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180 coding compliance auditor jobs found

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AAPC Recruiting Services
Full Time
 
Medical Coding Compliance Specialist - Onsite Only
AAPC Recruiting Services Jacksonville, FL, USA
Summary: The position will reduce inpatient  facility, ambulatory procedure visit (APV), or professional services coding (PSC) backlog created by workload  surges, manning shortages, or computer system issues. This position will conduct focused audits for coding  compliance or training purposes; develop standardized coding training; deliver coding education/training to  individuals or groups; and identifying/educating on clinical documentation improvement opportunities. Knowledge and Skill: Knowledge of The International Classification of Diseases, Ninth Revision, Clinical Modification (ICDCM), procedural coding, healthcare common procedure coding system (HCPCS)/current  procedural terminology (CPT) nomenclature, medical and procedural terminology, anatomy and  physiology, pharmacology, and disease processes to perform the duties described. Knowledge of reimbursement systems, including Prospective Payment System (PPS) and Diagnostic Related  Groupings...

Jun 20, 2023
South Peninsula Hospital
Full Time
 
HMC Medical Coder
South Peninsula Hospital Hybrid (Homer, AK, USA)
This  HMC Medical Coder  position is located in our  Homer Medical Center. Hours:   This is a full-time benefited position, 40 hours per week, day shift.  This position is in-person, and has the potential to be a hybrid schedule (part remote, part in-person). If hybrid, work 2 days in person and 3 days remote. Starting Salary:   $27.23 – $46.18/hr (rate of pay range quoted is for 0-30 years of experience, rate is higher with more years of experience, rate is higher with certification, PLUS shift differentials for evenings, nights and weekends) What you'll do : Be responsible for reviewing, coding, and accurately assigning diagnosis and procedure codes to Homer Medical Center/ South Peninsula Hospital (HMC/SPH) super bills. Identify the appropriate codes to the highest specificity using appropriate coding guidelines, thus ensuring all coded records meet HMC/SPH, state and federal requirements. Perform coding in a timely and accurate manner to...

Sep 26, 2023
TI
Full Time
 
Medical Coding - Trainer Specialist (New Paltz, NY HYBRID)
The Institute for Family Health Hybrid (New Paltz, NY, USA)
SUMMARY: Great opportunity for someone who is out going, loves teaching and appreciates the value in training clinicians how to code and document for the services provided.   Looking for a dynamic individual who will serve as an expert source of information regarding the impact of coding and documentation as it relates to patient care, quality outcomes measures, risk of mortality/severity of illness indicators, and correct reimbursement.   This individual will be responsible for the planning, management, implementation and delivery of coding reviews, engaging presentations, as well as provide assistance in the development of EHR best practice workflows.  This position assists in the development of proper documentation and coding policies and procedures. This position will provide training for a variety of audiences including clinical staff and administrative staff. Travel to various Institute locations will be required. RESPONSIBILITIES: Shall take the lead on...

Sep 25, 2023
SG
Full Time
 
Coding Manager
South Georgia Medical Center Valdosta, GA, USA
We're looking for a Coding Manager like YOU! Responsible for the management of all coding functions within the system for professional services.   Conducts performance reviews.  Monitors coding accuracy, performs monthly audits of both internal, and contract staff to ensure 95% accuracy maintained consistently.  Reports noncompliance issues detected through auditing to Director. Develops and coordinates corrective action plans, follow-up audits, and ongoing monitoring. Analyzes and adjusts workflow to facilitate productivity and monitors productivity. Trains coding personnel.  Maintains unbilled accounts due to coding at acceptable levels and works to remove barriers that delay coding and billing.  Works with all practice managers and department leads to resolve billing problems. Also, coordinate with the Professional Billing Manager to resolve claims issues. Updates policy and procedure manuals.  Stays up to date on coding conventions and billing compliance...

Sep 11, 2023
Franciscan Health
Full Time
 
Ambulatory Charge Review and Coding Manager
Franciscan Health Munster, IN, USA
WHAT YOU CAN EXPECT Quality Assurance: Reviews patient charts to verify all services provided are accurately captured. Reviews procedure codes and diagnosis codes for accuracy. Audits documentation to confirm support for charges. Prepares corrections as needed for provider charges to process correctly. Audits and analyzes software system and charts to identify trends and issues. Researches, resolves, or escalates, as appropriate. Subject Matter Expert: Serves as Subject Matter Expert and resource to direct staff on inquiries and consultation on developing/mapping workflows, technology issues, and unique or complicated coding situations. Audits the staff’s work to comply with standards. Collaboration: Collaborates and communicates with management regarding all aspects related to charge review and coding, including but not limited to workflows, updates, errors, and trends. Identifies solutions to resolve widespread issues where appropriate....

