61 coding auditor and quality coordinator days jobs found

Job Description Be a part of a world-class academic healthcare system at UChicago Medicine as a Coding Auditor - DRG/APC Coordinator for the Health Information Management department. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area.    In this role, the Coding Auditor - DRG/APC Coordinator is responsible for ensuring accuracy and quality of coding assignments for all records requiring DRG and/or APC coding, and ensures optimal and timely reimbursement.   Essential Job Functions   Performs data quality reviews on inpatient and outpatient records to ensure proper coding guidelines have been followed and appropriate DRG or APC assignments have been made for appropriate reimbursement  Provides DRG/APC and coding quality information and statistical reports to the Coding Manager  Communicates with the Medical Staff and House staff as needed to discuss clinical questions with respect to the...

Lead Medical Coder and Auditor ProSidian Consulting is looking for a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land dominance, across the full range of military operations and the spectrum of conflict, in support of combatant commanders". The Regional Health Command's Readiness Mission includes dental care of active duty Soldiers, public health services, veterinary services, and providing management and support to wounded, ill and injured Soldiers assigned to its seven warrior transition units. The ProSidian Engagement Team Members work to provide health...

Job Opportunity At The Ridge Behavioral Health System The Ridge Behavioral Health System is seeking a talented and dynamic Medical Records Certified Coder to join our team of dedicated healthcare professionals! Monday - Friday, Dayshift This is an onsite position at our facility in Lexington, KY. The Ridge Behavioral Health System is a 110-bed hospital located in the heart of the Bluegrass, Lexington, KY. The Ridge provides psychiatric and substance use disorder treatment for children, adolescents, and adults. The Ridge offers Partial Hospitalization, Intensive Outpatient Programs, Individual Counseling, as well as Medication Management for all ages. We have provided behavioral health services to over 92 Kentucky counties for more than 39 years. As the only free-standing psychiatric hospital in the Central Kentucky area, we are here to help. Please join our team as we expand our services to meet the needs of our community. Job Duties include: Meets coding quality score of...

Job Description Job Description Description: Come and join our growing organization as a Medical Biller! Roswell Park Care Network is a recognized leader in oncology and specialty care, supporting community physician practices across New York State. We are committed to delivering exceptional patient care while advancing innovative treatment options in a collaborative and patient-focused environment. We offer an outstanding benefits package designed to support your professional growth and work-life balance: Work-Life Balance: Monday–Friday schedule — no nights or weekends Comprehensive Benefits: Medical, dental, and vision coverage Health Reimbursement Account: Employer Funded Retirement Savings: 401(k) with company match Paid Time Off: Generous vacation and sick time Insurance Coverage: Company-paid life insurance, with options for Long-Term Disability, Critical Illness, and Accident coverage Paid Holidays: 11 recognized holidays The Medical...

AUDITOR SUPERVISOR Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/5263463) Apply  AUDITOR SUPERVISOR Salary $5,023.00 - $9,856.00 Monthly Location Baton Rouge, LA Job Type Promotion Job Number 512-218535-26 Department Wildlife & Fisheries-Office of the Secretary Opening Date 03/10/2026 Closing Date 3/15/2026 11:59 PM Central Description Benefits Questions About this Job LDWF supports a strong work ethic in its employees and incorporates the use of good science, accurate information and technology. The Office of the Secretary exists to provide leadership and support services, administrative direction, and accountability for departmental programs; administrative direction and leadership to ensure the success of subordinate programs; and department-wide coordination, communication, personnel and basic resources needed to accomplish the department’s mission. The incumbent in this position will...

Are you a current UMass Memorial Health caregiver? Apply now through Workday. Exemption Status: Non-Exempt Hiring Range: $23.81 - $40.14 Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations . Schedule Details: Monday through Friday Scheduled Hours: 7a-3:30p Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5470 ED Coding and Revenue Capture Union: SHARE (State Healthcare and Research Employees) This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place...

Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $60,367.47 - $90,551.20 The Senior Hospital Coder is responsible for performing detailed coding quality audits, scheduled and random, on staff and providing thorough education and feedback, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI. Responsible for monitoring and tracking trends of staff, bringing forward concerns to leadership regarding coding quality and productivity, completes duties as assigned by the Quality Manager. Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. Senior Hospital Coder may be asked to assist with denials work, including researching and writing appeal letters. These individuals are highly skilled and considered experts in medical coding. Essential Duties and...

Internal Reference Number: R1049162 Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! This open position is within one of our subsidiary companies called CGS Administrators. CGS has been a proven provider of administrative and business services for state Medicaid agencies, managed care organizations, commercial...

