20 supervisor coding quality auditor jobs found

Hcc Risk Adjustment Auditor/Coder We are looking for HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities include the following: Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use...

Coding Compliance Auditor In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments and accuracy and completeness of all ICD-10-CM, CPT, and HCPCS codes assigned by professional revenue coders and providers. All assigned codes must be supported by professional documentation contained within the medical record and must be in compliance with federal coding compliance regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics Re: coding accuracy rates, compliance rates, denial analytics, etc. Recommend education topics based on audit findings and assist in the continuing education of professional coders and providers. Understands coding/billing computer systems...

Western Growers Health — a part of Western Growers Family of Companies — provides employer-sponsored health benefit plans to meet the needs of those working for the agriculture industry. The unmatched benefit options provided by Western Growers Health stem from the core mission of Western Growers Association (est. 1926) to support the business interests of employers in the agriculture industry. Our mission at Western Growers Health is to deliver value to employers by offering robust health plans that meet the needs of a diverse workforce. By working at Western Growers Health, you will join a dedicated team of employees who care about offering quality health benefits and excellent customer service to plan participants. If you want to start making a difference working in the health care industry, then apply to Western Growers Health today! Compensation: $46,669.19 - $65,668.50 with a rich benefits package that includes profit‑sharing. This is a remote position and can reside...

We are looking for experienced HCC Risk Adjustment Auditors/Coders, Sr. to join our team! Position Summary The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use of diagnosis and procedure codes. Interface...

Job Details Job Location: Burlingame, CA 94010 Salary Range: $42.79 - $48.75 Hourly ESSENTIAL JOB FUNCTIONS HCC Coding and Risk Adjustment (RA) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines. Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance. Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy. Provider Training and Clinical Documentation Improvement (CDI) Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding. Provide one‑on‑one and group training to providers and clinical staff to improve documentation quality and accuracy. Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards. Data Analysis and Reporting Analyze coding data to identify trends, documentation...

Direct Jobs is looking for a Coding Department Supervisor in Los Angeles, California. This role involves overseeing daily operations of certified coding staff, ensuring coding quality and compliance with regulations. The ideal candidate has extensive experience in medical coding and supervisory roles. Responsibilities include monitoring productivity, conducting audits, and supporting staff development. Salary range is $65,800 - $130,800 annually. #J-18808-Ljbffr

Coding Compliance Auditor Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience...

Technical Compliance Auditor The Technical Compliance Auditor audits and reviews technical components of Conditions of Participation and Conditions of Payment, billing and other non-clinical items included in the annual Compliance Auditing and Monitoring Plan to ensure compliance with all regulatory guidelines and quality initiatives. Job Responsibilities Conducts prospective and retrospective documentation audits to confirm compliance with documentation and billing rules and regulations set forth by the Centers for Medicare and Medicaid Services (CMS), Medicare carrier and Fiscal Intermediary State regulations and internal policies. Presents findings as directed. Interacts with department leaders and/or their staff to discuss billing compliance issues and uses the information for recommending change of existing procedures or processes. Develops reports identifying positive and negative billing trends through audits and interaction with departments. Selects targeted accounts to...

Calaim Medical Billing Specialist The CalAIM Medical Billing Specialist is responsible for managing the day-to-day administrative and billing operations related to Enhanced Care Management (ECM) and Community Supports (CS) services. This position supports the organization's CalAIM programming by ensuring accurate claims submission, authorization management, billing compliance, encounter tracking, and reimbursement optimization in accordance with DHCS, Managed Care Plan (MCP), Medi-Cal, and organizational requirements. The Billing Specialist works closely with care managers, housing support staff, leadership, and Managed Care Plans to ensure timely and compliant billing processes while maintaining accurate records within electronic medical records (EMR/EHR) and billing systems. ***This is not a remote position*** Qualifications High school diploma or equivalent required; Associate's degree in Medical Billing and Coding, Healthcare Administration, Business Administration,...

Job Description Job Description Job Summary Medical Biller The Medical Biller reports to the Billing Manager in person at out office in Ontario, CA and is responsible for the accurate, compliant, and timely billing of clinical laboratory services, including blood testing, microbiology/culture testing, and toxicology services. This role requires strong expertise in Medicare Part A vs Part B billing, skilled nursing facility (SNF) workflows, and commercial payer laboratory billing rules. The Medical Biller manages claims from Pending Review through payment resolution while ensuring full compliance with Medicare, Medicaid, and commercial payor regulations. No Remote Work Available Supervisory Responsibilities None Essential Duties and Responsibilities Laboratory Billing & Claims Management Review laboratory patient demographics, insurance, ordering provider, and facility information. Prepare, review, and submit insurance claims for laboratory...

MISSION, VISION, AND VALUES Our mission is to provide quality, comprehensive healthcare and supportive services to our community. Our vision is "Improving the Health and Well-Being of Our Community." Our core values are Integrity, Compassion, and Excellence. Employees are expected to demonstrate a strong commitment to the mission, policies, goals, and philosophy of Harbor Community Health Centers. JOB SUMMARY Reporting to the Revenue Cycle Manager (RCM), the Medical Biller II is responsible for the billing and collection activities for the clinic's primary care, pediatric, behavioral health, and dental services. This position works closely with providers, Front Office staff, and the Quality Improvement Department. ESSENTIAL DUTIES & RESPONSIBILITIES Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. An individual must be able to perform each essential duty satisfactorily to be successful in this...

