19 provider coding auditor educator jobs found

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 or...

Coding Auditor Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. POSITION OVERVIEW Coder Certification Required. The Coding Auditor is responsible for determining that ICD-10, CPT-4, and HCPCS coding is supported by the clinical documentation in the medical record as well as validating medical necessity per CMS Local Coverage Determination (LCD). Applies working knowledge of medical terminology, anatomy, CPT-4 and ICD-10 codes and...

Job Details Compliance Auditor Job Description JOB SUMMARY Under general supervision, performs risk-based audits of clinical documentation, coding, and billing records to ensure that documentation supports services billed and complies with applicable regulatory and organizational requirements. This position independently validates documentation and coding compliance, identifies areas of compliance risk, and supports internal audit activities and external audit readiness across hospital-and provider-based settings. This role is outcome-driven and requires the ability to independently manage audit workload, documentation, and deadlines. ESSENTIAL FUNCTIONS • Performs risk-based audits of clinical documentation, physician, technical, and specialty billing and payment records by analyzing medical records, coding records, and health system bills to validate that documentation supports services billed and complies with applicable regulations and guidelines. • Evaluates...

Compliance Auditor Under general supervision, performs risk-based audits of clinical documentation, coding, and billing records to ensure that documentation supports services billed and complies with applicable regulatory and organizational requirements. This position independently validates documentation and coding compliance, identifies areas of compliance risk, and supports internal audit activities and external audit readiness across hospital-and provider-based settings. This role is outcome-driven and requires the ability to independently manage audit workload, documentation, and deadlines. • Performs risk-based audits of clinical documentation, physician, technical, and specialty billing and payment records by analyzing medical records, coding records, and health system bills to validate that documentation supports services billed and complies with applicable regulations and guidelines. • Evaluates the accuracy and appropriateness of coding, billing, and documentation...

Job Details Sr. Coder Job Description REMOTE Sr. Certified Coding Medical Records : Review patient medical records and assign appropriate codes using systems like ICD-10-CM, CPT, and HCPCS for diagnoses and procedures. Claims Processing: Prepare and submit claims to insurance companies, ensuring compliance with regulations and accuracy in coding to facilitate reimbursement. Collaboration: Work closely with healthcare providers, billing specialists, and other staff to clarify documentation and ensure accurate coding practices. Auditing and Compliance: Conduct audits of medical records to ensure coding accuracy and compliance with federal regulations and insurance standards. Training and Support: Provide training and support to healthcare staff on coding practices and documentation requirements. Required Qualifications Certification: Must hold a certification from recognized organizations such as AAPC (CPC) Experience: Typically requires a minimum of 2-3...

Responsibilities Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. To learn more about IPM visit Physician Services - Independence Physician Management - UHS. POSITION OVERVIEW Coder Certification Required .The Coding Auditor is responsible for determining that ICD-10, CPT-4, and HCPCS coding is supported by the clinical documentation in the medical record as well as validating medical necessity per CMS Local Coverage...

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...

Job Title Medical Coding Specialist Job Description Collects, reviews, retrieves and codes Evaluation & Management codes, and major procedures (surgical procedures, anesthesia reports, radiology reports/procedures) and other services for Medicine/Surgical practices, based on data from medical records and reports for quality assessment, audit and billing purposes. Responsibilities Duties and Responsibilities Essential Functions: Performs chart audits, reviewing for accuracy and compliance. Reviews operative reports and other documentation and assigns appropriate diagnosis (ICD-10), procedure codes (CPT-4), and other services (HCPCS) for final billing. Research and process invoice corrections. Reviews and analyzes coding/billing procedures. Presents training and feedback concerning medical coding, compliance, and reimbursement to physicians/providers. Coordinates and implements reimbursement improvement activities with staff and providers. Meets...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

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:...