Overview Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs...and more! Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. Reviews discrepancies...

DRG Coder The purpose of this position is to apply the appropriate diagnostic and procedural codes to individual health information for data retrieval, analysis, and claims processing. The DRG coder creates consistency and efficiency in inpatient claims processing and data collection to optimize DRG reimbursement and facilitate data quality in hospital inpatient services. Responsibilities The coder abstracts pertinent information from patient records and assigns ICD-9-CM/ICD-10-CM, ICD-10-PCS or CPT/HCPCS codes, creating APC or DRG group assignments. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. The coder keeps abreast of coding guidelines and reimbursement reporting requirements. Brings identified concerns to supervisor or department manager for resolution. Abides by the standards of Ethical Coding as set forth by the American Health Information Management...

Inpatient Drg Coding Auditor Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs...and more! Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. Reviews discrepancies...

Overview Reviews and audits claims for billing, coding, services and other compliance or reimbursement issues. Assists with non-clinical aspects of the claims review process and acts as a coding resource. Provides training and support to Medical Care at Home Clinicians and staff to provide best practices of claims coding. Applies coding skills to various initiatives to ensure compliance in claims submissions. Works under moderate supervision. What We Provide Per Diem team members are eligible for some benefits and can access our extensive Employee Assistance Program that includes financial, legal, and mental health counseling programs as well as participate in a 403b retirement savings program. What You Will Do Reviews medical claims, records and other requested information for billing, coding and other compliance or reimbursement related issues; makes coding and documentation recommendations for adherence to risk adjustment models. Reviews medical documentation to ensure all...

Job Description Job Description About Sound Founded in 2001 and headquartered in Nashville, TN, Sound Physicians is a nationally respected, physician-led medical group practicing in 400+ hospitals across 45 states. Our team of 4,000+ clinicians and 1,000+ business professionals across the country is united by one mission: to build exceptional clinical partnerships that unlock quality, affordable, dignified care for everyone – no matter who they are or where they live . With physician-led clinical teams and more than two decades of operational expertise, we’ve refined what it takes to consistently deliver exceptional care in hospital medicine, emergency medicine, critical care, anesthesia, and telemedicine. Why join us? A remote-first culture that values flexibility and collaboration Opportunities to grow your career while making a real impact A team that champions inclusivity, innovation, and excellence Whether working virtually or onsite at one of our...

PURPOSE OF THIS POSITION This position is responsible for all medical claims including pre‑billing and follow‑up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre‑claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization’s operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow‑up activities and collection of accounts. Job Duties/Responsibilities Maintains a thorough understanding and education of federal and state regulations and payer specific policies and...

Clinic Coder 3 The Clinic Coder 3 abstracts clinical information from a variety of medical records, charts and documents and assigns appropriate codes to patient records according to established procedures. Assigns codes for specialty practices. Works with coding databases and confirms CPT assignments. Reviews and audits Physician Group provider medical records for documentation and coding compliancy and quality with federal and state laws and regulations. Familiar with standard concepts, practices, and procedures within a particular field. Relies on instructions and pre-established guidelines to perform the functions of the job. This position relies on guidelines and some experience and judgment to complete job and works under general supervision. Researches complex coding scenarios. Creates and presents coding education to clinical providers. Responsibilities Coding/Abstracting Determines the appropriate sequencing of diseases, diagnoses, and surgeries. Accurately assigns...

Auditing Team Lead Under direct supervision, the Auditing Team Lead provides day to day supervision and instruction of the auditors. The Auditing Team Lead oversees the internal and external auditing function and assists Director Inpatient Coding, Coding Audits, and Education in developing reports specific to audit findings and assists with implementing action plans. The Auditing Team Lead ensures internal audits are accurate, complete and reported on a timely basis and serves in an advisory and educator role for Coding Specialists. The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified. 1. Provides for day to day supervision and instruction for the auditors which includes audit assignments, problem solving, monitoring productivity and scheduling. Manages time and attendance...

Risk Adjustment Nurse/Coder AvMed, a division of Sentara Health Plans in the Florida market, is hiring a Risk Adjustment Nurse/Coder (RN/CPC, COC, CIC, CCS-P, CCS, RHIT, RHIA) in Doral, FL! Full-time permanent position (40 hours) Standard working hours: 8am to 4:30pm EST, M-F This is a hybrid position, 2 days onsite in AvMed Doral Office, 3470 NW 82nd Ave Suite 1100, Doral, FL 33122, and 3 days remote. Job Profile Summary The Risk Adjustment Clinical Coder/Nurse performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories...

