24 coding auditor i jobs found

Coding Auditor I - Education Program at Baylor Scott & White Health in Boise, Idaho, United States Job Description JOB SUMMARY The Coding Auditor 1 is proficient in various types of coding and is responsible for performing coding quality audits and providing feedback to coders. The Coding Auditor 1 utilizes the International Classification of Disease (ICD-10-CM/PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS-DRG, APR-DRG, APC etc.) ESSENTIAL FUNCTIONS OF THE ROLE Performs routine coding quality reviews on all coders including third party suppliers as appropriate. Performs coding quality reviews in collaboration with or for internal customers of the organization. Provides feedback as appropriate depending on findings. Abstracts and validates required data elements...

Job Description Job Description Scheduled Shift: Monday- Friday 0830-1700 and other shifts as needed. JOB SUMMARY: Under the direction of the Manager of Compliance, the Billing Compliance Auditor I, performs compliance audits and investigations with a primary focus on revenue cycle by reviewing laboratory medical records for documentation compliance for CPT, Level II HCPCS, and claims to determine compliance with all regulations of federal and state agencies and third-party payors policy. Requires knowledge of CPT, Level II HCPCS, diagnosis coding, claims review, and commercial and government payer regulations. Contributes to the development of the Compliance Program, annual audit work plan, awareness, and mitigation of revenue cycle risks. ESSENTIAL FUNCTION: 1. Provides coding compliance expertise to company to ensure compliance with official coding policies, regulations, requirements, and standards as promulgated by Medicare, various state Medicaid agencies,...

Overview: Quincy Medical Group (QMG) is seeking a Compliance Auditor & Educator to enhance our compliance program by facilitating the audit process of medical records to determine compliance with governmental and third-party rules and regulations. QMG is a multi-specialty group practice with more than 155 physicians and providers in West Central Illinois, Southeast Iowa, and Northeast Missouri. We have been a recognized leader in healthcare for more than 85 years, continually leading the way in transforming healthcare. At Quincy Medical Group, we work to understand what matters most to our employees, and we invest in helping them flourish both personally and professionally. We provide a comprehensive benefits package that includes paid leave options, childcare assistance, tuition reimbursement, and paid volunteer and community impact opportunities. This role is Monday - Friday, 8:00am-5:00pm. Responsibilities: The Compliance Auditor & Educator...

Compliance Auditor I Hiring Range $57,449.60 to $76,606.40 Pay Range $57,449.60 to $86,174.40 Compliance Auditor II Hiring Range $65,769.60 to $87,692.80 Pay Range $65,769.60 to $98,654.40 Job Summary: The Southcentral Foundation (SCF) Compliance Auditor is responsible for supporting the Compliance department by assisting the Compliance Internal Auditor in the ongoing implementation, maintenance, and advancement of the organization's corporate compliance program. Under the direction of the Compliance Internal Auditor, this position is responsible for conducting auditing and monitoring activities encompassing revenue cycle, finance, and other business practices including compliance with conditions of participation, coding and billing, financial and business controls, and compliance with applicable laws and regulations. SCF programs are established to serve a primary population comprised of Alaska Native people who are affiliated with Cook Inlet Region, Inc. (CIRI)...

Job Description Job Description Job Description: We are seeking an experienced Medical Coder III with advanced expertise in coding medical services for inpatient coding. This role involves assigning codes for professional and institutional services in inpatient discharges, consultations, and surgical procedures. The ideal candidate will review documentation, correct discrepancies, and collaborate closely with auditors and clinical staff to ensure coding accuracy and compliance with health regulations. Minimum Qualifications: Education : Completion of one of the following: Associate’s degree or higher in Health Information Management, Healthcare Administration, or biological sciences. University certificate in medical coding. At least 30 semester hours of university/college credits that include relevant coursework (anatomy/physiology, medical terminology, health information management, and/or pharmacology). Completion of an AAPC or AHIMA coding certification...