Sep 02, 2023
AAPC Recruiting Services
Full Time
 
Operations Manager
AAPC Recruiting Services Phoenix, AZ, USA
As the Operations Manager, you play a crucial role in ensuring the smooth functioning and efficiency of our organization. Your primary responsibility is to provide leadership to your assigned office and oversee its overall performance. You will work closely with the Director of Operations to drive process improvements, implement changes, and evaluate the success of new initiatives. Your role also involves managing employees in compliance with company policies and regulations, from recruitment and training to performance management and issue resolution. Key Responsibilities: Enhance Organizational Effectiveness: Streamline operational systems, processes, and policies to align with our mission. Improve management reporting, information flow, and organizational planning. Boost Operational Efficiency: Enhance the effectiveness and efficiency of operations in your assigned region. Foster collaboration and communication between support and business functions....

Sep 01, 2023
AAPC Recruiting Services
Part Time
 
Part Time - Interventional Radiology Medical Coder - 100% Remote
AAPC Recruiting Services Remote
Essential Job Functions: 100% remote Part-time, permanent opportunity Perform quality assurance audits on internal coders, clients, and procedures, as assigned. Serve as a trusted asset to answer all Coder questions, as they relate to Interventional Radiology Coding. Will accurately perform audits on coders. Will perform any other audits needed as assigned. Perform MIPS Audits as assigned. Assigning CPT, HCPCS, ICD-10-CM and ASA codes. Ensuring compliance with medical coding policies and guidelines. Performs other related duties as assigned. Required Skills: Ability to communicate in a clear, professional, and timely manner with all staff members. Proficient in Microsoft Office Suite. Ability to work independently and in a fast-paced environment. Strong problem-solving skills. Strong analytical skills. Excellent organizational skills and attention to detail. Education and Experience: High school diploma or equivalent required....

Aug 31, 2023
CC
Full Time
 
Risk Adjustment Coding Team Lead
CSI Companies Remote
CSI Companies seeks interested candidates to join our growing Coding and Clinical Integrity Practice as a Coding Team Leader.  This is an incredible opportunity for an individual who enjoys managing and coaching, operations, creating and forming a team, and developing processes and procedures for maximum efficiency. This Coding Team Leader is responsible for leading a team of coders in the identification, collection, assessment, and validation of claim/encounter information consistent with all regulatory and official coding guidance.  The Team Leader will also be responsible for quality review of the work of others and coaching and remediating performance related issues. Primary Duties May Include, But Are Not Limited To Leads Risk Adjustment and Coding operations including education, data analysis, audits and overseeing record review processes. Oversees day to day operations, including monitoring of performance and operational metrics. Creates reports...

Aug 28, 2023
AAPC Recruiting Services
Full Time
 
Ambulatory Procedure Visit Coder (APV Coder) - 45 mins North of San Diego - Hybrid
AAPC Recruiting Services Hybrid (CA, USA)
Responsibilities :  Responsible for assignment of accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System  (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic) for  outpatient encounters in a US Government facility. Plays a significant role in coding compliance activities. Knowledge and Skill: Excellent computer/communication skills Knowledge of anatomy/physiology and disease process, medical terminology, coding guidelines (outpatient), documentation requirements, familiarity with medications and reimbursement guidelines; and encoder experience. Ability to handle multiple projects and appropriately prioritize tasks to meet deadlines Education/Certifications: RHIT, RHIA, CPC, CCS-P Obtain the required CEU requirements to maintain current and proper certifications Experience: Minimum of 3 years in the...

Aug 21, 2023
AAPC Recruiting Services
Full Time
 
Outpatient Medical Coder - 45 mins North of San Diego - Hybrid
AAPC Recruiting Services Hybrid (CA, USA)
Responsibilities :  Responsible for assignment of accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System  (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic) for  outpatient encounters in a US Government facility. Plays a significant role in coding compliance activities. Knowledge and Skill: Excellent computer/communication skills Knowledge of anatomy/physiology and disease process, medical terminology, coding guidelines (outpatient), documentation requirements, familiarity with medications and reimbursement guidelines; and encoder experience. Ability to handle multiple projects and appropriately prioritize tasks to meet deadlines Education/Certifications: RHIT, RHIA, CPC, CCS-P Obtain the required CEU requirements to maintain current and proper certifications Experience: Minimum of 3 years in the...

