17 virtual coding auditor inpatient jobs found

Location: Virtual Employee PRIMARY PURPOSE Conducts audits of medical record coding to ensure compliance with established guidelines, provides results of audits, and assists with educational activities related to findings to promote adherence to state/federal laws and regulatory requirements. MINIMUM SPECIFICATIONS Education: - Must be a graduate of a Health Information Management program or must have successfully completed an approved Coding educational program. Experience - Must have six (6) years of proven coding experience in an acute care setting. Equivalent Education and/or Experience - May have an equivalent combination of education and experience in lieu of specified requirements. Certification/Registration/Licensure - Because of the lag in SCCE, HCCA, NCRA, and AHIMA updating the status of certifications, current employees whose certification is granted through one of these associations are allowed up to seven (7) calendar days, after expiration, to...

divh2Job Posting/h2pConducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials./ph3Job Responsibilities/Duties:/h3p Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to...

Job Description Job Description Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc.   Job Responsibilities/Duties: · Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or...

JOB SUMMARY The CRC Auditor, conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims, were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and / or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends...

DRG Coding Auditor Principal _Virtual: _ _ ​_ This role enables associates to work virtually full-time, with the exception of 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. 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 an accommodation is granted as required by law. 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 Coding Auditor Principal _Virtual: _ _ ​_ This role enables associates to work virtually full-time, with the exception of 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. 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 an accommodation is granted as required by law. 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...

DHR Health - US:TX:McAllen - Days Summary: POSITION SUMMARY: The Inpatient coder reviews and analyzes documentation in the medical record for inpatient visits to ensure accuracy of diagnosis and procedure codes. Coder finalizes the coding and abstracting of the medical record according to ICD-10-CM/PCS, CPT, and HCPCS coding conventions and guidelines supported by the clinical documentation in the medical record. Coder analyzes diagnosis and procedure codes concurrently assigned by Clinical Documentation Specialists. The Inpatient Coder assumes primary responsibility for DRG validation/accuracy, primary role in assisting CDS and medical staff members with improving quality of clinical documentation. Sequence the diagnoses and procedures using official coding guidelines. Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges. Resolve Inpatient billing edits. Abide by the Standards of Ethical Coding as set...

Sr Health Information Management Coder Dallas, Texas Job Title: Senior Health Information Management Coder Location: Dallas, Texas Job Type: Full-Time Apply Job details Sr Health Information Management Coder Location: Dallas, Texas Salary: $80,000 to $86,000 FullTime,Permanent Are you passionate about ensuring accurate and efficient coding for healthcare records? Here's an exciting opportunity for you! Verovian Nursing Recruitment Agency is seeking a dedicated and experienced Senior Health Information Management Coder in Dallas, Texas. As a Senior HIM Coder, you will play a vital role in the review and coding of medical records, ensuring compliance with all relevant regulations and optimizing the reimbursement process for the healthcare facility. If you're intrigued by the prospect of this role, we encourage you to apply for this fulfilling opportunity to become an essential part of a healthcare team that is renowned for its expertise and...

EQUAL EMPLOYMENT OPPORTUNITY Race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate shall not be a factor in employment for this position. Due to the nature of hospital services, it may become necessary to work extended hours. POSITION SUMMARY This position is responsible for accurately coding accounts from at least one main outpatient work type (Observation, Same Day Surgery, and/or ER) as well as assisting with the coding of other outpatient work types as needed. All accounts should be completed within three (3) days following discharge. POSITION SUPERVISORY...

EQUAL EMPLOYMENT OPPORTUNITY Race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate shall not be a factor in employment for this position. Due to the nature of hospital services, it may become necessary to work extended hours. POSITION SUMMARY This position is responsible for coding outpatient clinical and outpatient recurring accounts. All accounts should be completed within three (3) days following discharge. POSITION SUPERVISORY RESPONSIBILITIES Reports To: HIM Coding Manager Supervises: None POSITION REQUIREMENTS Minimum Education...

