904 coder quality auditor jobs found

divh2Coder Quality Auditor/h2pThe Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties./ppJob Responsibilities:/pulliQuality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess...

Thank you for considering a career at Ensemble Health Partners! Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture...

divh2Coder Quality Auditor/h2pThe Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties./ppJob Responsibilities:/pulliQuality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess...

divh2Coder Quality Auditor/h2pThe Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties./ppJob Responsibilities:/pulliQuality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess...

divh2Coder Quality Auditor/h2pThe Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties./ppJob Responsibilities:/pulliQuality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess...

divh2Coder Quality Auditor/h2pThe Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties./ppJob Responsibilities:/pulliQuality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess...

Lead Compliance Auditor - Heavy Anesthesia & Healthcare Expertise Needed. This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Are you a seasoned compliance professional with a passion for anesthesia and healthcare auditing? Do you thrive in fast-paced environments where your expertise can make a real impact? FlexStaff is seeking a dynamic, detail-oriented Lead Compliance Auditor to join our client's team and lead the charge in safeguarding healthcare integrity and regulatory excellence! Position Summary: As a Lead Compliance Auditor, you will leverage your extensive anesthesia auditing experience to oversee comprehensive compliance reviews, develop training programs, and collaborate with senior leadership to enhance our compliance framework. Your expertise will ensure the organization remains at the forefront of regulatory adherence, risk mitigation, and quality improvement. Ready to make a difference in healthcare compliance...

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...

Be Part of an Extraordinary Team 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. Build the Possibilities. Make an Extraordinary Impact. Title : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **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. 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. Alternate locations may be considered if candidates...

Position Type Full Time Description Work Where You Matter! At St. Croix Hospice we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient’s quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Compliance Auditor (Clinical) Position Overview The Compliance Auditor is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that St. Croix Hospice complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations while collaborating with leadership...

Job Description Lead Compliance Auditor - Heavy Anesthesia & Healthcare Expertise Needed. This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Are you a seasoned compliance professional with a passion for anesthesia and healthcare auditing? Do you thrive in fast-paced environments where your expertise can make a real impact? FlexStaff is seeking a dynamic, detail-oriented Lead Compliance Auditor to join our client's team and lead the charge in safeguarding healthcare integrity and regulatory excellence! Position Summary: As a Lead Compliance Auditor, you will leverage your extensive anesthesia auditing experience to oversee comprehensive compliance reviews, develop training programs, and collaborate with senior leadership to enhance our compliance framework. Your expertise will ensure the organization remains at the forefront of regulatory adherence, risk mitigation, and quality improvement. Ready to make a difference in...

Position Summary The Revenue Cycle Auditor - Credentialed Coder is responsible for end to end auditing of professional and facility claims to ensure accurate, complete, and compliant coding and billing. This role partners closely with revenue cycle leadership, coding teams, and clinical providers to identify root causes of denials, drive best practices in claims resolution, and deliver targeted education that improves documentation quality and reimbursement accuracy. The ideal candidate brings deep working knowledge of ICD 10 CM/PCS, CPT®, and HCPCS Level II, along with hands on experience using NCCI/CCI edits, MUEs, and payer policies across inpatient, outpatient, and professional settings. Key Responsibilities Audit & Compliance • Perform prospective and retrospective audits of medical records and associated charges to validate code selection, modifiers, medical necessity, and documentation sufficiency across inpatient, outpatient, ED, and professional services. •...

Be Part of an Extraordinary Team 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. Build the Possibilities. Make an Extraordinary Impact. Title : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **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. 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. Alternate locations may be considered if candidates...

JOB SUMMARY: This position is responsible for reviewing a patient's medical records after a Clinic visit and translating the information into codes that insurers use to process claims for patients. Duties include confirming treatments with medical staff, identifying missing information, and submitting information to insurers for reimbursement. RESPONSIBILITIES (ESSENTIAL FUNCTIONS): Accurately assigns and sequences codes (ICD-10-CM, CPT, HCPCS/modifiers as necessary) for each patient encounter, following proper coding guidelines and legal requirements to ensure compliance with federal and state regulations. Ensures professional/physician billing CPT codes/ICD-10 codes are assigned correctly and sequenced appropriately as per government and insurance regulations. Queries providers or other Clinic team members when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Assigns and enters...

Health Ministries Clinic (HMC) is seeking a Coding Auditor (with PCP auditing experience) as a trusted expert to join our integrated care team in Newton, Kansas. This is a full-time, on-site position offering the opportunity to support patient care in a collaborative, mission-driven environment. At Health Ministries Clinic, we offer more than just primary care with a full spectrum of services including behavioral health, lab, diagnostic, pharmaceutical and dental. We are seeking an experienced Coding Auditor with a multi-speciality coding background. The Coding Quality Auditor is responsible to ensure Health Ministries Clinic's compliance with national coding guidelines, FQHC coding guidelines and regulations. The Coding Auditor plays a crucial role in minimizing coding errors and preventing fraudulent activities. The Coding Auditor is responsible to ensure accurate and consistent coding which results in appropriate reimbursement and data integrity. This role requires...

Be Part of an Extraordinary Team 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. Build the Possibilities. Make an Extraordinary Impact. Title : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **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. 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. Alternate locations may be considered if candidates...

Coding Auditor at AllCare Health with the Quality department in Grants Pass, Oregon We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options. Summary of the Position This position is responsible for the development, implementation, and maintenance of auditing practices related to medical record coding and documentation, with the objective of capturing accurate and complete risk adjustment outcomes for Medicare members leading to an increased level of care. The risk adjustment coder ensures that member medical records are following the Centers for Medicare & Medicaid Services (CMS) Risk Adjustment Data Validation procedures by performing the following duties. Essential Duties Ensuring the accuracy and correlation of diagnosis codes, dates of service, and chart notes. Identifying and...

Description WHAT IT'S LIKE AT SGMC HEALTH Purpose . No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place. Excellence . We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service. Team Spirit. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. Award Winning Performance. We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides. WHY YOU WILL LOVE SGMC HEALTH SGMC has great benefit options, depending on the role that you are going into- including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities...

Description Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future - we provide the venue for individuals who...

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...