14 provider coding auditor educator jobs found

Become a part of our caring community The 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 Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

Job Summary The Coding Supervisor is responsible for overseeing the daily operations of the coding team, ensuring accurate and compliant coding practices across all clinical departments. This role provides leadership, training, and quality assurance for coding staff, supports provider education, and collaborates with Revenue Cycle and Compliance teams to optimize reimbursement and maintain regulatory compliance. Job Specific Competencies Team Leadership & Oversight Supervises coding staff including Coder I and Coder II. b. Monitors productivity and quality metrics, ensuring standards are met or exceeded. c. Conducts regular team meetings and one-on-one check-ins to support performance and development. Quality Assurance & Compliance Oversees internal/external audits and reviews coding accuracy, documentation, and billing compliance. b. Ensures adherence to federal, state, and payer-specific coding guidelines. c. Coordinates with Compliance and Revenue...

Description Coding Specialist is a nationally certified professional coder who educates and supports Providers, Division Directors/Managers and clinical staff by providing ongoing coding training to ensure adherence to agency regulations. Coders conduct random chart audits and provide direct feedback to providers, investigate and answer provider coding questions, review data/reports and give additional feedback, routinely visit Providence Medical Groups clinics and attend clinical meetings, and stay current with annual updates to CPT, ICD‑10 and HCPCS codes. Required Qualifications Certification from American Academy of Professional Coders (upon hire) Certification from American Health Information Management Association (upon hire) 2 years experience in medical insurance reimbursement, medical billing and coding related to charge review and work RVUs. Experience reviewing patient account information, insurance explanation of benefits, computer screens, and financial records....

Inpatient Medical Coder Company Overview Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG is bidding on a federal contract for several coding positions. You would be a W-2 employee with HPMG, not a government employee. Summary Responsible for assigning accurate ICD codes for diagnoses and procedures. The Medical Severity - Diagnostic Related Group (MS-DRG) is automatically assigned by the grouper software for inpatient stays. Inpatient coders may also assign accurate ICD diagnoses, CPT and HCPCS codes, modifiers, and quantities from medical record documentation for professional services (rounds or IBWA encounters). They train and educate military staff on coding issues and play a significant role in coding compliance activities. Mandatory Knowledge and Skills Excellent computer and communication skills for provider and staff interactions. Knowledge of anatomy/physiology, disease processes, medical terminology,...

Inpatient Facility Medical Coder (OR; WA) Candidates must reside either in Washington or Oregon to be considered for this position. Essential Responsibilities Proficient in medical record review and translating clinical information into coded data. Identify and assign appropriate codes for diagnoses, procedures and other services rendered, while also validating any Computer Assisted Coded (CAC) assignments for dual coding. Utilizing the Code Base Charge Trigger system (CBCT) and OPTUM 360 EncoderPRO software system for professional surgical services, analyzing and maintaining systems accuracy, validity and meaningfulness for both professional and facility services. Utilizes electronic patient data system and clinical information system (EpicCare) to access patient encounter information. Abstracts and enters clinical data elements as defined by the needs of the organization. Identifies and assigns principal diagnosis and procedure codes, sequencing them as needed for proper...

Coding Specialist is a nationally certified professional coder who educates and supports Providers, Division Directors/Managers and clinical staff by providing ongoing coding training to ensure adherence to agency regulations. Coders will conduct random chart audits and provide direct feedback to providers. Coders will be responsible for investigating and answering provider coding questions. Coders will review various data/reports and provide additional feedback. Coders will routinely visit Providence Medical Groups (PMG) clinics and attend clinical meetings. Coders will stay current with annual updates to CPT and ICD-10 and HCPCS codes. Providence caregivers are not simply valued – they’re invaluable. Join our team at Physician Management Group in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications:...

Providence in Spokane, United States is seeking a Coding Specialist to educate providers on coding standards and conduct chart audits. You will also answer coding questions and review financial records. A national certification is required, along with 2 years of experience in medical billing and coding. Join our team focused on whole-person care, where your contributions are valued. We empower our caregivers to provide the best patient care, especially for vulnerable communities. #J-18808-Ljbffr

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. Core Values 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: Benefits may vary based upon position type and/or level. Job Summary The...

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...

Job Summary and Responsibilities As a Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Every day you will accurately translate patients’ medical records into standardized codes for diagnoses and treatments. Using your expertise and training, you will ensure compliance with legal, regulatory, and organizational standards. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time. Abstracts, assigns and sequences ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures as supported by documentation. Assures the final diagnoses and operative procedures as stated by the physician are valid and coded to the highest level of specificity. Abstracts all...

Job Summary And Responsibilities As a Coder II, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Every day you will accurately translate patients’ medical records into standardized codes for diagnoses and treatments. Using your expertise and training, you will ensure compliance with legal, regulatory, and organizational standards. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time. Responsibilities Abstracts, assigns and sequences ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures as supported by documentation. Assures the final diagnoses and operative procedures as stated by the physician are valid and coded to the highest level of...

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

CTHCA Medical Billing Specialist Hot Job Reservation Wide - WA Overview Salary Range $23.08 - $28.12 Hourly Description Closing Date: Open Until Filled with Bi-weekly Reviews Position: CTHCA Medical Billing Specialist (2 Positions) Salary: $23.08 to $28.12 per hour DOE Reports To: Revenue Cycle Supervisor Location: Nespelem Health Center, 6 Month Training in Nespelem, WA, with Possibility of Working in Other Districts Upon Completion of Training. Basic Functions: This is a Non-Exempt Position. Performs Clerical Standard and Procedures of the Medical Billing Office Through Direct Contact with Eligible Programs Using Computer-Aided Data Entry Screens. Qualifications Minimum Qualifications: Education and Training: Requires a High School Diploma or GED Requires 12 Months Billing and Coding Experience with Anatomy and Pathophysiology Training Willing to Obtain a Certified Professional Coder (CPC) Certificate or Certified Professional Biller (CPB)...