65 professional coding auditor educator jobs found

divh2Coding Specialist/h2pResponsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment./ppstrongMinimum Qualifications:/strong/pp1. Graduate of Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience./pp2. Certification in one of the following: RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), COC (Certified Outpatient Coder), CCS...

Professional Coding Auditor And Educator - Remote This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation...

Professional Coding Auditor And Educator - Remote This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation...

divh2Coding Auditor Provider Educator/h2pNAH 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:/pulliAlabama/liliArizona/liliFlorida/liliGeorgia/liliIdaho/liliIndiana/liliKansas/liliMichigan/liliMissouri/liliNorth Carolina/liliOhio/liliOklahoma/liliPennsylvania/liliSouth Carolina/liliTennessee/liliTexas/liliVirginia/li/ulpThe 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...

Position Description Performs medical billing coding and documentation quality audits; provides feedback to coding and reimbursement specialists, coders, and educates them. This job has no supervisory responsibilities. Major/Essential Functions Current and active professional medical billing coding certification required from an accredited organization. Billing and coding experience in a multi-specialty group practice and/or academic practice setting is preferred. Five or more years of health care items/services. Managerial/supervisory and program management implementation experience strongly preferred. Ability to initiate administrative activities as necessary. Excellent oral and written communication skills. Ability to write and present ideas and information in a concise manner. Ability to work collaboratively with all individuals. Professional bearing, sound business judgment and persuasive skills. Strong problem-solving skills, self-starter, ability...

Job Description Job Description Description: Title: Medical Biller & Coder (Cross-Trained in Registration & Education Support) Department: Revenue Cycle / Business Office Reports To: Business Office & Billing Operations Manager FLSA Status: Non-Exempt Location: Rural Critical Access Hospital / Multi-Clinic Health System Position Summary The Medical Biller & Coder is responsible for accurate and compliant coding, charge review, claim preparation, and follow-up to ensure timely reimbursement for hospital and clinic services. This position also plays a critical role in identifying trends, documentation gaps, coding issues, and new regulatory or payer updates—and communicating these findings through staff education. This position works under the direct supervision of the Business Office & Billing Operations Manager, who provides oversight, training, and direction for all billing, coding, registration cross-training, and revenue cycle...

We've learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas®. Job Summary The Healthcare Compliance Billing & Coding Auditor is responsible for performing independent audits of billing and coding practices across hospital departments and clinic providers to ensure compliance with organizational policies, federal and state regulations, and payer requirements. Reports to Chief Compliance Officer Job Specific Responsibilities 1.Conduct comprehensive audits of billing and coding documentation for accuracy and compliance in both hospital and clinic settings. 2.Identify discrepancies, potential compliance risks, and recommend corrective actions. 3.Develop audit reports and present findings to leadership. 4.Stay current with regulatory changes, coding guidelines (ICD-10, CPT, HCPCS), and compliance standards. 5.Collaborate with clinical and administrative teams to implement best...

DHR Health - US:TX:McAllen - Days Summary: POSITION SUMMARY: The Inpatient coder reviews and analyzes documentation in the medical record for inpatient visits to ensure accuracy of diagnosis and procedure codes. Coder finalizes the coding and abstracting of the medical record according to ICD-10-CM/PCS, CPT, and HCPCS coding conventions and guidelines supported by the clinical documentation in the medical record. Coder analyzes diagnosis and procedure codes concurrently assigned by Clinical Documentation Specialists. The Inpatient Coder assumes primary responsibility for DRG validation/accuracy, primary role in assisting CDS and medical staff members with improving quality of clinical documentation. Sequence the diagnoses and procedures using official coding guidelines. Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges. Resolve Inpatient billing edits. Abide by the Standards of Ethical Coding as set...