Outpatient Professional Medical Coder Greenberg-Larraby, Inc. (GLI) is actively seeking a skilled Outpatient Professional Medical Coder to join our dynamic healthcare team based in Temple, TX This position is onsite in Temple, TX. In this role, you will be responsible for reviewing and coding outpatient medical records, ensuring adherence to coding standards and guidelines. Your expertise will play a vital role in ensuring accurate billing and compliance, contributing to the overall quality of patient care at GLI. You'll collaborate effectively with healthcare providers to clarify clinical documentation and ensure that all coding assignments align with the latest coding practices. If you are a detail-oriented professional ready to excel in a collaborative environment, we invite you to apply! Requirements Minimum Requirements: One active coding credential required: RHIT, RHIA, CCS, CCS-P, or CPC At least three (3) years of outpatient or professional...

General Summary: The Coding Educator is responsible for the development, management, and oversight of a comprehensive coding program encompassing all activities of the organization. This position serves as the documentation and coding liaison to clinicians, ensuring compliance with government and organizational policies and procedures. Supervisory Responsibilities: This position has no supervisory responsibilities. General Requirements: All duties performed will be done accurately and in a timely manner. Ensures customer service is always maintained at the highest level. Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. Must always adhere to customer service expectations including in-person and virtual (via telephone, or telehealth applications) communication. English and Spanish proficiency preferred. Strong organizational skills are a requirement in this position. Assist with special projects as needed. Other...

General Summary: This role focuses on the Risk Adjustment process that supports the documentation of acuity diagnoses for the Managed Care (MC) patient population and required activities for submission of records to Medicare Advantage (MA) payers under established capitated contracts. It assists with medical record reviews for HCC diagnoses, correct usage of various coding guidelines (ICD-10-CM, CPT, HCPCS) and federal and MA payor regulations, as well as clinical validation of appropriate supporting documentation. Supervisory Responsibilities: This position has no supervisory responsibilities. General Requirements: All duties performed will be done accurately and in a timely manner. Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy. Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. Must always adhere to customer service expectations including in-person and virtual (via...

JOB SUMMARY This position will be functioning under minimal supervision while utilizing independent decision making. This position will assist the manager and supervisor in training new team members, coordinate inquiries from ancillary departments regarding DNFB and edit tasks. The Sr. Edit Coder will investigate and solve edit issues and communicate root cause data to management in order mitigate potential upstream and downstream impacts. Responsible for modifying and completing moderate to high complexity reviewing and resolving coding and charge edits using ICD-10-CM, CPT and HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record. Working in billing editor systems as required. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Performs claim edit...

Outpatient Professional Medical Coder Greenberg-Larraby, Inc. (GLI) is actively seeking a skilled Outpatient Professional Medical Coder to join our dynamic healthcare team based in Temple, TX This position is onsite in Temple, TX. In this role, you will be responsible for reviewing and coding outpatient medical records, ensuring adherence to coding standards and guidelines. Your expertise will play a vital role in ensuring accurate billing and compliance, contributing to the overall quality of patient care at GLI. You'll collaborate effectively with healthcare providers to clarify clinical documentation and ensure that all coding assignments align with the latest coding practices. If you are a detail-oriented professional ready to excel in a collaborative environment, we invite you to apply! Requirements Minimum Requirements: One active coding credential required: RHIT, RHIA, CCS, CCS-P, or CPC At least three (3) years of outpatient or professional...

Compliance Billing & Coding Auditor page is loaded## Compliance Billing & Coding Auditorlocations: Business and Technology Centertime type: Full timeposted on: Posted Todayjob requisition id: R18998We’ve learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas.Job Summary The Healthcare Compliance Billing & Coding Auditor is responsible for performing independent audits of billing and coding practices across hospital departments and clinic providers to ensure compliance with organizational policies, federal and state regulations, and payer requirements. Reports to Chief Compliance Officer Job Specific Responsibilities 1. Conduct comprehensive audits of billing and coding documentation for accuracy and compliance in both hospital and clinic settings. 2. Identify discrepancies, potential compliance risks, and recommend corrective actions. 3. Develop audit reports and...