Coding Auditor The Coding Auditor is responsible for determining that ICD-10, CPT-4, and HCPCS coding is supported by the clinical documentation in the medical record as well as validating medical necessity per CMS Local Coverage Determination (LCD). Applies working knowledge of medical terminology, anatomy, CPT-4 and ICD-10 codes and coding skills/ experience to ensure timely and accurate audits of clinical documentation as requested. Key responsibilities include: Performs accurate and timely review of clinical documentation as requested to ensure that ICD-10, CPT-4 and HCPCs coding is supported by the clinical documentation in the medical record. Meets or exceeds established performance targets (productivity and quality) established by the Manager, Coding. Reviews audit samples following CBO IPM policy and utilizing established protocols, audit tools and worksheets to report accurate and timely findings to the Coding Manager. Meets or exceeds established performance...

Position Overview Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi‑specialty physician networks and urgent care clinics that align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continued growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. Coder Certification Required . The Coding Auditor is responsible for determining that ICD‑10, CPT‑4, and HCPCS coding is supported by the clinical documentation in the medical record as well as validating medical necessity per CMS Local Coverage Determination (LCD). The role applies working knowledge of medical terminology, anatomy, CPT‑4 and ICD‑10 codes and coding...

Independence Physician Management (IPM), a UHS subsidiary, seeks a Coding Auditor to ensure ICD-10, CPT-4 and HCPCS coding is supported by medical records and meets CMS LCD guidelines. The role requires CPC certification, auditing experience, and strong knowledge of coding policies; you will review documentation, educate providers, and support front-end coding accuracy. IPM offers comprehensive benefits and opportunities within a national health system; on-site in Wayne, PA with collaboration #J-18808-Ljbffr

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Wayne Memorial Hospital in Honesdale, PA is seeking a full-time Medical Coder Supervisor to evaluate medical records, assign ICD-10 and CPT codes, and ensure 95% accuracy in coding audits. This role also links clinicians with the coding team and supports the revenue cycle to maximize compliant reimbursement. The supervisor will guide the coding staff, disseminate current guidelines, and provide education on coding practices, using Meditech and 3M systems as needed. #J-18808-Ljbffr

General Summary Collects, reviews, retrieves and codes Evaluation & Management services, Pathology, and minor procedures based on documentation in the medical record and reports for quality assessment, audit, and billing purposes. Duties and Responsibilities Essential Functions: Performs chart audits, reviewing for accuracy and compliance. Reviews operative reports and other documentation and assigns appropriate diagnosis (ICD-10) and procedure codes (CPT) for final billing. Researches and processes invoice corrections. Reviews and analyzes coding/billing procedures. Presents training and feedback concerning medical coding, compliance, and reimbursement to physicians/providers. Coordinates and implements reimbursement improvement activities with staff and providers. Adheres to WellSpan Coding Compliance Guidelines. Common Expectations: Maintains job specific standards and expectations relative to productivity...

Position Overview Compliance Auditor – monitors and improves the quality of clinical and financial documentation related to the provision of patient services. Under general supervision, the Compliance Auditor compares clinical and financial records to ensure documentation supports patient charges, codifies findings, and assists in reporting, monitoring, and education. Responsibilities Performs audits of clinical documentation of physician, technical or specialty (e.g., Home Health, Hospice, Inpatient Rehab) billing and payment records and applicable industry standard billing codes by analyzing medical records, coding records and health system bills, validating clinical documentation in conjunction with the bill; assessing the level and accuracy of coding; determining that governmental and third‑party payer regulations are being complied with; and evaluating appropriateness of billing and coding procedures. Evaluates accuracy of coding and billing performance by individuals,...

Description Full-time - This is not a remote position. Evaluates medical records, provides clinical abstracts and assigns appropriate clinical diagnosis and procedure codes for both inpatient and outpatient services in accordance with nationally recognized coding guidelines. Meets quality standards of having 95% of principal diagnoses and procedures correctly coded. Serves as a liaison between clinicians and the coding staff. Collaborates with all members of the revenue cycle to ensure data quality and optimum reimbursement allowable under the federal and state payment systems. Supervises the coding department in relation to the following: distribution of work assignments, dissemination of current coding guidelines and modern technology information, and provides relevant coding education to the coders, clinicians, and revenue cycle staff. Minimum Requirements Knowledge and understanding of ICD10 and CPT coding principles as recommended by the American Health...