65 professional coding auditor educator jobs found

Coding Auditor & Provider Educator NAH reserves the right to make hiring decisions based on applicants' state of residence if outside the state of Arizona. NAH currently hires for remote positions in the following states: Alabama Arizona Florida Georgia Idaho Indiana Kansas Michigan Missouri North Carolina Ohio Oklahoma Pennsylvania South Carolina Tennessee Texas Virginia The Coding Auditor & Provider Educator is a critical role responsible for ensuring the accuracy, completeness, and compliance of medical coding (CPT, HCPCS, ICD-10-CM) for professional services. This individual will conduct thorough coding audits, identify areas for improvement in documentation and coding practices, and develop and deliver targeted educational programs to physicians, advanced practice providers (APPs), and clinical staff. The primary goal is to optimize revenue integrity, mitigate compliance risks, and foster a culture of accurate and compliant documentation and...

Job Summary Under the general direction of the Director CDI/Coding or designee, the Medical Records Coder I will improve documentation, data quality and revenue cycle operations. The coder assigns International Classification of Disease system- 10 (ICD), CM, and PCS codes according to AHA - AMA Guidelines, CMS and NGS. Core Job Responsibilities Assign diagnosis and procedure codes, for accurate and timely billing of most appropriate payer Audit charges and establish proper coding in collaboration with providers Initiate and follow up on queries with providers Assist departments with diagnostic and procedural coding Respond to Insurance, compliance and RAC denials Review and assist in the maintenance of coding related policies and procedures Perform other duties as required. Education/Experience Requirements REQUIRED: AS in Health Information Management , a related degree or equivalent experience Knowledge of EMR, Coding Software, and...

Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $60,367.47 - $90,551.20 The Senior Hospital Coder is responsible for performing detailed coding quality audits, scheduled and random, on staff and providing thorough education and feedback, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI. Responsible for monitoring and tracking trends of staff, bringing forward concerns to leadership regarding coding quality and productivity, completes duties as assigned by the Quality Manager. Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. Senior Hospital Coder may be asked to assist with denials work, including researching and writing appeal letters. These individuals are highly skilled and considered experts in medical coding. Essential Duties and...

Medical Record Coder At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments. For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding. Submits daily productivity report to HIM manager by defined deadline. Meets and maintains HIM coding quality and...

Medical Biller Birch Family Services is a leading provider of education, employment, and community support services for individuals with autism and developmental disabilities and their families in New York City. Every year, the organization supports more than 2,000 people across 31 locations in Manhattan, Queens, Brooklyn, and the Bronx. From preschool to graduation, employment, housing, and beyond, Birch Family Services provides fully integrated programs and services to support individuals in achieving their goals across their lifetime. Position Summary: Position will be responsible for assisting with the processing of claims for participants in the agency's Community Service programs and Education Program, assuring that the agency is accurately capturing client and student billing information. In addition, this position will be responsible for assisting in maintaining and reconciling social security funds for the individuals who reside in the agency's residences and any...

Job Description Job Description 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...

Job Description Job Description Benefits: 401(k) Dental insurance Health insurance Paid time off Vision insurance 401(k) matching RECOVRY is seeking a highly organized and detail-oriented Medical Biller to join our healthcare team. The ideal candidate will be responsible for ensuring accurate and timely billing and coding for patient services as well as oversee our billing operations. This role will include administrative patient services. This role is a crucial part of our medical office, and we are looking for someone who is passionate about providing excellent patient care while also ensuring the financial well-being of our organization. Duties: Utilize medical coding skills to assign accurate ICD-10 and CPT codes to patient records and submit claims to insurance companies Verify patient insurance coverage and obtain necessary authorizations for services Analyze and resolve billing discrepancies and denials in a timely and efficient manner Maintain accurate...

Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a 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 works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. If you live...

Physician Coding Auditor This is a full-time, remote position that offers a flexible schedule. Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare, Medicaid, and third-party payer guidelines to ensure receipt of accurate reimbursement. Physician Coding Auditor is expected to adhere to MedKoder's internal coding/auditing policies and expectations set forth by department management. Physician Coding Auditor must prioritize daily duties, communicate effectively, and make the decisions necessary to complete all assigned tasks and accomplish their goals. Candidates ideally have recent auditing experience specializing in some of the following profee areas: Ophthalmology, Behavioral Health, Cardiovascular/Cardiothoracic Surgery, Complex ENT Surgery, Dental, Complex Plastic Surgery, Orthopedic Surgery, Peds...

Podiatry Coder Salary Range: $21.00 - $35.64 Hourly Position Type: Full Time Job Shift: Day Education Level: High School Travel Percentage: None Coder, Podiatry Job Summary The Podiatry Coder is responsible for reviewing, interpreting, and assigning accurate CPT, ICD-10-CM, and HCPCS codes specific to podiatric services, while ensuring compliance with federal regulations, payer policies, and organizational standards. This role reviews provider documentation and operative reports for podiatry-related proceduresincluding office visits, surgical procedures, wound care, and ancillary servicesto abstract and code clinical data using standard classification systems. Duties and Responsibilities Demonstrate our core values of being patient centered, team focused, service driven, accountable, and innovative every day. Review and audit physician documentation and surgical reports to accurately assign diagnosis and procedure codes for orthopedic services, including office...

