8 quality assurance coder auditor jobs found

Job Description The Patient Safety DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem. The role generates highly complex audit findings recoverable claims for the benefit of the Company across all lines of business. The position focuses on very complex coding cases paid through various DRG methodologies such as APS-DRG, APR-DRG, AP-DRG, MS-DRG, or TRICARE, with findings that may be reviewed only by other DRG Coding Audit Principals or Executives. Responsibilities Analyzes and audits claims by integrating advanced medical chart coding principles found in Official Coding Guidelines, Coding Clinics, and the ICD-10 Alphabetic and Tabular Indices, as well as complex clinical guidelines, maintaining objectivity in audit activities. Draws on extremely advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate sophisticated...

Anticipated End Date: 2026-07-24 Position Title: Patient Safety DRG Coding Auditor Principal Job Description: Location: This role enables associates to work virtually full-time, except for 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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 accommodation is granted as required by law. The Patient Safety DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex...

Registered Nurse - Diagnosis Related Group Coding Auditor Principal – Carelon Payment Integrity Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. 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. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients. Specializes in review of DRG coding via medical records and attending physician’s statements provided by acute care hospitals on paid DRG,...

Salary: $48,270.14 Annually Location : St. Croix, VI Job Type: Classified Job Number: 201905001 Department: |Virgin Islands Police Department- STX| Opening Date: 10/28/2025 Closing Date: 7/23/2026 11:59 PM Atlantic (Canada) Description Under the general supervision of the Deputy Commissioner or designee, the Police Compliance Auditor performs professional performance audits and conducts comprehensive procedural and operational audits of the Police Department programs, procedures, and activities; analyzes data, prepares audit documents and reports. Work is performed in accordance with standard departmental regulations, policies or procedures. Work is reviewed to ensure conformity. Duties and Responsibilities Conducts compliance and performance audits and reviews of Police operations; assess police operations and programs for effectiveness, efficiency and economy. Assesses whether Police operations are in compliance with applicable laws, regulations,...

Job Responsibilities Abstracts pertinent information from patient records for provider services. Reviews the International Classification of Diseases, Clinical Modification (ICD), Current Procedural Terminology (CPT), or Healthcare Common Procedure Coding System (HCPCS) codes, including modifiers, assigned by providers. Works with providers to correct any codes or charges when errors are identified. Reviews medical records for diagnoses that meet medical necessity according to the CMS Local Coverage Determination (LCD) and/or National Coverage Determination (NDC) guidelines. Reviews and interprets provider notes using CPT and ICD coding books and/or software. Ensures codes are accurate and sequenced correctly in accordance with government and insurance regulations. Works with providers to correct any identified errors. Conducts chart audits for provider documentation and recognizes when it is necessary to obtain further clarification from providers when documentation is...

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...

Your Future Role At A Glance Location: Indianapolis, IN Facility: Joshua Max Simon Primary Care Center Department: Primary Care Schedule: Monday - Friday, 8 - 4:30pm | flexibility required Life At Ascension: Where Purpose Meets Opportunity Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 97,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you'll find an inclusive and supportive environment where your contributions truly matter. Benefits That Help You Thrive Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options Financial security & retirement: employer-matched 403(b), planning and hardship resources, disability and life insurance Time to...

Radiology Medical Coder Radiology Medical Coder Job Description Client Profile - An Indiana based Independent Physician-Owned radiology practices founded in 1967. Job Summary - The Radiology Coder is responsible for coding and charge submission activities, including abstracting CPT Professional Fee Coding and inpatient/outpatient coding and billing. This involves reviewing medical records and assigning appropriate ICD, CPT, and HCPCS codes. Job Duties Review and analyze medical records ensuring the correct assignment of ICD-10, CPT and HCPCS codes. Accurately code diagnostics imaging, interventional radiology procedures and other radiological services Ensure that documentation supports the assigned codes and matches physician orders and radiology reports Abstract relevant data such as procedural dates, providers, and patient demographics for billing and reporting. Collaborate with radiologists and other medical professionals to clarify diagnoses and procedures when...