17 provider coding auditor educator jobs found

Job Opportunity at SSM Health St. Mary's Hospital - Madison It's more than a career, it's a calling. Worker Type: Regular Job Highlights: Monday to Friday, 8:00 to 4:30 (flexible), full-time (.9/36 hours). This is a new role supporting imaging and procedure lab charges and charge reconciliation. The individual will help define and build the role. The position supports St. Mary's and the WI region as needed. Job Summary Supports assigned department(s) as a subject matter expert for achieving operational efficiency, compliance, and exceptional patient care. Serves as a liaison between and resource for clinical and Revenue/Financial departments with strong understanding of both components. Job Responsibilities and Requirements PRIMARY RESPONSIBILITIES Serves as a resource and subject matter expert to the department for workflows, documentation, coding, charging, and software applications. Manages all work queues using subject matter expertise to investigate/correct errors...

Supervisor Of Waukesha Memorial Hospital Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. This position is the evening & overnight Supervisor of Waukesha Memorial Hospital. The position is full-time, Monday - Friday, primarily covering the evening shift 3:00pm-11:00pm, and overnight shift 11:00pm - 7:00am. Our office is located at 725 American Ave, Waukesha, WI Primary Responsibilities: Investigates, resolves, and documents patient,...

At Suvida Healthcare, we are not just caregivers; we’re compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well‑being of an underserved community and their families. Our multi‑disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare‑eligible Hispanic seniors. Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service‑centered, and more compassionate healthcare family and Employer of Choice! Will you join us Suvidanos , to help achieve our Higher Purpose? What Makes Us Unique We are an empowered...

Job Description Job Description The PB Coder is responsible for reviewing, analyzing, and accurately coding ambulatory and/or hospital-based encounters. This role performs initial charge review for E/M visits, diagnostic tests, and procedures across multiple specialty departments to determine the appropriate assignment of CPT, ICD-10, HCPCS codes, and modifiers for reporting physician services to third-party payers. The PB Coder ensures all coding aligns with established coding standards, regulatory requirements, and reimbursement policies. Essential Duties and Responsibilities: Analyzes provider documentation to assure appropriate Evaluation & Management (E/M) levels are assigned using the correct CPT and current Evaluation and Management Guidelines Analyzes provider documentation to assure that appropriate CPT codes are assigned for surgeries and other diagnostic procedures. Ensures that all coding aligns with coding standards, regulatory requirements and other...

Become a part of our caring community. Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities You will deliver coding and documentation education to providers and clinic staff within IPA clinics. You will be a consultative resource and ongoing support for providers in assigned clinics. You will conduct documentation audits to identify gaps, trends, and opportunities for improvement. You will perform quarterly...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data integrity and validation of the coded information for external and internal affairs. This position typically reports to the Coding Compliance Manager. Minimum Qualifications Education: High school diploma or GED, required....

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings and recommendations...

At Houston Methodist, the Lead Outpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to outpatient encounters based on documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. FLSA STATUS Non-exempt...

JOB SUMMARY: The primary purpose of the position is to review both procedural and diagnostic (ICD-10) coding to ensure appropriate billing and insurance regulations are met. This position will be staffed during clinic hours and is largely remote. Occasionally in-person meetings with providers will be required. Must live within reasonable traveling distance from Hudson, WI.CORE DUTIES AND RESPONSIBILITIES:Have in-depth understanding of coding and compliance rules and regulations.Responsible for reviewing provider documentation, coding and posting charges for healthcare services; including Primary Care, Lab/Pathology, Podiatry and more.Provide coding education and engage with assigned providers.Research and communicate governmental and payer-specific rules and regulations to ensure coding compliance.Identify and communicate best practices based on provider documentation, insurance payer medical policies and CMS guidelines.Review, code and post charges for hospital outpatient and...

Job Opportunity at SSM Health St. Mary's Hospital - Madison It's more than a career, it's a calling. Worker Type: Regular Job Highlights: Monday to Friday, 8:00 to 4:30 (flexible), full-time (.9/36 hours). This is a new role supporting imaging and procedure lab charges and charge reconciliation. The individual will help define and build the role. The position supports St. Mary's and the WI region as needed. Job Summary Supports assigned department(s) as a subject matter expert for achieving operational efficiency, compliance, and exceptional patient care. Serves as a liaison between and resource for clinical and Revenue/Financial departments with strong understanding of both components. Job Responsibilities and Requirements PRIMARY RESPONSIBILITIES Serves as a resource and subject matter expert to the department for workflows, documentation, coding, charging, and software applications. Manages all work queues using subject matter expertise to investigate/correct...

Datavant is looking for an Inpatient Auditing Specialist to join their remote team. The successful candidate will conduct coding audits, provide education, and maintain high standards of accuracy while working flexibly from home. The role requires at least 5 years of experience in facility inpatient coding and knowledge of EMRs like Epic and Cerner. Benefits include a competitive salary, medical coverage, and training from professionals. #J-18808-Ljbffr

Become a part of our caring community The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate DRG and ICD-10-CM/ PCS coding assignments for accuracy within the coding disputes team from a variety of medical records. The Disputes Auditor - MSDRG Inpatient Coding on the Disputes Team consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality. Will be an experienced medical coding auditor with in-depth experience in inpatient coding audits (MSDRG/APDRG) Ensures overall accuracy and compliance of coding disputes reviews by adhering to all appropriate coding guidelines and communicates disputes outcomes to providers in a professional and concise manner. Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices Manages multiple...

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world. At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you're interested in joining a health care system that is changing the face of care and well-being in our community, we...

Job Details Job Location: GLHP Remote - MADISON, WI 53713 Position Type: Full Time Salary Range: $65,000.00 - $75,000.00 Job Shift: Day Oasis Specialist/ICD-10 Coder Remote Position General Purpose Responsible for the organization, development and monitoring and management of the Quality Assessment and Performance Improvement (QAPI) program for Interim Healthcare. Responsible for coordinating the QAPI program for home care and hospice operations. Essential Functions Will complete all proper ICD-10 coding and review all OASIS assessments Locks down all SOC, Recerts, follow-up, discharges, and ROC OASIS and POCs Manage the submission of OASIS and HIS/HOPE assessments for all agencies, ensuring timely submission within 30 days Foster a professional environment that supports employee development and achievement of organizational goals through training and educational resources Utilize QAPI Plus (Centralized/Electronic QAPI Program) for data trending for the development of patient...

At Houston Methodist, the Lead Outpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to outpatient encounters based on documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. FLSA STATUS Non-exempt...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data integrity and validation of the coded information for external and internal affairs. This position typically reports to the Coding Compliance Manager. Minimum Qualifications Education: High school diploma or GED, required....

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings and...