21 coding compliance auditor jobs found in Baltimore, MD

Support Center If you are a current Adventist HealthCare employee, please click this link to apply through your Workday account. Adventist Healthcare seeks to hire an experienced Coding Compliance Auditor for our Organizational Integrity department who will embrace our mission to extend God's care through the ministry of physical, mental, and spiritual healing. As a Coding Compliance Auditor, you will: •Conducts a high volume of coding compliance audits across Adventist HealthCare (AHC) in accordance with the Department Work Plan. •Assists with the development, updating, maintenance, and dissemination of training and education materials to AHC clinicians, managers, and coding department staff. Provide material and conduct presentations for Compliance education programs as needed. •Performs independent research, and assessment and remain current with CMS, NGS Medicare, and Office of Inspector General (OIG) regulations, guidelines, bulletins, coding practices & methods,...

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 coding classification systems....

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 coding classification systems. II. Principal Responsibilities and Tasks 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. Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching plans in...

Job Description Job Description ABOUT US: Laredo Technical Services, Inc. provides staffing services to federal Government agencies all over the world. LTSI connects the right people to the right opportunity. With our experience in placing our Team Members throughout the United States and overseas, we excel at providing experienced, professional personnel for a wide range of Professional and Office Administration as well as Medical services. Our goal is to provide the highest quality of professionals in the industry.   LTSI’s culture delivers a strong work ethic while going above and beyond with a sense of urgency. We are the employee-driven company. We strive for excellence every day, which is what sets us apart from all the other government contractors. Our strong work ethic, sense of urgency and commitment to going above and beyond for our clients is what we value most!   As a Certified Service-Disabled Veteran Owned Small Business (SDVOSB) Minority Business Enterprise...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching plans in...

Job Description Duties will include: selecting the correct diagnosis and procedure codes based on documentation and payer specificity requirements; communicating with physicians about coding questions and issues; using modifiers to ensure clean claims; maintaining current knowledge of coding and billing policies; and other duties as assigned. Requirements : Qualified applicants will possess: H.S. diploma or equivalent (GED); Certified Professional Coder (CPC or CCS-P) certification required; previous experience in professional coding and/or auditing; PC proficiency; knowledge of payers in the specialty; extensive knowledge of CPT and ICD-9 coding; knowledge of government regulations related to teaching physician documentation; and knowledge of medical terminology, anatomy, and physiology. CPC-A license applicants are encouraged to apply. Essential Job Functions Selects the appropriate procedural and diagnostic code based on provider documentation, utilizing HIPAA...

Job Description Job Description Company Description The University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of Nursing and University of Maryland, Baltimore who educate the state's future health care professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban and rural communities across the state of Maryland. UMMS puts academic medicine within reach through primary and specialty care delivered at 11 hospitals, including the flagship University of Maryland Medical Center, the System's anchor institution in downtown Baltimore, as well as through a network of University of Maryland Urgent Care centers and more than 150 other locations in 13 counties. For more information, visit...

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 coding classification systems. II. Principal Responsibilities and Tasks 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. Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and observation...

Duties will include: selecting the correct diagnosis and procedure codes based on documentation and payer specificity requirements; communicating with physicians about coding questions and issues; using modifiers to assure clean claims; maintaining current knowledge on coding and billing policies; and other duties as assigned. Requirements Qualified applicants will possess: H.S. diploma or equivalent (GED); Certified Professional Coder (CPC or CCS-P) certification required, previous experience in professional coding and/or auditing; PC proficiency; knowledge of payers in specialty; extensive knowledge of CPT and ICD-9 coding; knowledge of government regulations as they relate to teaching physician documentation; and knowledge of medical terminology, anatomy, and physiology is required. CPC-A license are encouraged to apply. ESSENTIAL JOB FUNCTINS 1. Selects the appropriate procedural and diagnostic code based on provider documentation, utilizing HIPAA Standardized Code Set...

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 coding classification systems. II. Principal Responsibilities and Tasks 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. Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and observation...

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 ESSENTIAL FUNCTION OF THE JOB 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 into the coding and abstracting system. Works collaboratively with the Clinical...

