495 compliance coding auditor jobs found

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...

Responsible for reviewing, analyzing, disseminating and reporting data on chart audits as well as audit documentation requirements of services billed per pre-established criteria approved by the Director of Compliance and the Quality and Compliance Committee. Works under the Supervision of the Quality and Compliance Director. Example of Essential Duties: Audit medical records for data collection and format, coding documentation and content utilizing pre-established criteria. Meets with physicians to review audit results and makes needed recommendations. Audit medical record for adherence to Toledo Clinic Electronic Medical Record policies and procedures, documentation of quality measures, treatment plans, patient follow-up, as well as federal and insurance guidelines. Perform educational sessions with physicians as needed. Create educational programs for physicians and coding staff to maintain compliance education. Maintain written or computerized log of all data collected....

Inspire health. Serve with compassion. Be the difference. Job Summary All team members of the Compliance Department are expected to be knowledgeable and comply with Prisma Health's Code of Excellence to Inspire Health, Serve with Compassion and Be the Difference. In addition, this position requires analytical skills and close attention to detail. This position is responsible for assisting Coding Compliance Manager/Supervisor and Director, Compliance Services in the execution of the annual Coding Compliance Plan. Assists in conducting project planning and developing appropriate audit procedures, and conducts audit procedures and reports findings. Coordinates efforts between the Office of Compliance Services and Physician Practices of the University Medical Group Administration to improve medical record documentation and overall compliance rates. Remote work may be considered for this position. Accountabilities Under the direction of the Coding Compliance...

Inspire health. Serve with compassion. Be the difference. Job Summary All team members of the Compliance Department are expected to be knowledgeable and comply with Prisma Health's Code of Excellence to Inspire Health, Serve with Compassion and Be the Difference. In addition, this position requires analytical skills and close attention to detail. This position is responsible for assisting the Coding Compliance Manager/Supervisor and Director, Compliance Services in the execution of the annual Coding Compliance Plan. Assists in conducting project planning and developing appropriate audit procedures, and conducts audit procedures and reports findings. Coordinates efforts between the Office of Compliance Services and Physician Practices of the University Medical Group Administration to improve medical record documentation and overall compliance rates. Remote work may be considered for this position. Accountabilities Under the direction of the Coding Compliance...

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,...

Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship and leadership programs And more! Description The Professional Coding Compliance Auditor develops and executes audit, monitoring, and education for professional billing, coding and documentation programs that confirm compliance, identifies reimbursement implications, and provides billing providers with relevant and timely information regarding audit results and risk areas. Principal duties and responsibilities: Prepares and oversees professional...

Join to apply for the Hospital Coding Compliance Auditor role at Emory Healthcare 2 weeks ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare, we fuel your professional journey with better benefits, valuable resources, ongoing mentorship, and leadership programs for all types of jobs, in a supportive environment that enables you to reach new heights in your career. And Be What You Want To Be. We Provide Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship and leadership programs And more! Description Reporting to the Manager, Compliance Audit and Analysis, develops and executes audit, monitoring, and education for inpatient hospital billing, coding, and documentation programs that ensure...

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Responsible for auditing coded inpatient or outpatient medical records applying ICD-10 CM/PCS and/or CPT-4. Reviews Ambulatory Payment Classification (APC), Medicare Severity Diagnosis Related Groups (MSDRG) and All Patients Refined Diagnosis Related Groups (APRDRG) assignment and queries following official coding guidelines and regulatory requirements. Provides training and education based on audit results and any regulatory changes that effect Federal, State and American Health Information Management Association (AHIMA) guidelines. Responsibilities: Performs all other duties as assigned. Maintains thorough knowledge of ICD-10CM/PCS, and CPT coding principles and guidelines;...

Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources,ongoing mentorship and leadership programs for all types of jobs, and asupportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship and leadership programs And more! Description The Professional Coding Compliance Auditor develops and executes audit, monitoring, and education for professional billing, coding and documentation programs that confirm compliance, identifies reimbursement implications, and provides billing providers with relevant and timely information regarding audit results and risk areas. Principal duties and responsibilities: Prepares and oversees professional billing and...