DHR Health - US:TX:Edinburg - Days Summary: MISSION STATEMENT: Our Mission is to improve the well-being of those we serve with a commitment to excellence: every patient, every encounter, every time. VISION: Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence. POSITION SUMMARY: Under general supervision, analyzes patient medical records to assure that documentation by providers conforms to legal and procedural requirements. Assigns specified codes to medical diagnoses and/or clinical procedures. Interacts with physicians and other providers regarding billing and documentation policies and procedures. Audits medical charts and records for compliance with federal coding regulations and guidelines. Provides a second level review of codes assigned to medical diagnoses and clinical...

Overview $125K Bonus! Monthly and Quarterly Bonus Incentives! Through our evidenced based medicine approach, Concentra's goal is to provide quality patient care while treating everyone with friendliness, skill, and respect. We strive daily to promote a diverse environment of acceptance and compassion for our colleagues and cultivate a welcoming atmosphere where our patients can heal. As we've grown, we've expanded into urgent care, wellness services, administration, onsite health and wellness centers, and telemedicine. All these services together make achieving health easier and more accessible for our patients, clients, colleagues, and all provide you with unmatched support, education, career advancement opportunities, and benefits. The Associate Director of Medical Operations position involves providing direct patient care and leading by example to ensure an exceptional patient experience. The role includes identifying and communicating opportunities for clinical...

Description Summary: Selected by CHRISTUS Health Coding Leadership, to focus coding skills and expertise to foster an environment of teamwork and service excellence mentoring, training, cross training their designated Regional Inpatient or Outpatient Coding team. Coding Lead will work with Coders as a resource to maintain current and high-quality ICD-10-CM, ICD-10-PCS and/or CPT coding for the Inpatient and/or Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Coding Leads will work to ensure Coders abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding and Reporting and AMA CPT Guidelines. Coding Lead will act as a liaison for coding related questions, providing clear and concise written or...

Description Summary: Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs, including but not limited to Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is an on-site position with a remote option. Responsibilities: Perform Medical Record reviews and audits based on organizational priorities. These can include both prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk adjustment....

Division: CHRISTUS Children's Hospital - San Antonio Work Arrangement: Onsite only Location: San Antonio, TX Salary Range: $63,052 to $80,000 FLSA Status: Nonexempt Work Schedule: Monday - Friday, 8 a.m. - 5 p.m. Summary Baylor College of Medicine- CHRISTUS Children's in San Antonio is seeking a highly motivated and competent professional to serve as a Senior Professional Fee Coder with primary responsibilities for managing and supporting the day-to-day functions of the revenue cycle under the direction of the Lead, Revenue Cycle. The candidate must be skilled in performing complex tasks required in healthcare services within the revenue cycle, to include documentation reviews, denial analysis, and educational initiatives but not limited to coding and provider education. The ideal candidate will have strong operational skills and ability to gain the confidence of faculty, staff, leaders, colleagues, etc. Will have experience with revenue integrity and can...

Job Family : Finance & Accounting Consulting Travel Required : Up to 25% Clearance Required : Ability to Obtain Public Trust What You Will Do: Guidehouse is seeking a Revenue Integrity Analyst (Medical Biller) with strong billing, coding, and revenue cycle expertise to support the modernization of MHS GENESIS, the DoD's enterprise EHR. The role ensures accurate billing, compliant charge capture, and efficient claim resolution by analyzing data, auditing documentation, and collaborating with clinical, coding, IT, and financial teams across the Military Health System. Responsibilities of this role are as follows, to include but not limited to: Support and optimize MHS GENESIS revenue cycle configuration, including charge capture workflows, billing rules, and work queues. Validate charge accuracy, coding logic, modifiers, and payer requirements; troubleshoot system and workflow issues. Analyze financial, clinical, and operational...

General Summary: The Coding Educator is responsible for the development, management, and oversight of a comprehensive coding program encompassing all activities of the organization. This position serves as the documentation and coding liaison to clinicians, ensuring compliance with government and organizational policies and procedures. Supervisory Responsibilities: This position has no supervisory responsibilities. General Requirements: All duties performed will be done accurately and in a timely manner. Ensures customer service is always maintained at the highest level. Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. Must always adhere to customer service expectations including in-person and virtual (via telephone, or telehealth applications) communication. English and Spanish proficiency preferred. Strong organizational skills are a requirement in this position. Assist with special projects as needed. Other...

