5 jobs found

Your Role   The Medi-Cal Operations team is responsible for Claims processing and ensuring Medi-Cal benefits are applied. The Medical Coder Auditor Senior will report to the Director of Medi-Cal Performance. In this role you will Serve as an expert Medi-Cal resource in the areas of coding, documentation, auditing, including CMS/HHS regulations and compliance issues surrounding requirements for risk adjustment. Review and monitors all Medi-Cal, HIPAA and CMS regulations for updates and changes pertaining to Medi-Cal programs. Determine and implement changes needed for systems and processes.   Your Work   In this role, you will: Perform audit projects, including and not limited to Government RADVs, and internal compliance audits Support and implement prospective, retrospective and auditing project strategy to support improved clinical documentation and coding Be responsible for facilitating and/or performing an audit of the providers’ medical...

Grady Health System offers many career paths for your professional growth. Whether you have many years of experience or are in the early stages on your career, you can find a rewarding position at Grady!  SUMMARY Supervises the coding function and corresponding staff and manages auditing and quality control and improvement initiatives. Investigates, diagnoses, and corrects problem accounts that impede the billing/revenue cycle. Coordinates and reviews the work of designated coding staff. Oversight of Coding Staff training and professional development and assumes full responsibility for the charge capture, coding, and charge entry of all assigned surgical cases into the practice management system. Responsible for coding and abstracting procedural (CPT) and diagnosis codes (ICD-10) for physician services, reviewing physician documentation in the electronic medical record for completeness and accuracy to ensure proper code assignment, providing physician feedback of...