Hospice of the East Bay (HEB) is a community-based hospice providing compassionate end-of-life care to patients and families across the East Bay. Our interdisciplinary team supports patients regardless of ability to pay, with bereavement support provided for up to one year following a loss. Join us and be part of a mission-driven organization consistently recognized as a "Best Place to Work." The Technical Compliance Auditor audits and reviews technical components of Conditions of Participation and Conditions of Payment, billing and other non-clinical items included in the annual Compliance Auditing and Monitoring Plan to ensure compliance with all regulatory guidelines and quality initiatives. Job Responsibilities: Conducts prospective and retrospective documentation audits to confirm compliance with documentation and billing rules and regulations set forth by the Centers for Medicare and Medicaid Services (CMS), Medicare carrier and Fiscal Intermediary State...

Job Description Job Description All for Health, Health for All, Inc. (AFH) is a nonprofit Federally Qualified Health Center (FQHC) and a certified Patient-Centered Medical Home. For over 40 years, we have provided high-quality, accessible healthcare services to medically underserved and diverse populations across Los Angeles County, Orange County, and the state of Nevada. Our integrated, team-based model includes general family practice, pediatrics, behavioral health, mental health services, and adult day health care. In the past year alone, we served over 30,000 patients across more than 90,000 visits at a dozen clinic locations. AFH is currently seeking dedicated and compassionate individuals to join our mission-driven team. We are hiring Full-Time medical biller/collector. SUMMARY An individual must be able to perform each essential duty satisfactorily which includes billing, posting payments, answering patient questions and concerns by phone or personally in fast-paced,...

Job DescriptionJob DescriptionMUST ATTEND ORIENTATION IN PERSON IN ARCATA, CALIFORNIASUMMARY :The primary function of this position is to review ICD, CPT and HCPCS coding for data and reimbursement.The coding function is a primary source for data and information used in health care today, and promotes quality client care, captures accurate reporting numbers and optimizes reimbursement.The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.Other duties may be assigned.Level IPerforms comprehensive review of the health record, evaluates the record for documentation, consistency, accuracy and correlation of recorded data.Ensures the final diagnosis as stated by the provider is valid, complete and accurately reflects the care and treatment rendered.Consults with provider when conflicting or ambiguous documentation is...

Job description TITLE: MEDICAL CODER DEPARTMENT: H.I.M SUPERVISOR: H.I.M. DIRECTOR CLASSIFICATION:FULL TIME NON-EXEMPT POSITION SUMMARY: This incumbent performs highly technical and specialized functions. The employee reviews, analyzes, and codes diagnostic and procedural information to ensure compliance with established coding guidelines, third party reimbursement policies and regulations. The coding function is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. ESSENTIAL FUNCTIONS: • Responsible for reviewing patient charts and entering pertinent patient data into RPMS database. • Compiles, sorts and verifies accuracy of data entered into the Electronic Health Record. • Assigns and sequences ICD-9-CM/CPT/HCPCS codes to diagnoses and procedures for documented information. • Assures the final diagnoses and operative procedures as stated...

Fully Remote | Professional Fee Coding Auditor | 3-Month Contract with Strong Extension Potential Openings: 6 The Patient Records Abstractor 4 fulfills a role as a Medical Coder for UCSF's physician practices. This position reviews patient records, discharge summaries, operative reports, and other clinical documentation to assign standardized codes for diagnoses, procedures, and services. The role applies national and international coding classifications to ensure records accurately reflect the care delivered, supporting compliant reimbursement and reliable clinical data. This position also serves as a Coding Educator responsible for providing education and training for physicians, staff, and other providers on professional fee coding and clinical documentation standards. Responsibilities include conducting coding quality reviews, analyzing findings, and providing follow-up education to coding staff and providers. The incumbent outlines and annotates applicable laws and...

Facility: Copley Drive City San Diego Department Job Status Regular Shift Day FTE 1 Shift Start Time Shift End Time Certified Coding Specialist--Physician-based (CCS-P) - The American Health Information Management Association (AHIMA); Certified Professional Coder (CPC) - AAPC Hours : Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Flex hours are 6:00-9:00 am to 14:30-17:30 pm Weekend Requirements: As Needed On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $34.170 - $44.090 - $49.370 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.? The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates,...

Health Coder - Hcc & Risk Adjustment Burlingame, CA 94010 Overview Salary Range $42.79 - $48.75 Hourly Description The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance. Essential Job Functions: Hcc Coding and Risk Adjustment (Ra) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with Hcc and risk adjustment guidelines....

Job Description Align yourself with an organization that has a reputation for excellence! Cedars Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company’s Workplace of the Year. This annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We provide an outstanding benefit package that includes health care, paid time off and a 403(B). Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals. What you will be doing in this role: The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. In this role, the Coder II reviews ICD-10-CM diagnosis coding and Current Procedural Terminology (CPT)...