27 hcc coding auditor senior jobs found

Join to apply for the HCC Coding Auditor Senior - Health Plan Admin role at TieTalent . Get AI-powered advice on this job and more exclusive features. Summary The HCC Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and procedures. Responsibilities include quality assurance auditing and risk adjustment code abstraction for programs such as Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This position offers onsite work with a remote option. Responsibilities Perform medical record reviews and audits, including prospective, concurrent, and retrospective workflows, to ensure accurate diagnoses for risk adjustment. Conduct code abstraction and coding quality audits to support compliance with CMS (HCC) guidelines. Review...

Description Summary: HCC Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is an onsite position with a remote option. Responsibilities: Perform Medical Record reviews and audits based on organizational priorities. These can include both prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk...

Summary:HCC Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is an onsite position with a remote option.Responsibilities:Perform Medical Record reviews and audits based on organizational priorities. These can include both prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk adjustment.Perform code...

Profee Coding Auditor (Full-Time, Monday-Friday) Join to apply for the Profee Coding Auditor (Full-Time, Monday-Friday) role at Washington Regional Profee Coding Auditor (Full-Time, Monday-Friday) 1 week ago Be among the first 25 applicants Join to apply for the Profee Coding Auditor (Full-Time, Monday-Friday) role at Washington Regional Get AI-powered advice on this job and more exclusive features. Organization Overview, Mission, Vision, And Values Our mission is to improve the health of people in the communities we serve through compassionate, high-quality care, prevention, and wellness education. Washington Regional Medical System is a community-owned, locally governed, non-profit health care system located in Northwest Arkansas in the heart of Fayetteville, which is consistently ranked among the Best Places to live in the country. Our 425-bed medical center has been named the #1 hospital in Arkansas for four consecutive years by U.S. News & World Report. We...

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 directives....

Candidates must reside either in Washintgon 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 Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP),...

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced individuals who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Role: MRA Coding Auditor The MRA Coding Auditor supports departmental Quality Assessment audits of the internal Coding Analyst team and vendors to ensure accurate and complete data is submitted to CMS. Assists in Risk Adjustment related data audits (RAF, prevalence, clinical documentation improvement, P360, process) to identify areas for...

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 Initiative...

About Legent Health At Legent Health, our mission is simple yet profound: To provide first-class health care that puts YOU first. Our vision reflects our commitment to excellence: Through robust physician partnerships, become a nationwide leader in compassionate, quality healthcare focused on the patient and available to everyone. Our values, also known as our brand pillars, define how we stay true to our identity in the healthcare industry and the communities we serve. These values are central to everything we do: Respect: We honor the time and trust of both patients and physicians by delivering organized, efficient services that ensure a seamless healthcare experience. Service: We are committed to highly personalized care for patients, their families, and the physicians who serve them, driving optimal outcomes for all. Leadership: We strive to be a trusted leader through innovation, clear communication, and unwavering dedication to excellence across our employees and...

Job Details Job Location : Washington Regional Med. Ctr. - Fayetteville, AR Position Type : Full Time Education Level : Certification in related field Salary Range : Undisclosed Job Shift : Day Job Category : Admissions & Billing Services Description Organization Overview, Mission, Vision, and Values Our mission is to improve the health of people in the communities we serve through compassionate, high-quality care, prevention, and wellness education. Washington Regional Medical System is a community-owned, locally governed, non-profit health care system located in Northwest Arkansas in the heart of Fayetteville, which is consistently ranked among the Best Places to live in the country. Our 425-bed medical center has been named the #1 hospital in Arkansas for four consecutive years by U.S. News & World Report. We employ 3,400+ team members and serve the region with over 45 clinic locations, the areas only Level II trauma...

Responsibilities NOT A REMOTE POSITION. MUST BE ONSITE We are pleased to announce the following available position: PRN CERTIFIED CODER (CPC) Coder/HIM Specialist analyzes and abstracts clinical data by assigning codes from the patient records in accordance to coding classification systems. Reviews patient encounters, queries physicians when needed, and identifies and reports issues. Assigns ICD-10-CM codes, creates DRG group assignments. Ensures that codes are accurate and relevant to the patient encounter. Codes inpatient, partial hospitalization, and outpatient charts. Prepares and submits charts required for Precyse Medicare audits. HIM Specialist/ physician Liaison: is responsible for assembly and analysis of discharge medical records. Reviews records for completeness, accuracy and compliance with regulations. Compiles, processes, and maintains records in a manner consistent with medical, administrative, ethical, legal, and regulatory requirements of the health...

Introduction Do you want to join an organization that invests in you as a Inpatient Coding Auditor? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. Benefits At HCA Healthcare, we want to ensure your needs are met. We offer eligible colleagues an attractive benefit package that includes medical, wellbeing, dental and vision benefits along with some unique benefits including: Medical, Dental, Vision, Life Insurance and Flexible Spending Paid Time Off (PTO) and Personal Leave 401K (100% annual match - 3% to 9% of pay based on years of service) Academic Assistance and Reimbursements for Tuition and Student Loans Employee Discounts including Tickets, Retail, Mental Health Apps, Education Apps, Identity Theft Protection etc. Home, Auto, and Pet Insurance Employee Stock Purchase Program (ESPP) Short Term & Long Term Disability coverage Adoption Assistance...

JOB DESCRIPTION Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location : Atlanta, GA Job Type : FTE Shift/Schedule : Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. Summary The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal...

