102 hcc coding auditor education specialist jobs found

Job Title Employment Type: Full time Description Purpose: Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization's strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge. Note: "patients" refers to patients, clients, residents, participants, customers, members Essential Functions Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program...

Job Title Employment Type: Full time Description Purpose: Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization's strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge. Note: "patients" refers to patients, clients, residents, participants, customers, members Essential Functions Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program...

Job Summary The Coding Auditor performs coding audits to assure compliance with Corporate Compliance Plan standards. This role develops, coordinates, and implements clinic wide education for coding and billing issues while serving as a resource to physicians, office staff, management and patients for coding and billing issues. Additionally, this role coordinates successful response to regulatory bodies and insurance companies for medical record reviews and audits. Minimum Education High School Diploma or GED. Bachelor’s degree in Healthcare Administration or Business Administration, preferred. Licensure, Registration and/or Certification Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA). Work Experience Minimum 3 years of hospital or physician auditing experience with 1 year of hospital or physician coding experience. Hierarchical Condition Categories (HCC)...

Full Time Days Job Summary: The Coding Auditor performs coding audits to assure compliance with Corporate Compliance Plan standards. This role develops, coordinates, and implements clinic wide education for coding and billing issues while serving as a resource to physicians, office staff, management and patients for coding and billing issues. Additionally, this role coordinates successful response to regulatory bodies and insurance companies for medical record reviews and audits. Minimum Education: High School Diploma or GED. Bachelor’s degree in Healthcare Administration or Business Administration, preferred. Licensure, Registration and/or Certification: Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA). Work Experience: Minimum 3 years of hospital or physician auditing experience with 1 year of hospital or physician coding experience. Hierarchical Condition...

To support the Coding Audit and Compliance team, the fully remote Certified Coding Compliance Auditor will conduct documentation and coding reviews, provide education and training to internal and external stakeholders, and manage client projects while ensuring adherence to productivity and quality standards. Key responsibilities Conduct detailed analysis of medical records and assign diagnostic codes according to regulatory guidelines Develop audit reports and corrective action plans based on findings, ensuring timely delivery of client projects Provide education and training sessions to both internal teams and clients on coding, documentation, and compliance matters Required qualifications High School Diploma; Bachelor's degree preferred Minimum of 3 years of CPT and ICD-10 medical coding and auditing experience Certified Risk Coder (CRC) certification and/or significant HCC coding experience required AHIMA - Certified Coding Specialist-Physician (CCS-P) or AAPC - CPC...

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: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts pertinent data points for billing and quality reviews. Communicates with various departments as needed to ensure accuracy of patient data. Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing). May assign and sequence basic CPT (Current...

JOB DESCRIPTION To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional coding...

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: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts pertinent data points for billing and quality reviews. Communicates with various departments as needed to ensure accuracy of patient data. Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing). May assign and sequence basic CPT (Current...

Inpatient Facility Medical Coder To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional coding...

Company Description Job Description To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional...

Inpatient Facility Medical Coder (40h Day) Remote Clackamas, OR Candidates must reside either in Washington or Oregon to be considered for this position. To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding...

This position operates on a hybrid work schedule. Candidate must reside in Los Angeles or Orange County. Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth. Who Are We? Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values. Why Join Us? We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation. Job Summary The Risk Adjustment Coding Auditor is responsible for conducting...

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: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and...

Location Miramar, Florida Summary Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments. For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding. Submits daily productivity report to HIM manager by defined deadline....

Job Details Location: Huntington Beach Office, Huntington Beach, CA 92647. Position Type: Full Time. Salary Range: $72,800.00 – $80,000.00. This position operates on a hybrid work schedule. Candidate must reside in Los Angeles or Orange County. Job Summary The Risk Adjustment Coding Auditor is responsible for conducting retrospective and prospective coding audits, diagnosis validation reviews, provider documentation assessments, and compliance monitoring activities to support accurate Medicare Advantage risk adjustment reporting and CMS audit readiness. This role reviews medical record documentation and ICD-10-CM diagnosis coding to ensure compliance with CMS Risk Adjustment program requirements, Official Coding Guidelines, AHA Coding Clinic guidance, and organizational policies. Functions & Responsibilities Conduct retrospective, prospective, and targeted coding audits to assess the accuracy, completeness, and compliance of ICD-10-CM diagnosis coding and HCC capture....