Jul 21, 2023
AAPC Recruiting Services
Full Time
 
Certified Coder in Northern CA - Onsite Only
AAPC Recruiting Services CA, USA
Certified Coder is a nonexempt position responsible for front office and general coding billing duties. Responsible for Coding Audits, Claim, Billing review and compliance.  Performance Requirements Knowledge Knowledge of billing practices and clinic policies and procedures. Knowledge of coding and clinic operating policies.  Knowledge of medical terminology Knowledge of health care insurance claim practices and compliance. Knowledge of computer systems, programs, and applications. Skills Proficient skills in computer programs. Skill in using a calculator. Abilities Ability to understand and interpret policies and regulations. Ability to read and interpret medical charts. Ability to examine documents for accuracy and completeness. Ability to communicate effectively and work with others.   Major Duties and Accountabilities Coordinates with clinical staff to verify charge and/or documentation information as needed Audits...

Jul 03, 2023
AAPC Recruiting Services
Full Time
 
Senior IR Medical Coder - USA Remote
AAPC Recruiting Services Remote
Essential Job Functions: 100% remote Full-time, permanent opportunity Perform quality assurance audits on internal coders, clients, and procedures, as assigned. Serve as a trusted asset to answer all Coder questions, as they relate to Interventional Radiology Coding. Will accurately perform audits on coders. Will perform any other audits needed as assigned. Perform MIPS Audits as assigned. Assigning CPT, HCPCS, ICD-10-CM and ASA codes. Ensuring compliance with medical coding policies and guidelines. Performs other related duties as assigned. Required Skills: Ability to communicate in a clear, professional, and timely manner with all staff members. Proficient in Microsoft Office Suite. Ability to work independently and in a fast-paced environment. Strong problem-solving skills. Strong analytical skills. Excellent organizational skills and attention to detail. Education and Experience: High school diploma or equivalent required....

Jun 30, 2023
TH
Coding Compliance Auditor - Physician Services - Remote
Tenet Health Frisco, TX, USA
Job Description As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! JOB SUMMARY The Coding Compliance Auditor conducts risk-based coding compliance audits of Physician Services encounters to validate code assignment is in compliance with the official coding guidelines as supported by clinical...

Sep 25, 2023
AD
Medical Coding Compliance Auditor CPC
Allied Digestive Health West Long Branch, NJ, USA
Job Description Job Description Allied Digestive Health is one of the largest integrated networks of gastroenterology care centers in the nation with over 200 providers and 60 locations throughout New Jersey and New York. As a fast-growing physician-led organization, our dynamic structure encourages physician input and decision-making, while simultaneously offering operational support. Our dedicated, compassionate team of providers prioritize personalized treatment plans for patients that deliver the highest quality of care. All of our doctors are board-certified in gastroenterology and hepatology. Several of them serve as chief of gastroenterology at nearby hospitals, and a number of them have been recognized as top-quality physicians in publications, including but not limited to: Best Doctors in America and Top Doctors New Jersey, and US News Health – US News & World Report. We are excited to announce that we are looking for a Full-Time Medical...

Sep 13, 2023
CH
Coding Compliance Auditor
Community Health Group Chula Vista, CA, USA
POSITION SUMMARY Audits medical records to ensure compliance with coding procedures and standards, based on CHG's protocols, regulatory requirements (CMS, DHCS, DMHC), and American Medical Association (AMA). Reviews and provides processing recommendations on routes from Claims Disputes and Claims Department. Collaborates with CMO to review medical records to validate claim determinations. Identifies training needs for Claims and Provider Services department. Ensures compliance with coding, fee-schedule, and system changes. Works closely with department leadership to improve efficiencies, make recommendations that will support the departmental goals and provide resources and education to Claims and Provider Services Departments. COMPLIANCE WITH REGULATIONS: Works closely with all departments necessary to ensure that processes, programs and services are accomplished in a timely and efficient manner in accordance with CHG policies and procedures and in compliance with applicable...

Sep 26, 2023
Uo
CODING COMPLIANCE AUDITOR
University of Maryland Medical System Baltimore, MD, USA
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...

Sep 25, 2023
Pr
Coding QI Compliance Auditor and Trainer II, Outpatient *Remote*
Providence Portland, OR, USA
**Description** **Providence St. Joseph Health is calling a Coding QI Compliance Auditor and Trainer II, Outpatient to work remotely within our footprint states: AK, CA, MT, OR, TX and/or WA.** The Coding QI Compliance Auditor and Trainer II, Outpatient is critical to the coding compliance program. By performing audits of hospital coding, training new coding staff, preparing and presenting educational sessions for the coders and staying current with official coding guidelines and regulations, the incumbent ensures the proper coding of PH&S hospital medical records. This position includes obtaining, recording and reporting essential data, assisting in problem solving of coding issues and acting as a subject matter expert for coding staff. **Responsibilities:** + Ensure accurate, compliant coding of hospital medical records through outpatient training, auditing and research. + Work with coders and CDI specialists to resolve complex coding and documentation issues. +...

