79 coding auditor education advisor jobs found

EDUCATION REQUIREMENTS 4 year / Bachelor's Degree in Health Information Management or related medical degree (Required) ;In lieu of a Bachelor's Degree; an Associate Degree and a Minimum of 4 years additional relevant experience is acceptable. EXPERIENCE REQUIREMENTS 4 - 5 years Experience with ICD-9, ICD-10, and HCPCS coding including hospital inpatient medical records  (Required) 4 - 5 years Extensive knowledge of medical terminology, pathophysiology, and pharmacology  (Required) 4 - 5 years Experience calculating and analyzing MS-DRG, DRG, APC, and other payer reimbursement methodologies  (Required) CERTIFICATIONS AND LICENSURES Required Certifications/Licensures: Certified Coding Specialist (CCS) Preferred Certifications/Licensures: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), AHIMA Approved ICD-10 Trainer GENERAL SKILLS...

EDUCATION REQUIREMENTS 4 year / Bachelor's Degree in Health Information Management or related medical degree (Required) ;In lieu of a Bachelor's Degree; an Associate Degree and a Minimum of 4 years additional relevant experience is acceptable. EXPERIENCE REQUIREMENTS 4 - 5 years Experience with ICD-9, ICD-10, and HCPCS coding including hospital inpatient medical records (Required) 4 - 5 years Extensive knowledge of medical terminology, pathophysiology, and pharmacology (Required) 4 - 5 years Experience calculating and analyzing MS-DRG, DRG, APC, and other payer reimbursement methodologies (Required) CERTIFICATIONS AND LICENSURES Required Certifications/Licensures: Certified Coding Specialist (CCS) Preferred Certifications/Licensures: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), AHIMA Approved ICD-10 Trainer GENERAL SKILLS Organizational Skills Communication Skills Interpersonal Skills Customer Relations Mathematical...

EDUCATION REQUIREMENTS 4 year / Bachelor's Degree in Health Information Management or related medical degree (Required) ;In lieu of a Bachelor's Degree; an Associate Degree and a Minimum of 4 years additional relevant experience is acceptable. EXPERIENCE REQUIREMENTS 4 - 5 years Experience with ICD-9, ICD-10, and HCPCS coding including hospital inpatient medical records  (Required) 4 - 5 years Extensive knowledge of medical terminology, pathophysiology, and pharmacology  (Required) 4 - 5 years Experience calculating and analyzing MS-DRG, DRG, APC, and other payer reimbursement methodologies  (Required) CERTIFICATIONS AND LICENSURES Required Certifications/Licensures: Certified Coding Specialist (CCS) Preferred Certifications/Licensures: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), AHIMA Approved ICD-10 Trainer GENERAL SKILLS...

EDUCATION REQUIREMENTS 4 year / Bachelor's Degree in Health Information Management or related medical degree (Required) ;In lieu of a Bachelor's Degree; an Associate Degree and a Minimum of 4 years additional relevant experience is acceptable. EXPERIENCE REQUIREMENTS 4 - 5 years Experience with ICD-9, ICD-10, and HCPCS coding including hospital inpatient medical records  (Required) 4 - 5 years Extensive knowledge of medical terminology, pathophysiology, and pharmacology  (Required) 4 - 5 years Experience calculating and analyzing MS-DRG, DRG, APC, and other payer reimbursement methodologies  (Required) CERTIFICATIONS AND LICENSURES Required Certifications/Licensures: Certified Coding Specialist (CCS) Preferred Certifications/Licensures: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), AHIMA Approved ICD-10 Trainer GENERAL SKILLS...

Introduction Do you want to join an organization that invests in you as a Inpatient Coding Auditor? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. Benefits At HCA Healthcare, we want to ensure your needs are met. We offer eligible colleagues an attractive benefit package that includes medical, wellbeing, dental and vision benefits along with some unique benefits including: Medical, Dental, Vision, Life Insurance and Flexible Spending Paid Time Off (PTO) and Personal Leave 401K (100% annual match - 3% to 9% of pay based on years of service) Academic Assistance and Reimbursements for Tuition and Student Loans Employee Discounts including Tickets, Retail, Mental Health Apps, Education Apps, Identity Theft Protection etc. Home, Auto, and Pet Insurance Employee Stock Purchase Program (ESPP) Short Term & Long Term Disability coverage Adoption Assistance...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength...

Overview This position is located at Winn Army Community Hospital, Hinesville, Fort Stewart GA. This is an employed civilian Medical Records Technician (Coder) position that affords job security, a competitive base salary, bonuses, moving expenses, full malpractice coverage, up to 26 days paid vacation, 11 days paid Federal Holidays, a sick leave benefit, CME opportunities, and a first-class health and retirement benefit package. Winn Army Community Hospital is a 112-bed community hospital which will feature a new Women's Health and Mammography Center. Our healthcare team provides primary and specialty care for a patient population of over 70,000. As a civilian family practice physician you will play an integral role in providing exceptional healthcare to the Soldiers and Families in our great Army and the 3rd Infantry Division. Key supporting specialties at Winn include OB/Gyn, general and orthopedic surgery, EENT, Psychiatry, Dermatology, and Urology. Enjoy the benefits of...

Summary:Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance.Responsibilities:Reviews encounters to assign and sequence appropriate diagnoses (including HCC Coding Hierarchical Condition Category) and CPT procedure codes as well as modifiers to complex diagnostic and surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures.Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Create electronic physicians queries within allowed scope for hospital outpatient coder.Reviews all appropriate work queues daily to address edits and make corrections following Health Information Management (HIM) coding policies and procedures. Conducts, audits and/or coding...