Coding Auditor II - Education Program at Baylor Scott & White Health in Boise, Idaho, United States Job Description JOB SUMMARY The Coding Auditor 2 is proficient in various types of coding and is responsible for performing coding quality audits, providing feedback to coders and auditors, and providing education via both written and oral presentations. The Coding Auditor 2 utilizes the International Classification of Disease (ICD-10-CM/PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS-DRG, APR-DRG, APC etc.). ESSENTIAL FUNCTIONS OF THE ROLE Performs routine coding quality reviews on all coders and/or auditors including third party suppliers as appropriate. Performs coding quality reviews in collaboration with or for internal customers of the organization....

Job Description Conducts coding audits to optimize diagnosis related groupings. Develops and implements coding instruction classes. Prepares coding guidelines; implements coding changes. Job Responsibility Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. Demonstrates effective skills in validation; provides ad-hoc education to the coding staff. Able to communicate effectively with coders and CDI staff. Demonstrates knowledge of coding policy and procedures. Maintains knowledge of all current Federal and State coding guidelines; remains up-to-date on system literature from all agencies. Monitors and evaluates case mix index; demonstrates comprehensive knowledge of case mix indexing. Reviews potential reassignments; demonstrates accurate and timely review of all reassignments. Implements coding changes; demonstrates ability to relate coding changes accurately and efficiently to staff....

Summary Reemployed annuitant: This vacancy does not meet the criteria for appointment of annuitants. This job is open to Federal employees - Competitive service Current or former competitive service federal employees. Career transition (CTAP, ICTAP, RPL) Federal employees who meet the definition of a "surplus" or "displaced" employee. Veterans Military spouses Clarification from the agency Current Career or Career-Conditional Federal Employees in the Competitive Service. Eligible Priority Placement Program DoD Military Spouses Preference (MSP) applicants, eligible PPP applicants, and current Federal VRA Employees. Interagency Career Transition Assistance Plan (ICTAP) eligibles in the local commuting area. Also open to all veterans who are eligible for competitive appointment under Veterans Employment Opportunities Act (VEOA) Duties Serves as the supervisory auditor in a branch (OR resident office at a large defense contractor or a large suboffice)...

Summary Reemployed annuitant: This vacancy does not meet the criteria for appointment of annuitants. This job is open to Federal employees - Competitive service Current or former competitive service federal employees. Career transition (CTAP, ICTAP, RPL) Federal employees who meet the definition of a "surplus" or "displaced" employee. Veterans Military spouses Clarification from the agency Current Career or Career-Conditional Federal Employees in the Competitive Service. Eligible Priority Placement Program DoD Military Spouses Preference (MSP) applicants, eligible PPP applicants, and current Federal VRA Employees. Interagency Career Transition Assistance Plan (ICTAP) eligibles in the local commuting area. Also open to all veterans who are eligible for competitive appointment under Veterans Employment Opportunities Act (VEOA) Duties Serves as the supervisory auditor in a branch (OR resident office at a large defense contractor or a large suboffice)...

Department of Labor - Bureau of Unemployment Compensation - UI Tax Job Class Code: 0612 Grade: 23 (Professional/Technical) Salary: $49,275 -$69,139 (Annually) Location: Bangor, ME Opening Date : January 9, 2025 Closing Date: January 26, 2025 Do you have accounting or auditing experience and meticulous eye for detail? The Maine Department of Labor, Bureau of Unemployment is seeking a Compliance Auditor to review employer's payroll and financial records to ensure proper worker status and accuracy of employee wage reporting. We offer a flexible hybrid remote and in office work schedule. Day-to-day duties: Examines and analyzes employer records to determine contributions due, reconcile findings on previously submitted reports, and determine the correct amount of any interest and penalties due or overpaid. Prepares audit reports and assembles audit schedules, tables, exhibits, and documentation to present audit findings and conclusions. Consults,...