Sep 26, 2023
SR
Compliance Coding Auditor/Educator
Spartanburg Regional Healthcare System Spartanburg, SC, USA
Join Our Team as a Compliance Coding Auditor/Educator: A Rewarding and Challenging Role Are you passionate about ensuring accurate and compliant coding practices in healthcare? As a Compliance Coding Auditor/Educator, you will play a crucial role in supporting our healthcare system by conducting ongoing audits and providing education on coding guidelines. Your expertise in CPT & ICD-9-CM guidelines will be essential in analyzing clinical documentation to ensure precise and thorough coding that reflects the level of care provided. Minimum Requirements + Education: Physician office and/or hospital-based coding experience required. + Experience: Extensive knowledge of CPT & ICD-9-CM guidelines necessary. + Certifications: CPC or CCS required, with appropriate auditing experience. Preferred Requirements + Education: An associate degree in a related field is recommended, but a bachelor's degree in a related field is preferred....

Sep 20, 2023
Panacea Healthcare Solutions, LLC
Full Time
 
Compliance, Coding & Documentation Auditor
Panacea Healthcare Solutions, LLC Remote
General Description The Compliance, Coding & Documentation Auditor position is responsible for performing primarily remote client coding audits for all professional services, Ambulatory Surgery Centers, Outpatient Facility, Interventional Radiology and Cardiology including research, report preparation and client follow up.      Essential Job Functions / Responsibilities Reviews/audits clinical documentation for all professional services, Ambulatory Surgery Centers, Outpatient Facility, Interventional Radiology and Cardiology Provides accurate audit results consistently including appropriate and current official resources Applies Teaching Physician Guidelines Applies Incident to and Split/Shared Guidelines ICD-10-CM auditing Modifier auditing Units auditing Researches coding/compliance issues/questions/concerns based on client needs Prepares appropriate written report to include findings and recommendations Prepares executive/written...

Aug 29, 2023
AP
Certified Coder (CPC) Medical Documentation Auditor
Apogee Physicians Scottsdale, AZ, USA
Job Description Job Description INTERNAL AUDITOR This individual works closely with the Senior Internal Coding Compliance Auditor and Chief Compliance Officer, under general supervision conducts and coordinates audits to ensure that provider documentation reflects the services provided and billed. Provides feedback and education to the clinical staff and should be able to answer questions and explain the findings. JOB REQUIREMENTS: Conducts and coordinates routine scheduled Evaluation and Management audits of provider documentation involved with professional fee billing, for accuracy of coding and providers’ physical presence; coordinates ad hoc audits Detects compliance issues by conducting routine audits for adherence to laws, regulations, and internal operating practice Provides feedback and makes recommendations to providers with the goal to educate the providers in coding for their services Performs other duties as assigned KNOWLEDGE, SKILLS, AND ABILITIES:...

Sep 27, 2023
UnitedHealth Group
Outpatient Coding Auditor - Remote
UnitedHealth Group Orlando, FL, USA
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Outpatient Coding Compliance Auditor conducts audits of outpatient facility and/or professional services coding to validate the integrity of ICD-10-CM diagnoses, CPT, HCPCS, modifiers and/or professional Evaluation and Management(E/M) codes assigned for all specialties and chart types. The Auditor validates assigned codes for accuracy based on medical record documentation and established...

Sep 26, 2023
UnitedHealth Group
Outpatient Coding Auditor - Remote
UnitedHealth Group San Antonio, TX, USA
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Outpatient Coding Compliance Auditor conducts audits of outpatient facility and/or professional services coding to validate the integrity of ICD-10-CM diagnoses, CPT, HCPCS, modifiers and/or professional Evaluation and Management(E/M) codes assigned for all specialties and chart types. The Auditor validates assigned codes for accuracy based on medical record documentation and established...

Sep 26, 2023
UnitedHealth Group
Outpatient Coding Auditor - Remote
UnitedHealth Group Austin, TX, USA
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Outpatient Coding Compliance Auditor conducts audits of outpatient facility and/or professional services coding to validate the integrity of ICD-10-CM diagnoses, CPT, HCPCS, modifiers and/or professional Evaluation and Management(E/M) codes assigned for all specialties and chart types. The Auditor validates assigned codes for accuracy based on medical record documentation and established...

Sep 26, 2023
UnitedHealth Group
Outpatient Coding Auditor - Remote
UnitedHealth Group Dallas, TX, USA
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Outpatient Coding Compliance Auditor conducts audits of outpatient facility and/or professional services coding to validate the integrity of ICD-10-CM diagnoses, CPT, HCPCS, modifiers and/or professional Evaluation and Management(E/M) codes assigned for all specialties and chart types. The Auditor validates assigned codes for accuracy based on medical record documentation and established...

Sep 26, 2023
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