Current Saint Francis Employees - Please click HERE to login and apply. Full Time Job Summary: The Coding Auditor performs coding audits to assure compliance with Corporate Compliance Plan standards. This role develops, coordinates, and implements clinic wide education for coding and billing issues while serving as a resource to physicians, office staff, management and patients for coding and billing issues. Additionally, this role coordinates successful response to regulatory bodies and insurance companies for medical record reviews and audits. Minimum Education: High School Diploma or GED. Bachelor's degree in Healthcare Administration or Business Administration, preferred. Licensure, Registration and/or Certification: Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA). Work Experience: Minimum 3 years of hospital or physician auditing experience with 1 year...

Coding Auditor Job Summary: The Coding Auditor performs coding audits to assure compliance with Corporate Compliance Plan standards. This role develops, coordinates, and implements clinic wide education for coding and billing issues while serving as a resource to physicians, office staff, management and patients for coding and billing issues. Additionally, this role coordinates successful response to regulatory bodies and insurance companies for medical record reviews and audits. Minimum Education: High School Diploma or GED. Bachelor's degree in Healthcare Administration or Business Administration, preferred. Licensure, Registration and/or Certification: Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA). Work Experience: Minimum 3 years of hospital or physician auditing experience with 1 year of hospital or physician coding experience. Hierarchical...

Coder 2 - Clinic To review and audit Network Provider medical records for documentation and coding compliancy and quality with federal and state laws and regulations. Responsibilities Quality and Performance Improvement Research, develops and implements standardized process for quality monitoring of inpatient and outpatient coding and abstracting. Conducts quality audits for coding according to pre-established criteria in coordination with the Coding and Reimbursement Specialist. Assists Management with evaluation of functions and processes of the coding area to determine opportunities to improve the efficiency and quality of the coding area. Implements innovative ideas and process changes. Attends meetings as required and strives to improve the quality of meetings by taking an active role in meeting topics. Participates in educational programs, in-services, and training sessions in an effort to share his/her own expertise with others and further the quality of education and...

Job Title Medical Coding Specialist Job Description Collects, reviews, retrieves and codes Evaluation & Management codes, and major procedures (surgical procedures, anesthesia reports, radiology reports/procedures) and other services for Medicine/Surgical practices, based on data from medical records and reports for quality assessment, audit and billing purposes. Responsibilities Duties and Responsibilities Essential Functions: Performs chart audits, reviewing for accuracy and compliance. Reviews operative reports and other documentation and assigns appropriate diagnosis (ICD-10), procedure codes (CPT-4), and other services (HCPCS) for final billing. Research and process invoice corrections. Reviews and analyzes coding/billing procedures. Presents training and feedback concerning medical coding, compliance, and reimbursement to physicians/providers. Coordinates and implements reimbursement improvement activities with staff and providers. Meets...

Summary This position, located in Health Information Management at Eastern Oklahoma VA Health Care System, involves coding and auditing patient records, ensuring coding accuracy and compliance. Candidates must be skilled in ICD, CPT, and HCPCS, and may provide coding education and conduct audits to improve data quality and documentation. Learn more about this agency Duties Help Complete all application requirements detailed in the "Required Documents" section of this announcement. Total Rewards of a VA Career: Total Rewards of a Allied Health Professional Code Assignment & Validation: Accurately reviews and assigns diagnostic and procedural codes using current versions of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS. Follows all official coding guidelines and industry standards (including AMA CPT Assistant and other established resources). Clinical Documentation Audit: Audits both inpatient and outpatient health records for completeness and accuracy of...

About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. Occ Summary The Medical Records Coder II is a certified coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-10-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures, and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract information from medical records following established methods and procedures. Work Performed Review the complex (problematic coding that needs research and reference checking) medical...

Join Our Caring Community Become a part of our caring community and help us put health first. The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS...

Job Title Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Seeking RN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Remote position in New York. Job Responsibility 1. Leverages clinical expertise to identify and validate DRG code assignment. 2. Full review of CDI suggested code changes. 3. Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. 4. Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5. Applies coding rules and regulations to the validation review process. 6. Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7. Communicates DRG changes and rationale to the coding and CDI staff. 8....