HIM Certified Coder IP + Department: Health Information Management + Entity: Champaign-Urbana Service Area + Job Category: Health Information + Employment Type: PRN - As Needed + Job ID: 40877 + Experience Required: None + Education Required: HS Diploma/GED + Shift: As Needed + Location: Remote + Usual Schedule: any + On Call Requirements: no + Work Location: Working from Home + Weekend Requirements: yes + Holiday Requirements: no Email a Friend Save Save Apply Now Position Summary: The HIM Certified Coder is responsible for accurate and timely coding of hospital inpatient, hospital outpatient and/or professional fee encounters using appropriate ICD10/ICDPCS, CPT, or HCPCs codes and appropriate coding software such as computer assisted coding and encoders as a means to ensure compliant billing of Carle claims. HIM Certified Coder is responsible for understanding and applying all regulatory coding guidelines,...

Youll want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast geography, advanced technology and educational opportunities. We are in the top 1% of hospitals internationally for receiving Magnet Recognition consecutively since 2006. And youll want to stay at Billings Clinic for the amazing teamwork, caring atmosphere, and a culture that values kindness, safety and courage. This is an incredible place to learn and grow. Billings, Montana, is a friendly, college community in the Rocky Mountains with great schools and abundant family activities. Amazing outdoor recreation is just minutes from home. Four seasons of sunshine! You can make a difference here. About Us Billings Clinic is a community-owned, not-for-profit, Physician-led health system based in Billings with more than 4,700 employees, including over 550 physicians and non-physician providers. Our integrated organization consists of a multi-specialty group...

Overview: WE ARE HIRING! Location: Remote About Us UofL Physicians is one of the largest, multi-specialty physician practices in the Kentuckiana region. With over 700 providers, 200 practice locations and 78 specialties, UofL Physicians academic and community physicians care for all ages and stages of life, from pediatrics to geriatrics with compassion and expertise. UofL Physicians academic providers are professors and researchers at the UofL School of Medicine, teaching tomorrows physicians, leading research in medical advancements and bringing the most progressive, state-of-the-art health care to every patient. With more than 13,000 team members physicians, surgeons, nurses, pharmacists and other highly-skilled health care professionals, UofL Health is focused on one mission: to transform the health of communities we serve through compassionate, innovative, patient-centered care. Our Mission As an academic health care system, we will transform the health of the...

Job Description Job Description Company Description At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better? Job Description Must reside in IL, IN, IA, or WI. The Outpatient Coder II reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.  Follows...

Job Description Job Description Job Description About This Role As part of the Global Medical Capabilities Governance, Risk, and Control team, the Associate Director, Medical Research Governance is responsible for governance of post-market medical research. Proposals include company-sponsored and investigator-sponsored studies, and the research may be on Biogen’s marketed products or in our disease areas. This individual will be responsible for the research review processes and administer the Medical Research Review Committee. The job involves interaction and partnership with Global, Regional, and Local stakeholders in all of Biogen’s therapeutic areas. What You’ll Do Administer the Medical Research Review Committee (MRRC) to facilitate the review of proposals against defined criteria, including managing review deadlines and inform appropriate stakeholders of the results Conduct budget review and fair market value analysis of investigator budgets and review...

Job Description Job Description Duties and responsibilities 1. Philosophy a) Supports the center’s ideology, mission, goals, and objectives b) Performs in accordance with the center’s policies and procedures c) Follows the center’s standards for ethical business conduct d) Conducts self as a positive role model and team member e) Recognizes patients’ rights and responsibilities and supports them in performance of job duties f) Participates in center committees, meetings, in-services, and activities 2. Communication a) Communicates effectively and professionally with patients, visitors, physicians, and coworkers b) Interacts with others in a positive, respectful, and considerate manner 3. Financial practices a) Uses center resources appropriately and avoids wasteful practices b) Reports wasteful practices c) Analyzes work area and makes recommendations for potential cost-effective improvements 4. Compliance program a) Contributes to the progress and...