Position OverviewPerform internal coding and documentation audits. Research, analyze, and respond to inquiries regarding coding and documentation compliance in accordance with all coding guidelines and Medicare/Medicaid regulations. Assist with coding, documentation, and billing questions to ensure compliant coding and billing. Develop final audit reports based on findings/observations during the audit process to present to providers or other appropriate staff members. Help identify areas for audit opportunities based on industry performance, regulatory focus areas and risk areas within the organization. Primary Department or Work Location: Facility Coding, UHS Revenue Cycle Operations Primary Work Shift: Day Scheduled Weekly Hours: 40 Compensation Range: $27.80 - $41.69 per hour, depending on experience Education/Experience Minimum Required: + Associates Degree , HIT preferred + One year of coding experience Preferred: + RHIA certification with a Bachelor's degree in...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength...

Profee Coding Auditor (Full-Time, Monday-Friday) Join to apply for the Profee Coding Auditor (Full-Time, Monday-Friday) role at Washington Regional Profee Coding Auditor (Full-Time, Monday-Friday) 1 week ago Be among the first 25 applicants Join to apply for the Profee Coding Auditor (Full-Time, Monday-Friday) role at Washington Regional Get AI-powered advice on this job and more exclusive features. Organization Overview, Mission, Vision, And Values Our mission is to improve the health of people in the communities we serve through compassionate, high-quality care, prevention, and wellness education. Washington Regional Medical System is a community-owned, locally governed, non-profit health care system located in Northwest Arkansas in the heart of Fayetteville, which is consistently ranked among the Best Places to live in the country. Our 425-bed medical center has been named the #1 hospital in Arkansas for four consecutive years by U.S. News & World Report. We...

Job Description Job Description Company Trajectory RCS joined the MedHQ family in 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing. healthcare cash flow through integration of both business office processes and clinical documentation. MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence,...

Summary:Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance.Responsibilities:Reviews encounters to assign and sequence appropriate diagnoses (including HCC Coding Hierarchical Condition Category) and CPT procedure codes as well as modifiers to complex diagnostic and surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures.Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Create electronic physicians queries within allowed scope for hospital outpatient coder.Reviews all appropriate work queues daily to address edits and make corrections following Health Information Management (HIM) coding policies and procedures. Conducts, audits and/or coding...

Job Description Job Description Picture Yourself at Biltmore Farms as part of the Vanderbilt legacy of hospitality! Why join our Front Office team as a Night Auditor / Front Desk Supervisor? $18.50/hour starting pay Outstanding medical, dental, and vision benefits coverage Fun wellness program with annual bonus of up to $600 401K retirement plan with employer matching program Parental leave with up to 6 weeks available for birth, adoption, and fostering Hilton-brand hotel discounts for you, your family, and your friends YMCA membership monthly discount Paid time off and paid holidays Friendly and supportive work environments Incredible employee learning and growth opportunities Exciting employee events and activities Essential Elements As a Biltmore Farms Night Auditor / Front Desk Supervisor, you are more than just a welcoming presence, you are the first impression our guests have to our hotel and to our city. The ideal candidate has good communication...

**DRG Coding Auditor Principal** _Virtual: This role enables associates to work virtually full-time, 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._ The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients. Specializes in review of DRG coding via medical record and attending physicians statement provided by acute care hospitals on paid DRG, especially on very complex coding cases that are paid using APS-DRG, APR-DRG, AP-DRG, MS-DRG or TRICARE methodology and findings may be so complex and advanced that disputes or appeals may only be reviewed by...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength...

Sentara Health is seeking to hire a qualified individual to join our team as a Compliance Coding Auditor! Position Status : Full-time, Day Shift Position Location: This is a remote position for residents of Virginia or North Carolina . Position Summary: Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the...

Compliance Coding Auditor page is loaded Compliance Coding Auditor Apply locations Sentara Patient Accounting time type Full time posted on Posted 2 Days Ago job requisition id JR-75300 City/State Norfolk, VA Overview Work Shift First (Days) (United States of America) Sentara Health is seeking to hire a qualified individual to join our team as a Compliance Coding Auditor! Position Status : Full-time, Day Shift Position Location: This is a remote position for residents of Virginia or North Carolina . Position Summary: Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal...

City/State Norfolk, VA Work Shift First (Days) Overview: Overview Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year. All...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength...

Summary:Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance.Responsibilities:Reviews encounters to assign and sequence appropriate diagnoses (including HCC Coding Hierarchical Condition Category) and CPT procedure codes as well as modifiers to complex diagnostic and surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures.Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Create electronic physicians queries within allowed scope for hospital outpatient coder.Reviews all appropriate work queues daily to address edits and make corrections following Health Information Management (HIM) coding policies and procedures. Conducts, audits and/or coding...

Job Description Job Description Seeking RN - BSN or MSN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Conducts Home Health Resource Group (HHRG) Validation to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibility Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. Applies coding rules and regulations to the validation review process. Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. Instructs professional staff in code changes, as needed. Assists clinical staff and nursing supervisors in providing appropriate documentation in the Medical Record. Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength...

Job Description Job Description Position Purpose: Under the direct supervision of the Director of Quality Assurance, the Licensed Nurse is responsible for supporting the compliance functions of the Quality Assurance and Performance Improvement department of JWCH. The responsibilities include: Maintaining defined review schedule for JWCH agency by (1) doing preparatory work for the audit including developing a scope of work, (2) reviewing the documentation, (3) preparing reports, (4) doing any necessary follow-up reviews and (5) ensuring that appropriate collected data are securely kept and maintained. Serve as a resource to clients in answering compliance questions from Internal Audit and Audit Advisory Services and assisting as necessary in their audit process. Essential Duties and Responsibilities : Conduct Compliance Reviews Complete compliance reviews within established parameters and initiate and carry out all assigned reviews according to defined...