impact You'll MakeContribute to complex healthcare consulting engagements involving coding and billing audits, disputes, claims analysis, investigations, compliance reviews, and litigation support.Deliver accurate, defensible analyses across inpatient and outpatient facilities, ambulatory surgery centers (ASCs), and professional fee services.Identify clinical documentation, coding, billing, reimbursement, contractual, regulatory, and fraud, waste, and abuse risks from provider and payor perspectives.Translate...

Certified Professional Coder ConsultantCome grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding.Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies.Our people are our future – we provide the venue for...

Michigan Health Specialists is recruiting a Medical Coder / Coding and Billing Specialist to convert clinical documentation into accurate, fully supported claims. You will code, audit, resolve denials, and collaborate with clinicians to close documentation gaps. You will assign ICD-10-CM, CPT, and HCPCS codes, apply E/M guidelines, and address CMS preventive billing rules. Epic experience is a plus as you query providers and educate on documentation improvements. #J-18808-Ljbffr

About the role As a Medical Coding Quality Auditor, you will play a critical role in ensuring coding accuracy, compliance, and quality across healthcare records. You will collaborate with coding professionals and physicians to support accurate clinical documentation, regulatory compliance, and operational excellence while maintaining high quality and productivity standards in a remote work environment. In this role, you will: Review medical documentation to accurately assign diagnosis and procedure codes. Communicate with physicians and other healthcare providers to obtain or clarify diagnoses and procedures through the coding query process. Assign accurate codes using electronic encoder applications in accordance with company policies, coding guidelines, and regulatory requirements. Perform peer reviews and quality audits of Health Information Management coding auditors and coders. Prepare and complete reports, audit findings, and other deliverables as requested. Monitor...

Job Description Job Description Description: TRIARQ HEALTH Radiation Oncology Coder Location: Remote (U.S.) — we are not currently hiring in Hawaii, Alaska, California, or New York. Employment Type: Full-Time TRIARQ Health is a visionary company that partners with doctors and healthcare professionals to transform their businesses into modern patient centered independent practices. Practices that partner with TRIARQ put the patient first and deliver high-value care with less effort which results in better patient outcomes and private practices that succeed. SUMMARY The Radiation Oncology Coder is responsible for ensuring all services rendered are captured timely, coded accurately, and meet documentation requirements when processed through the EMR and Billing Systems. Demonstrates working knowledge of all facets of role, relevant regulations, and organizational and departmental policies and procedures for Radiation Oncology services. This individual works...

Job DescriptionJob DescriptionMedical Coding Compliance SpecialistCompensation :Up to $85,000 annually, determined by your experience and qualifications.Job Location :Remote (US)Job Highlights :Work-Life Balance :Monday to Friday schedule for a fulfilling personal and professional life.Competitive Compensation :Be rewarded with a generous salary and benefits package.Career Growth Opportunities :Unlock your potential and advance in your career with our support.Supportive Work Environment :Join a team that values and appreciates your contributions.Comprehensive Training :Enhance your skills and knowledge through our extensive training programs.Compliance and Peace of Mind :Work with confidence knowing that we prioritize compliance with employment laws and regulations.Paid Time Off and Holidays :Enjoy well-deserved time off to relax and recharge.Life Insurance Coverage :Protect your loved ones with our employer-paid life insurance policy.Collaborative Team Environment :Thrive in a...