Overview The HIM Certified Coder is responsible for accurate and timely coding of hospital inpatient, hospital outpatient and/or professional fee encounters using appropriate ICD10/ICDPCS, CPT, or HCPCs codes and appropriate coding software such as computer assisted coding and encoders as a means to ensure compliant billing of Carle claims. HIM Certified Coder is responsible for understanding and applying all regulatory coding guidelines, such as National and Local Coverage Determinations and application of CPT modifiers. HIM Certified Coder is also responsible for understanding and applying coding knowledge to resolve billing edits related to coding. HIM coder uses Carle electronic medical record systems to review clinical encounters. Qualifications License/Certifications: Certified Inpatient Coder (CIC) - American Academy of Professional Coders (AAPC); Registered Health Information Administrator (RHIA) - American Health Information Management Association(AHIMA);...

We are seeking candidates that reside in the EST or CST time zones. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us and help our members achieve their best possible health and quality of life. Responsibilities Medical Coding Compliance Specialist I Optimizes/reviews documentation for the application of...

Coding Specialist Sr. Medical Records Requisition ID 2024-53302 Category Health Information Management (HIM) Overview Utilizing 3M encoding system, the Coding Specialist is responsible for accurate assignment of I-10 and CPT codes to inpatient and outpatient medical records for the purpose of reimbursement, research and compliance with federal regulations. Must meet coding quality and quantity standards. Also responsible for researching newly identified diagnoses and/or procedures for code assignments and performing related miscellaneous duties as assigned. Why Nationwide Children's Hospital? The moment you walk through our doors, you feel it. When you meet our patient families, you believe it. And when you talk with anyone who works here, you want to be part of it. Welcome to Nationwide Children's Hospital, Where Passion Meets Purpose. Here, Diversity, Equity and Inclusion are integrated into our core values and practices. We are passionate about building, sustaining and evolving...

Description We are seeking candidates that reside in the EST or CST time zones. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us and help our members achieve their best possible health and quality of life. Responsibilities Medical Coding Compliance Specialist I Optimizes/reviews documentation for the application of...

Job Description Job Description Medical Coding Supervisor- Cayuga Medical Associates- Full Time- Days Cayuga Health and its affiliates are the region's leading healthcare system and most trusted providers of integrated health services, empowering our people in our mission to equitably improve the well-being of the communities we serve. Our commitment to providing extraordinary healthcare begins with our team of extraordinary professionals who are continuously discovering clinical innovations and enhancing access to the most up-to-date facilities, equipment, technologies, and research protocols. Cayuga Health's commitment to our employees includes competitive compensation, comprehensive employee benefits programs, and the opportunity to explore and build a career in healthcare through our many professional development programs. The Medical Coding Supervisor oversees the coding staff, supporting education, compliance, and workflow efficiency to ensure accurate and timely...

Job Description Job Description Company Description The University of Maryland Medical System is a 14-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women’s and children’s health and physical rehabilitation. UMMS is the fourth largest private employer in the Baltimore metropolitan area and one of the top 20 employers in the state of Maryland. No organization will give you the clinical variety, the support, or the opportunities for professional growth that you’ll enjoy as a member of our team.  Job Description I. General Summary Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure...

Navajo Preference Employment Act : NAVAJO/INDIAN PREFERENCE TCRHCC is located within the Navajo Nation and, in accordance with Navajo Nation law and applicable federal law, has implemented a Navajo/Indian Preference in Employment Policy. Pursuant to this Policy, applicants who are enrolled members of the Navajo Nation, Hopi Tribe, and San Juan Southern Paiute Tribe and who meet the necessary qualifications for this position will be given preference in hiring and employment for this position. Applicants who are legally married to an enrolled member of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe, who have resided within the territorial jurisdiction of the Navajo Nation or other federally-recognized American Indian Tribe for at least one continuous year immediately preceding the date of application, and who meet the necessary qualifications for this position will be given secondary preference. Applicants who are enrolled members of any other federally-recognized...