Job Description Job Description About HCCS: Welcome to Healthcare Coding & Consulting Services (HCCS) — one of the nation's leading providers of remote coding and auditing services. We’re more than just a vendor; we are a trusted partner dedicated to excellence in every chart we code. At HCCS, all of our coders and auditors are U.S.-based, W-2 employees . We do not outsource or subcontract any work, ensuring consistency, compliance, and quality in everything we do. As we continue to grow across multiple specialties, we’re looking for experienced, detail-oriented professionals to join our team. Founded in 2006, HCCS is built on decades of collaboration, with many of our team members working together for over 20 years. This history has cultivated a culture of camaraderie, mutual respect, and shared values that drive our commitment to high-quality results. Now Hiring: Part-Time Remote Inpatient Coder We're currently seeking a part-time Inpatient (IP)...

Job Description Job Description About Company: Welcome to Healthcare Coding & Consulting Services (HCCS), one of the nation's leading providers of remote coding and auditing services. We take pride in being more than a typical vendor and welcome the opportunity to demonstrate how we achieve this distinction. All of our coders and auditors are U.S.-based, W-2 employees. We do not outsource or subcontract any of our work, although we greatly value our business partners who entrust their coding and auditing to us. HCCS is continuously expanding, welcoming new provider and partner clients, and hiring across multiple specialties. We invite you to explore our online presence to learn more about us. Although HCCS began operations in 2006, our management team, many of our auditors, and a significant number of our coders have worked together for over twenty years. This long-standing collaboration has fostered an environment of genuine camaraderie and mutual trust,...

Possible $5000 Sign On Bonus for External Hires! Remote Coder positions are available in all states EXCEPT CA and HI Nuvance Health has a network of convenient hospital and outpatient locations - Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care, and two urgent care offices. Non-acute care is offered through various affiliates, including the Thompson House for rehabilitation and skilled nursing services, and the Home Care organizations. Summary: Appropriately analyzes and codes complex inpatient records for facility. Position requires high-level expertise in coding and documentation guidelines, coding clinics, and knowledge of MS DRGs, CC/MCC for appropriate reimbursement and compliance....

Job Description Our client, a leading academic medical center, is seeking an Accounts Receivable/ Medical Billing Supervisor. The Accounts Receivable Supervisor will be responsible for the oversight of administrative functions and assisting the A/R Manager. The position is responsible for collection of and analysis of productivity statistics, the preparation of reports, report analysis and recommendation of system updates to increase revenue. Responsibilities: Train and mentor new staff on best practices Perform quality assurance audits Run daily, weekly and monthly productivity statistics reports for staff Collect and present any payer trends that negatively impact payments Present issues and examples to manager regarding contracting issues Develop trending reports regarding reimbursements Ability to effectively communicate trending data using effective written and presentation skills Ability to create ad-hoc reports Requirements:...

Job Overview Responsible for auditing all Senior HMO members' medical records to ensure accuracy of Risk-Adjustment data and reimbursement. Maintain a professional, positive and caring attitude at all times Duties Audit PCP, specialist and hospital records for additional HCC diagnoses. Audit all assigned providers wellness visits and send a CAP based on last year chronic conditions. Log the patients Prepare provider report card following completion of each PCP review utilizing comments function of qHMO. Forward provider report card to HCC Manager. Update encounter information with additional HCC data. Conduct Risk Adjustment Data Validation (RADV) audits as requested by HCC Manager. Orient providers in the use of qHMO and documentation for Risk Adjustment. Reinforce to providers the necessity for thorough and accurate documentation and reporting of Risk Adjusted diagnoses. Contact a provider when necessary to clarify medical record documentation. Attend required...

Blue Cross of Idaho is looking for Risk Adjustment Medical Coder who will be responsible for the medical record retrieval and over-reads for audit project activities as they relate to risk adjustment and revenue accuracy. Collaborate and support cross-functional teams needed for various risk adjustment program efforts to ensure coding, documentation, and reporting accuracy. Location: this position has preference to be based in Meridian Idaho and offers hybrid work location; potential consideration for working fully remote within a mutually acceptable location. #LI-Remote; #LI-Hybrid. Required Certifications Must hold: Certified Professional Coder (CPC) In addition to CPC, must also hold, or acquire within one year of hire: Certified Risk Adjustment Coder (CRC) Required Experience: 3/+ years' experience in health industry (healthcare and/or health insurance) to include medical record coding, preferably with HCC and/or Risk Adjustment coding experience. Preferred...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. 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. General Description of the Job Class Coordinate/review the work of vendor outsourcing partners and assist with the training and continuing education programs. Code medical records utilizing ICD-9-CM/ICD-10CM and CPT-4 coding conventions. Review the medical record to ensure specificity of diagnoses, procedures, and appropriate/optimal reimbursement professional...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. 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. General Description of the Job Class Coordinate /review the work of vendor outsourcing partners and assist with the training and continuing education programs. Code medical records utilizing ICD-9-CM/ICD-10-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures, and appropriate/optimal reimbursement...

Join to apply for the Claims Reconsideration Coder role at Neighborhood Health Plan of Rhode Island 2 weeks ago Be among the first 25 applicants Join to apply for the Claims Reconsideration Coder role at Neighborhood Health Plan of Rhode Island Position Overview The Claims Reconsideration Coder (CRC) is a multidisciplinary Certified Professional Coder accredited through the American Academy of Professional Coders or Certified Coding Specialist accredited through American Health Information Management Association. This role will evaluate medical record documentation by abstracting the pertinent information that supports the services billed to allow a determination for payment or denial on claim submissions that meet the criteria for a medical note review. Relies on sound review methods applied to the content of the medical notes, benefits, payment policies, clinical medical policies, NCCI edits, CMS, coding manuals (CPT, HCPC, ICD-10), and other industry supported resources...