757 coding auditor specialist jobs found

Are you ready to make a difference in the healthcare industry? Join PacificSource and play a vital role in helping our members access quality, affordable care! As an equal opportunity employer, PacificSource is committed to diversity and inclusivity in our hiring practices. All qualified candidates will be considered without regard to any protected status. The Medical Coding Auditor Specialist will engage with complex claims by utilizing advanced adjudication skills, and providing clinical interpretation to resolve grievances and appeals. You'll work collaboratively to refine our claims research policies with an emphasis on process improvement. Your expertise will be crucial in identifying potential fraud and managing erroneous payment recoveries. Key Responsibilities: Engage in the provider and member appeals process, addressing intricate claim issues with advanced adjudication expertise. Offer guidance on claims requiring in-depth research, conducting clinical...

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare...

A leading health data platform company is seeking an Inpatient Auditing Specialist to perform coding audits, provide education, and ensure compliance with regulations. The role requires 5+ years of experience and proficiency in certain coding certifications. This position offers a fully remote setup with a flexible schedule, competitive compensation, and comprehensive employee benefits. Join a dynamic team dedicated to improving healthcare through data-driven solutions. #J-18808-Ljbffr

Join Datavant, a pioneering data platform company that is transforming health data exchange. Our mission is to ensure that every healthcare decision is supported by accurate data, available at the right time and in the most beneficial format. As a vital component of a premier health data network, our platform offers secure, accessible, and impactful data, empowering various healthcare stakeholders, including life sciences firms, government agencies, and care providers. By joining Datavant's vibrant team, you will contribute to innovative technology solutions that tackle crucial challenges in healthcare. We celebrate diversity and value a wide array of professional, educational, and personal experiences to help us reach our ambitious goals in the healthcare industry. Key Responsibilities: Conduct thorough audits of coded medical charts in accordance with specified client guidelines, as directed by the quality supervisor. Skillfully navigate and implement diverse client...

Join Datavant, a pioneering data platform company transforming health data exchange. Our mission is to ensure that every healthcare decision is guided by accurate data at the right moment and in the most useful format. As a leading health data network, our platform offers secure, accessible, and actionable data, empowering various healthcare stakeholders, including life sciences firms, government agencies, and care providers. By becoming part of Datavant's high-performing and values-driven team, you'll play a vital role in creating innovative technology solutions that tackle significant challenges in healthcare. We celebrate a diverse team bringing together a wealth of professional, educational, and personal experiences to achieve our ambitious goals in the healthcare sector. Key Responsibilities: Conduct thorough audits of coded medical charts according to specific client guidelines as directed by the quality supervisor. Efficiently navigate and apply various client...

Join Datavant, a leading data platform company that is revolutionizing health data exchange. Our mission is to ensure every healthcare decision is backed by accurate data at the right moment and in the most useful format. As part of a premier health data network, our platform provides secure, accessible, and actionable data, empowering various healthcare stakeholders, including life sciences firms, government agencies, and care providers. By joining Datavant's dynamic team, you'll contribute to innovative technology solutions that address significant challenges in healthcare. We celebrate diversity and value a wide range of professional, educational, and personal experiences to achieve our ambitious goals in the healthcare sector. Key Responsibilities: Perform comprehensive audits of coded medical charts in compliance with specific client guidelines as directed by the quality supervisor. Expertly navigate and apply various client protocols. Maintain a quality...

Join Datavant, a pioneering data platform company transforming health data exchange. Our mission is to ensure that every healthcare decision is guided by accurate data at the right moment and in the most useful format. As a leading health data network, our platform offers secure, accessible, and actionable data, empowering various healthcare stakeholders, including life sciences firms, government agencies, and care providers. By becoming part of Datavant's high-performing and values-driven team, you'll play a vital role in creating innovative technology solutions that tackle significant challenges in healthcare. We celebrate a diverse team bringing together a wealth of professional, educational, and personal experiences to achieve our ambitious goals in the healthcare sector. Key Responsibilities: Conduct thorough audits of coded medical charts according to specific client guidelines as directed by the quality supervisor. Efficiently navigate and apply various client...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

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...

Overview Hi, we\'re Oscar. We\'re hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. If...

Job Description Job Description Hi, we're Oscar. We're hiring a Senior Specialist, Coding Auditor to join our Payment Integrity. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: You will support issue resolution in the Oscar claim environment. You will be responsible for the end-to-end claims repayment quality, process improvement and supporting root cause analysis . You will report into the VP, Payment Integrity. Work Location: This is a remote position, open to candidates who reside in: Tempe, Arizona; Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; New York City, New York; Philadelphia, Pennsylvania; Salt Lake City, Utah. While your daily work will be completed from your...

Discover Vanderbilt University Medical Center Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. EOE/Vets/Disabled. Job Summary Applies specialized skills and training independently to evaluate and advise whether professional, outpatient and inpatient hospital documentation meets applicable standards for coverage, accuracy, and completeness as well as coding and general compliance, with the goals of identifying and preventing compliance risk and providing timely and effective education and remediation. Provides hands-on training and day-to-day productivity and...

Discover Vanderbilt University Medical Center : Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research. Organization: Compliance Operations - VUH Job Summary: Applies specialized skills and training independently to evaluate and advise whether professional,...

A leading healthcare provider in Mobile is seeking a Coding Specialist focused on ensuring accurate medical coding and billing processes. The role requires an Associate's degree in health information technology and a relevant certification. Responsibilities include performing audits, providing educational support to staff, and resolving coding-related issues. This position aims to improve compliance and coding accuracy, making a significant impact on the quality of care provided. Interested candidates should possess strong attention to detail and effective communication skills. #J-18808-Ljbffr

A leading healthcare provider is seeking a Coding Specialist in New York. The role encompasses ensuring accuracy in medical coding, performing audits, and maintaining compliance with coding guidelines. Candidates should hold relevant certifications and have at least three years of related experience. The position offers a comprehensive benefits package, supporting employees' health and well-being. Join us to make a significant impact in healthcare for women, babies, and children. #J-18808-Ljbffr

A nationwide health services company seeks a Nurse Auditor 2 to perform clinical audits and validate medical records to ensure accuracy and compliance. This remote position requires a current U.S. RN license and a minimum of 1 year of experience with Home Health Care Payment methodologies. Candidates should demonstrate solid judgment, MS Office proficiency, and excellent communication skills. The role is a full-time opportunity with a pay range of $78,400 - $107,800 annually, plus a bonus incentive plan. #J-18808-Ljbffr

A leading healthcare organization is seeking a Nurse Auditor 2 to perform clinical audits and ensure compliance in medical record documentation. This remote role requires a valid U.S. RN license and a minimum of one year of clinical experience. Responsibilities include validating medical documentation, making clinical decisions based on coding, and working independently to manage workload. The position offers a salary range of $78,400 - $107,800 annually and is eligible for a bonus incentive plan. #J-18808-Ljbffr