2 sr coder jobs found

Essential Functions: Coordinates with Compliance Audit Manager and Sr. Audit Director on any billing compliance investigations. Reviews and audits documentation in the medical records and charges submitted including CPT and ICD-10information to ensure compliance. Reviews charge information, claim forms, and insurance correspondence to determine if coding, billing, claim follow-up, payment receipts, posting activities, and credit processing are being performed in an accurate and timely manner and is supported by documentation. Analyzes billing trends to identify areas of non-compliance and prepares regular reports on audit findings to Compliance Manager. Collaborates with the Compliance Team to develop annual audit work plans. Educates providers when deficiencies in documentation and code selection are identified. Develops corrective action plans and participates in compliance investigations as needed. Performs other duties as...

Job Description Nemours is seeking a Sr. CDM Specialist  in Orlando, FL This position is responsible for: assistance in maintenance of Charge Description Master (CDM) within Nemours hospital revenue producing departments. Works with the CDM/HB Manager to ensure an accurate CDM and Coding process resulting in clean and compliant claims. Acts as liaison and problem solver for CDM issues with Administration, insurance companies, charge capture departments, Health Information Management, Utilization Management, Recovery Auditors, Managed Care, Corporate Compliances, and Central billing Office (CBO).  Responsibilities: Responsible for the coordination of ongoing CDM consistency within revenue producing departments. Includes maintaining accurate descriptions, coding, in-activations, and revenue code assignments.      Demonstrate and incorporate a working knowledge of the hospital's billing and coding software applications as related to coding...