8 regulatory analyst coder jobs found

Risk Adjustment Coding Specialist Remote LRH Medical Center - Lakeland, FL Work Hours per Biweekly Pay Period: 80.00 Shift: Monday Friday Location: Remote Pay Range: $29.21 - $36.51 Position Summary Under the direction of the LHRPG Coding Manager, the Risk Adjustment Coder is responsible for encursing proper risk adjustment coding by performing coding audits of physicians and Advanced Practice Providers. Ensures accurate representation of the care provided and ensures accuracy in the HCC codes reported. This role assists in improvement in the overall completeness and accuracy of quality data and outcomes through extensive interaction with physicians, nursing and administrative staff. Ensures the appropriate clinical diagnosis and procedure codes are assigned in accordance with the appropriate level of service provided with nationally recognized coding guidelines. The coder provides coding expertise as well as administrative oversight to ensure successful...

Overview: BerryDunn is seeking a Senior Consultant to join our Healthcare Group as a member of the Healthcare Compliance Practice Area. You will join a core team tasked with assisting the firm’s clients with clinical documentation improvement, revenue integrity efforts, regulatory research, and general coding and billing compliance in a multitude of healthcare settings. This role involves complex audit reviews , provider education , and data-driven analysis to identify trends, mitigate risk, and optimize revenue integrity. This position is planned to sit remotely. The ideal candidate for this position will possess both a clinical and compliance background with experience coding/auditing a diverse array of professional services and specialties, including behavioral health.   You Will: Perform comprehensive audits of facility and outpatient/professional claims for coding accuracy (i.e. CPT, HCPCS, ICD-10-CM/PCS, DRG, APC, and E/M levels) Review clinical...

Ortho Las Vegas Medical Billing Specialist – Revenue Cycle / A/R Follow Up Position: Medical Billing Specialist Department: Billing / Revenue Cycle Status: Full-Time Location: Ortho Las Vegas Reports To: Billing Manager Position Summary The Medical Billing Specialist is responsible for supporting the revenue cycle operations of the practice by managing insurance claim follow-up, resolving claim denials, and ensuring timely reimbursement from insurance carriers. This role focuses on accounts receivable management, denial resolution, claim corrections, and payer communication to maintain healthy revenue cycle performance. The position works closely with the Billing Manager, providers, and administrative staff to ensure accurate claim submission, proper documentation, and compliance with payer requirements. This role plays an essential part in maintaining the financial health of the practice by reducing revenue delays and resolving billing issues...

This is a Stanford Health Care job. A Brief Overview The Director - Hospital Coding oversees, directs, and provides leadership of the facility coding function across the enterprise, acting within the Mid-Revenue Cycle Department, Revenue Cycle Division reporting to the VP, Mid-Revenue Cycle. Responsible for the management of hospital coding operations including ICD, DRG, and CPT code assignment, case abstracting, occasional charge capture, pre-bill quality reviews and other billing edit work queues. The Director participates in the formulation of objectives and strategies for integrating clinical information to support the goals of patient care, teaching, research, and optimizing management of resources. The Director provides leadership in driving key outcomes for hospital/facility coding, including key partnerships with Compliance, CDI, Quality, & other clinical improvement groups. Through a combination of data analytics, and process improvement techniques, this leader...

UW Medicine Enterprise Records and Health Information has an outstanding opportunity for an INPATIENT CODING EDUCATION ANALYSTS. WORK SCHEDULE 100% FTE Mondays - Fridays 100% Remote POSITION HIGHLIGHTS Performs daily activities related to auditing, education and training of one or more content areas ERHI has coding oversight for. Serve as an expert in Inpatient coding, respond to general coding questions (ICD, DRG, CPT and HCPCS), engage in the development and/or implementation of audit/monitoring plans, participate in the development and/or delivery of educational and outreach materials, report on unit activities, maintain unit records, monitor regulatory developments, and help develop Coding program policies and procedure. DEPARTMENT DESCRIPTION Enterprise Records and Health Information (ERHI) is a Shared Service Department that supports all aspects of the patient medical record from governance, integrity, documentation timeliness, completion, clinical...