Job Type Full-time Description Come and join our growing organization as a Medical Biller! Roswell Park Care Network is a recognized leader in oncology and specialty care, supporting community physician practices across New York State. We are committed to delivering exceptional patient care while advancing innovative treatment options in a collaborative and patient-focused environment. We offer an outstanding benefits package designed to support your professional growth and work-life balance: Work-Life Balance: Monday-Friday schedule - no nights or weekends Comprehensive Benefits: Medical, dental, and vision coverage Health Reimbursement Account: Employer Funded Retirement Savings: 401(k) with company match Paid Time Off: Generous vacation and sick time Insurance Coverage: Company-paid life insurance, with options for Long-Term Disability, Critical Illness, and Accident coverage Paid Holidays: 11 recognized holidays The Medical Biller...

Job DescriptionJob DescriptionMedical Records Coder / Certified - Full Time (PARTIAL REMOTE / IN OFFICE FOR MTGS)POSITION SUMMARY :Codes medical records using diagnostic coding.Ensures accurate submission of all coding data for reimbursement purposes.Ensures Regulatory Compliance and follows all Federal regulations for all payment systems.POSITION REQUIREMENTS :Minimum EducationHigh School Diploma or equivalentCertificate Required :One of the following Coding Certifications :CCS-Certified Coding SpecialistCPC-Certified Professional CoderCPC-H-Certified Professional Coder-HospitalCOC-Certified Outpatient CoderCIC-Certified Inpatient CoderCMC-Certified Medical CoderMinimum Work ExperienceAbility to read and communicate in English; Bilingual preferredGood communication and multi-tasking skillsMinimum of 2 years' experience with ICD-10 and CPT / HCPCS coding in an acute facility and / or physician's office preferredKnowledge of computer applications for codingKnowledge of medical...

Department / Unit :Health Information ManagementWork Shift :Day (United States of America)Salary Range :$60,367.47 - $90,551.20This position is Fully RemoteProfessional Coding Auditor will apply an advanced professional coding skill set to act as a service line coding team lead expert, working collaboratively to support all workflows related to professional fee coding / charging / denials follow-up.Coordinates with others as needed to ensure comprehensive and timely completion of professional coding processes.Audit CPT and ICD-10 diagnosis coding applied by providers and coding staff to assure compliance with federal and state regulations and insurance carrier guidelines.Provide education, instruction and training to providers and coding staff.Act as an expert for the HCC / Risk adjustment coding.This position is remote but does require onsite education to providers as needed.Essential Duties and ResponsibilitiesReview, analyze, and validate CPT and ICD-10 diagnosis codes and...

PURPOSE OF THIS POSITION This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization's operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. JOB DUTIES/RESPONSIBILITIES Duty 1: Maintains a thorough understanding and education of federal and state regulations and payer...

Responsibilities $2500 SIGNING BONUS! The Ridge Behavioral Health System is seeking a talented and dynamic Medical Records Certified Coder to join our team of dedicated healthcare professionals! Monday - Friday, Dayshift *This is an onsite position at our facility in Lexington, KY. The Ridge Behavioral Health System is a 110-bed hospital located in the heart of the Bluegrass, Lexington, KY. The Ridge provides psychiatric and substance use disorder treatment for children, adolescents, and adults. The Ridge offers Partial Hospitalization, Intensive Outpatient Programs, Individual Counseling, as well as Medication Management for all ages. We have provided behavioral health services to over 92 Kentucky counties for more than 39 years. As the only free-standing psychiatric hospital in the Central Kentucky area, we are here to help. Please join our team as we expand our services to meet the needs of our community. Job Duties include: Meets coding quality...

Coder 2 - Clinic To review and audit Network Provider medical records for documentation and coding compliancy and quality with federal and state laws and regulations. Responsibilities Quality and Performance Improvement Research, develop, and implement standardized processes for quality monitoring of inpatient and outpatient coding and abstracting. Conduct quality audits for coding according to pre-established criteria in coordination with the Coding and Reimbursement Specialist. Assist Management with evaluation of functions and processes of the coding area to determine opportunities to improve the efficiency and quality of the coding area. Implement innovative ideas and process changes. Attend meetings as required and strive to improve the quality of meetings by taking an active role in meeting topics. Participate in educational programs, in-services, and training sessions in an effort to share expertise with others and further the quality of education and personal growth...

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...