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 Summary: Position Summary: Under the direction of the Compliance Officer the main duties for this position include: analysis of professional coding and billing data, review of applicable regulations or guidelines and professional coding and billing audits. Duties/Responsibilities: Analysis of coding and billing data, identification of trends and aberrations. Performance of routine and investigatory audits evaluating compliance with applicable laws, regulations, coding, and billing guidelines. Interpretation of coding, billing, and regulatory standards. Preparation and completion of audit reports including recommendations, education and corrective action. Knowledge, Skills and Abilities: Strong computer skills specifically Microsoft word and Microsoft excel applications. Strong analytical, problem-solving and time management skills. Expertise in report writing and oral communications. Ability to interpret regulations, payment and reimbursement systems, billing and coding...

Physician Compliance Auditor Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal...

divh2Coder Quality Auditor/h2pThe Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and 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 and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties./ppJob Responsibilities:/pulliQuality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess...

divh2Inpatient/DRG Validation Coding Auditor/h2pThe Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations./ppHas an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems./ppConducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding,...

Experienced Medical Compliance Auditor Compliance Auditor - Hybrid position- Chappaqua, NY- $100K-$115K Are you passionate about healthcare compliance and eager to make a meaningful impact? FlexStaff is seeking a detail-oriented and experienced Compliance Auditor to join our client's dynamic team! This hybrid position offers the perfect blend of in-office collaboration and remote work, all while contributing to an organization committed to excellence in patient care and regulatory adherence. In this pivotal role, you'll leverage your healthcare environment experience-whether as a Certified Professional Coder or similar professional-to audit and monitor clinical records, ensuring accuracy, completeness, and compliance. Your expertise with medical terminology, coding, and documentation will support our mission to uphold the highest standards of integrity and ethical practice. You'll conduct anesthesia chart reviews, identify billing and coding discrepancies, and communicate...

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...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217* Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical diagnoses and clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements. Trains, instructs and provides technical support...

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,...

This position follows a hybrid model with 1-2 onsite days. Job Description Conducts concurrent and occasionally onsite medical chart reviews for pediatric and neonatal ICU patients. Collaborates with medical directors and staff to enhance the quality of physician documentation, ensuring a precise representation of the patients' severity of illness, anticipated risk of mortality, and the complexity of care administered. Ensures the accuracy, completeness, and compliance of medical coding and documentation for all pediatric patient encounters. Strives to optimize coding practices, minimize denials, and maintain the highest standards of data integrity. Job Responsibilities Analyzes and interprets complex pediatric medical records to ensure accurate capture and coding of diagnoses, procedures, and appropriate levels of service, adhering to established coding guidelines (ICD-10-CM, CPT, HCPCS). Applies advanced knowledge of pediatric anatomy, physiology, and medical terminology to...

Req Number 177189 Job Description Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibilities 1.Leverages clinical expertise to identify and validate DRG code assignment. 2.Full review of CDI suggested code changes 3.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. 4.Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules and regulations to the validation review process. 6.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to the coding and CDI staff. 8.Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State...

Description JOB SUMMARY: Responsible for accurate coding and billing of provider office, inpatient and outpatient charges to ensure coding and billing compliance is maintained. Maintains an extensive knowledge of CPT Procedural Coding, ICD-10 Diagnosis Coding and HCPCS Level II coding along with Evaluation and Management (E&M) documentation requirements. Duties & Responsibilities Responsible for reviewing and submitting charges from the coding workqueues (WQ). Manually enters off-premise charges in Charge Review. If applicable, manually enters in-house charges for certain Specialty areas as designated. Ability to code for many different Specialties as assigned. Provides cross-coverage in the department as needed and directed by the Coding and Compliance Manager /Data Collection Team Leader. Arrives the Surgery Schedule on a daily basis using the DAR function. Checks each patient in to create the visit number. Reviews and processes re-submits. Works closely with the...

Professional Coder page is loaded## Professional Coderlocations: 22 New Scotland Avenue Albany, NY 12208time type: Part timeposted on: Posted Todayjob requisition id: 68228Department/Unit:Health Information ManagementWork Shift:Day (United States of America)Salary Range:$55,895.80 - $83,843.71The Professional Coder will review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 DX codes. This position is remote.**Essential Duties and Responsibilities*** Effectively reviews, analyzes, and validates CPT, ICD-10 diagnosis codes, HCPCS, modifiers and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines.* Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes.* Understands National Correct Coding Initiative (NCCI) edits...

Overview Employer Industry: Healthcare Services Why consider this job opportunity: Estimated pay range of $26.13 - $33.97 per hour, depending on experience Opportunity for career advancement and growth within the organization Supportive and collaborative work environment focused on quality care Chance to make a positive impact on coding compliance and education for healthcare providers Work with a renowned healthcare organization recognized for excellence in patient care What to Expect (Job Responsibilities) Perform comprehensive audits to assess the integrity of coding and billing for physician and clinical fees Identify and correct documentation, coding, and billing errors as well as evaluate medical necessity of services billed Develop and execute educational opportunities and resources based on audit results and coding compliance trends Lead provider education events to discuss audit results and implement action plans Establish positive working relationships as a subject...