General Summary: This role focuses on the Risk Adjustment process that supports the documentation of acuity diagnoses for the Managed Care (MC) patient population and required activities for submission of records to Medicare Advantage (MA) payers under established capitated contracts. It assists with medical record reviews for HCC diagnoses, correct usage of various coding guidelines (ICD-10-CM, CPT, HCPCS) and federal and MA payor regulations, as well as clinical validation of appropriate supporting documentation. Supervisory Responsibilities: This position has no supervisory responsibilities. General Requirements: All duties performed will be done accurately and in a timely manner. Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy. Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. Must always adhere to customer service expectations including in-person and virtual (via...

Woundlocal is looking for a detail-oriented Medical Coder to join our dynamic team in Austin! Responsibilities: Review and analyze medical documentation to ensure accurate coding and billing processes. Assign appropriate codes for diagnoses, procedures, and services according to the guidelines and regulations. Stay up-to-date with coding standards and insurance requirements, including ICD-10, CPT, and HCPCS coding systems. Collaborate with healthcare providers to clarify documentation and ensure completeness. Identify and resolve discrepancies in medical records and coding for accurate claims processing. Evaluate and re-file appeals of patient claims that were denied. Stay up-to-date on new coding ruleas and code changes. Assist in audits and provide necessary documentation for compliance and quality assurance activities. Collect and distribute coding related information and billing issues to management and provider when changes happen. Provide accurate...

Job Family : Finance & Accounting Consulting Travel Required : Up to 25% Clearance Required : Ability to Obtain Public Trust What You Will Do: The Revenue Integrity Analyst (Medical Coding) supports accurate documentation, compliant coding, and optimized charge capture within MHS GENESIS, the Military Health System's enterprise EHR. The role ensures correct configuration of revenue cycle workflows and reduces revenue leakage through data analysis, system support, and cross-functional collaboration. Responsibilities of this role are as follows, to include but not limited to: System Configuration & Support: Validate and troubleshoot MHS GENESIS revenue cycle build, including coding workflows, charge capture, charge router logic, and billing integrations. Ensure accurate mapping of CPT, ICD-10, HCPCS, modifiers, and charge codes. Data Analysis: Analyze clinical and financial data to identify coding variances, charge gaps, and revenue...

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...

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. While your daily work will be...

Be Part of an Extraordinary Team Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. Build the Possibilities. Make an Extraordinary Impact. Title : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **Virtual: ** _ _ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates...

JOB SUMMARY Support and provide coding and compliance training to clinical personnel, billing, and/or other client staff. Establish effective communication with clinical staff, and/or hospital staff to address documentation, coding, and reimbursement issues. Use knowledge of coding and compliance guidelines to identify potential billing / reimbursement issues. Participate in special audits and system administration as necessary. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Performs diagnosis data submissions to Client, Vendors and internal Stakeholders Develop monthly productivity and revenue projections Responsible for chart assignment oversight and monitoring accounts on hold Prepares data collection reports for leadership Monitors diagnosis submission progress; Audit diagnosis submission files to ensure accuracy Reviews, analyzes and oversight of prebill/post bill reviews and pending accounts Works to resolve...

Location: Medical Center - Fort Worth Department: HIM-Coding Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: The HIM Coder Analyst III requires superior knowledge of and skill in applying International Classification of Diseases and Procedures (ICD), and Current Procedural Terminology (CPT) code sets and associated Medicare/Medicaid rules and guidelines. Reviews and interprets patient medical record documentation to identify pertinent diagnoses and procedures and assigns ICD-9-CM, ICD-10-CM/PCS and CPT 4 codes accurately and timely to the highest level of specificity based upon physician documentation for inpatient, observation and outpatient ambulatory procedures/treatment room records. Validates the coded data to one or more Diagnosis Related Groupers (DRG) validates the Present on Admission (POA) indicators for accuracy. Primarily codes more complex and difficult inpatient medical records. Identifies and abstracts specified...