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...

The Medical Group Coding Auditor and Educator is responsible for auditing clinical documentation and coding practices to ensure accuracy, compliance, and adherence to national standards. This role involves educating both medical coders, providers and Auditor, Educator, Audit, Healthcare, Medical, Coder, Accounting

Job Description Job Description Description: POSITION: ProFee Coder / Auditor STATUS: Full-Time LOCATION: Fully Remote SCHEDULE: Monday through Friday FLSA STATUS: Non-Exempt / Eligible for Overtime POSITION SUMMARY: The purpose of the ProFee Coder / Auditor position is to code/audit physician surgical cases and or anesthesia cases to determine appropriate designation of diagnosis, procedure and modifiers while maintaining compliance with coding guidelines and client guidelines. POSITION RESPONSIBILITIES: Analyze, evaluate and review client medical records to ensure accuracy of code assignment including ICD-10-CM diagnosis, CPT procedure codes, ASA codes, and Modifiers. Perform validation audits by analyzing, evaluating and reviewing client medical records to ensure accuracy of code assignment. Demonstrate proficiency in coding and maintain 95% accuracy. Follow and adhere to AHIMA’s Standards of Ethical Coding, all applicable regulations and...

Employment Type: Full time Shift: Day Shift Description: The Coding Auditor & Educator performs medical record audits including analysis of medical record documentation; validation of primary and secondary diagnoses and procedures; and ensuring proper assignment of diagnosis and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). Monitor's accuracy of centralized coder's charge capture and coding with proper ICD-10, CPTs, HCPCs, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. Partners with leadership to improve HCC and other Risk Adjustment capture with provider and coder education. Conducts ongoing reviews of patient medical record documentation and procedural and diagnosis coding by each practitioner. Educates practitioners on coding, documentation, and compliance matters. SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE: 1. CPC, RHIT, CRC or CDEO accreditation is...

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 LMHS Compliance Auditor Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare organization, passionately dedicated to improving the health and well-being of our community. With a history dating back to 1898, LMHS remains a cornerstone of healthcare excellence, catering to the evolving needs of Licking County. Our cutting-edge facility provides a comprehensive spectrum of patient care services, from life-saving emergency medicine to the comforting embrace of home healthcare, with a unique range of specialized medical services, including cancer, heart health, maternity, and mental wellness. When you join the LMHS team, you become a vital part of your local community Hospital. Working at LMHS is not just a job, it is a unique opportunity to directly impact the health and well-being of your friends, family, and neighbors. You will be providing care in a place in which you are personally connected, where the impact of your work...

Job Description Job Description Compliance Auditor Corporate Compliance Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare organization, passionately dedicated to improving the health and well-being of our community. With a history dating back to 1898, LMHS remains a cornerstone of healthcare excellence, catering to the evolving needs of Licking County. Our cutting-edge facility provides a comprehensive spectrum of patient care services, from life-saving emergency medicine to the comforting embrace of home healthcare, with a unique range of specialized medical services, including cancer, heart health, maternity, and mental wellness. When you join the LMHS team, you become a vital part of your local community Hospital. Working at LMHS is not just a job, it is a unique opportunity to directly impact the health and well-being of your friends, family, and neighbors. You will be providing care in a place in which you are personally connected, where the...

About the job Medical Record Audit / Coding Auditor OUR CLIENT is a contracting and data management services organization dedicated to primary care physicians throughout Florida IN THIS ROLE YOU are responsible to assist in the development, undertaking and maintenance of a long term comprehensive, clinical coding audit program for inpatient and outpatient activity. To develop and Implement policies to support the clinical coding audit function Receive, review and communicate findings on patient billing coding related complaints. Identify training needs through the audit program of work and liaise with the clinical coding training manager and audit manager to provide the necessary training identified Conduct routine, risk based, proactive or reactive compliance reviews of procedural and diagnosis coding/billing and medical record documentation performed by clinical service providers Prepare reports as required relative to these monitoring and review activities. Work...

Description Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future - we provide the venue for individuals who...