Job Description Job Description We have an immediate opening for a part-time Orthopedic and Plastic Surgery Medical Coder.  Candidate will be a highly skilled and detailed-oriented Certified Medical Coder with specialized experience in Ambulatory Orthopedic and Plastic Surgery Coding for Same-Day Surgeries (outpatient procedures).  The ideal candidate will possess extensive knowledge of CPT, ICD-10-CM and HCPCS coding systems, along with a strong understanding of outpatient surgical documentation and regulatory compliance.  Preference will be given to candidates with same-day surgery coding and ASC coding specialties. Purpose The Medical Coding Specialist plays a key part in ensuring accurate coding for optimal reimbursement and compliance with all coding and billing guidelines. Organizational Structure:   The Coding Specialist reports to the Coding Manager. Key Responsibilities: Accurately review and assign CPT, ICD-10-CM, and HCPCS Level II codes to orthopedic and...

Orthopedic and Plastic Surgery Medical Coding Specialist Orthopedic and Plastic Surgery Medical Coding Specialist 1 day ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. We have an immediate opening for a part-time Orthopedic and Plastic Surgery Medical Coder. Candidate will be a highly skilled and detailed-oriented Certified Medical Coder with specialized experience in Ambulatory Orthopedic and Plastic Surgery Coding for Same-Day Surgeries (outpatient procedures). The idealcandidate will possess extensive knowledge of CPT, ICD-10-CM and HCPCS coding systems, along with a strong understanding of outpatient surgical documentation and regulatory compliance. Preference will be given to candidates with same-day surgery coding and ASC coding specialties. Purpose The Medical Coding Specialist plays a key part in ensuring accurate coding for optimal reimbursement and compliance with all coding and billing guidelines. Organizational...

Job Summary: Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, third party payors, other regulatory agencies and Kaiser Permanente policy. Functions includes, but are not limited to working charge review work queues for reimbursable accounts for all internal and external surgical services. Serves as a technical coder for all specialties. Assists supervisor in responding to coding questions from other levels of coders and in responding to providers. Conducts special projects and focused reviews of encounters as requested. Essential Responsibilities: Required to research and assign. HCPCS Level II codes for ambulatory surgical services and/or professional services performed. Ability to research, analyze and/or review detailed and high complexity code edits and transactions within the Kaiser Permanente system. Provides additional support to the coding...

Job Summary: Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, third party payors, other regulatory agencies and Kaiser Permanente policy. Functions includes, but are not limited to working charge review work queues for reimbursable accounts for all internal and external surgical services. Serves as a technical coder for all specialties. Assists supervisor in responding to coding questions from other levels of coders and in responding to providers. Conducts special projects and focused reviews of encounters as requested. Essential Responsibilities: Required to research and assign. HCPCS Level II codes for ambulatory surgical services and/or professional services performed. Ability to research, analyze and/or review detailed and high complexity code edits and transactions within the Kaiser Permanente system. Provides additional support to the coding staff...

Job Description Job Description INTRODUCTION Under the supervision of the Medical Coding Manager, the Medical Coding Specialist is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The Medical Coding Specialist also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. MAJOR DUTIES/ESSENTIAL FUNCTIONS Essential and other important responsibilities and duties may include, but are not limited to the following: Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered. Supports the Medical Coding Manager to respond to audit...

INTRODUCTION Under the supervision of the Medical Coding Manager, the Medical Coding Specialist is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The Medical Coding Specialist also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. MAJOR DUTIES/ESSENTIAL FUNCTIONS Essential and other important responsibilities and duties may include, but are not limited to the following: Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered. Supports the Medical Coding Manager to respond to audit findings and make applicable coding...

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 ESSENTIAL FUNCTION OF THE JOB 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 into the coding and abstracting system. Works collaboratively with the Clinical...

General Summary of Position Assists the MedStar Family Choice (MFC) compliance and privacy programs. Conducts both internal and external audits to ensure compliance with regulatory requirements. We recruit, retain, and advance associates with diverse backgrounds, skills, and talents equitably at all levels. Key Responsibilities Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations. Analyzes existing clinical policies and makes recommendations to improve program integrity and organization processes. Assists in investigating potential compliance/privacy violations. Assists with and tracks responses to external government inquiries, investigations, data requests, subpoenas, and fair hearings. Responds to government requests for claims data/information. Assists with internal and...

We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance though our various wellbeing programs. Location: Remote (Work-from-Home) Schedule: Monday to Friday Experience: Minimum 5 years of related experience (facility-based auditing and coding experience). Travel: None required About the role: As an ICD-10 Auditing Consultant Inpatient , you will make an impact by playing a critical role in ensuring the accuracy, compliance, and quality of ICD-10-CM and ICD-10-PCS coding for inpatient records. You will be a valued member of the Cognizant team and work collaboratively with stakeholders and team. In this role, you will: - Ensure Coding Accuracy and Compliance * Conduct thorough reviews of inpatient ICD-10 coded records to ensure accuracy, completeness, and compliance with...