729 hospital coding auditor jobs found

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The LPS (Learning & Performance Solutions) QA Inpatient Coding Auditor will provide expert coding audit services across various acute hospital organizations for inpatient services. Review medical record documentation and related coding of inpatient encounters utilizing the ICD-10-CM/PCS classification and CMS MS-DRG system. Verify coding accuracy and that coders base code assignment in a manner consistent with relevant laws, regulations, official coding guidelines and industry standards. This individual...

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The LPS (Learning & Performance Solutions) QA Inpatient Coding Auditor will provide expert coding audit services across various acute hospital organizations for inpatient services. Review medical record documentation and related coding of inpatient encounters utilizing the ICD-10-CM/PCS classification and CMS MS-DRG system. Verify coding accuracy and that coders base code assignment in a manner consistent with relevant laws, regulations, official coding guidelines and industry standards. This individual...

ResponsibilitiesEvaluates coding based on Coding Guidelines.Reviews records for all care settings.Identifies high volume, high risk coding, and reimbursement and quality problems.Responsible for accurate assessment, analysis and summary of findings for coding validation.Provide auditing and feedback that is incorporated into training education programs.This position offers a fully remote work opportunity.Employees in this role must reside in one of the following states to be considered for fully remote positions :Kentucky, Indiana, Missouri, Ohio, Tennessee, Alabama, Virginia, Mississippi, North Carolina, South Carolina or Louisiana.QualificationsRequired :One year coding in healthcare settingOne of :CCA or CCS or CPCDesired :DiplomaCertified Coding Associate OR Certified Coding Specialist OR Certified Professional Coder.

Lead Medical Coder and Auditor ProSidian Consulting is looking for a talented professional ready to deliver real value to clients in a fast-paced, challenging environment. ProSidian Consulting is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. ProSidian seeks a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines. Utilize encoders and various coding resources. Perform CPT Procedure...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines. Utilize encoders and various coding resources. Perform CPT Procedure reviews. Maintain strict patient and physician confidentiality and follow all federal, state and hospital guidelines for release of information. Maintain current...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines. Utilize encoders and various coding resources. Perform CPT Procedure...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This is a work from home position that requires the selected candidate to have a permanent address and live in New Mexico or be willing to relocate to New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217 Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...

Compliance Coding Auditor Hours: Variable Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $48.140 - $62.110 - $76.080 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines. Utilize encoders and various coding resources. Perform CPT Procedure...

DRG Coding Auditor Principal This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case...

Coding Auditor Sr CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through homecare and community-based services. The CareBridge Coding Auditor Sr is responsible for auditing coders that diagnosis data collected from physician and hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements. Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from...

Profee Coding Auditor Do you have the career opportunities as a Profee Coding Auditor you want with your current employer? We have an exciting opportunity for you to join Work from Home which is part of the nation's leading provider of healthcare services, HCA Healthcare. Work from Home offers a total rewards package that supports the health, life, career, and retirement of our colleagues. The available plans and programs include comprehensive medical coverage, additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans, auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance, and more. Free counseling services and resources for emotional, physical, and financial wellbeing are also provided. There is a 401(k) Plan with a 100% match on 3% to 9% of pay, an Employee Stock Purchase Plan with 10% off HCA Healthcare stock, family...

divh2Coding Auditor Sr/h2pCareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through homecare and community-based services. The CareBridge Coding Auditor Sr is responsible for auditing coders that diagnosis data collected from physician and hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements./ppLocation: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance...

Compliance Auditor 5119 - G1 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. Occupational Summary Conduct health-system wide compliance audits to ensure data integrity, compliance with federal and state regulations pertaining to but not limited to: federal healthcare program requirements, clinical trials billing, privacy, conflict of interest, and anti‑kickback and physician relationships. Exercise independent decisions using analytical and problem‑solving skills. Provides critical analytical and support with respect to third‑party payer external audits (i.e. RAC, ADR/TPE, UPIC, etc.). Work Performed Interpretation of applicable federal and state law and regulations to plan audit parameters, determine department's compliance with such regulations and communicate to department necessary...

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. Compliance Auditor 5119 - G1 Occupational Summary Conduct health-system wide compliance audits to ensure data integrity, compliance with federal and state regulations pertaining to but not limited to: federal healthcare program requirements, clinical trials billing, privacy, conflict of interest, and anti-kickback and physician relationships. Exercise independent decisions using analytical and problem solving skills. Provides critical analytical and support with respect to third party payer external audits (i.e. RAC, ADR/TPE, UPIC, etc.). Work Performed Interpretation of applicable federal and state law and regulations to plan audit parameters, determine department's compliance with such regulations and communicate to department necessary...

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, development, and leadership programs And more Work Location: Atlanta, GA Description The Corporate Director Compliance Auditor - Healthcare Provider provides expert leadership in evaluating and strengthening the organization's compliance program across clinical, billing, privacy, and operational domains. This role leads complex, risk-based compliance audits to ensure adherence to federal and state healthcare regulations and...