399 inpatient complex coder auditor jobs found

Physician Compliance Auditor 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. 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...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Physician Compliance Auditor 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. 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...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Physician Billing (PB) Coding Auditor And Educator Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Physician Billing (PB) Coding Auditor and Educator is responsible for auditing and educating healthcare providers on related applicable clinical documentation. This work supports coding and billing regulations that ensure appropriate reimbursement, public reporting, and various initiatives as directed by the Hackensack Meridian Health (HMH) Network. A day in the life of an Physician Billing (PB) Coding Auditor and...

Physician Compliance Auditor 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. 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...

Overview All Jobs > Nurse Inpatient Coding Auditor, CIC or CCS certified Nurse Inpatient Coding Auditor, CIC or CCS certified Fully Remote • Remote Full-time Description Company ProgenyHealth is a leading provider of care management solutions for premature and medically complex newborns positively impacting maternal and infant health outcomes across America. Our program builds a network of support for an uninterrupted continuum of care from prenatal health, through any resultant NICU stay, and all the way to one full year of life. Our team of neonatologists, pediatricians, and NICU nurses provide continuity of care in collaboration with providers from hospital to caregivers at home and throughout the first year of life. We help overcome systemic barriers to support healthier pregnancies and healthier starts to life for all moms and babies, one family at a time. Job Role The Clinical RN Chart Reviewer will perform clinical reviews of medical records and other documentation to...

Registered Nurse - Diagnosis Related Group Coding Auditor Principal – Carelon Payment Integrity Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. 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 rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients. Specializes in review of DRG coding via medical records and attending physician’s statements provided by acute care hospitals on paid DRG,...

Registered Nurse - Diagnosis Related Group (DRG) Coding Auditor Principal - Carelon Payment Integrity Job Description : Registered Nurse - Diagnosis Related Group Coding Auditor Principal - Carelon Payment Integrity Location : Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. 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 rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients. Specializes in review...

Description Sierra7 is looking for Inpatient and/or Outpatient Medical Coding Auditor to support the Department of Veterans Affairs. The Auditor will have expertise in International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS). The Medical Coding Auditors will serve as experts of current coding conventions and guidelines related to professional and facility coding and perform audits of encounters to identify areas of non-compliance in coding. This is a Part Time opportunity, and we are looking for auditors who can commit to a minimum of 20 hours per week, scheduled at your discretion from Monday through Sunday weekly. Part Time - minimum of 20 hours per week - $30 per hour Position Responsibilities : • Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the...

Senior Specialist, Coding Auditor Join to apply for the Senior Specialist, Coding Auditor role at Oscar Health. Hi, we’re Oscar. We’re hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and abuse (FWA) on all our operations. You will report to the Manager, SIU Coding Audit. Work Location Oscar is a blended work culture where everyone, regardless of work type or location,...

Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. If you live...

Compliance Auditor I (Professional Billing Integrity Services) (39887) Job Type:Full TimeFTE/Bi-Weekly Hours:1.0/80Shift:DaysHours in Shift:8Location:Palo AltoReq:39887 Job Description Job Summary This paragraph summarizes the general nature, level and purpose of the job.Compliance Professional Services Billing Integrity Auditors conduct Compliance Department audits to determine organizational integrity of billing for professional services, including detection and correction of documentation, coding, and billing errors.Audits consist of evaluation of the adequacy and accuracy of documentation in support of services billed, including ICD/CPT/HCPCS and other third-party payor codes, Teaching Physician guidelines, medical necessity of services, reimbursement overpayments and underpayments, and compliance with other documentation, coding and billing standards.Compliance Professional Services Billing Integrity Auditors evaluate the adequacy and effectiveness of internal and operational...

Overview 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 stakeholders...

Manager Compliance Coding Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for qualified candidates like you to join our Texas Health family. Work location: Texas Health Resources Core work hours: Monday - Friday; 8:00a-5:00p; Position Summary The Coding Compliance Manager oversees and manages auditing and monitoring activities related to billing and coding compliance. This role is responsible for developing policies, procedures, and risk-based educational materials to ensure adherence to federal and state regulations, as well as THR policies. Key responsibilities include analyzing audit data to identify areas of concern, collaborating with auditees, providers, and leadership to guide rebuttals, and establishing management correction plans when necessary. Additionally, the Compliance Auditor Manager effectively communicates audit findings through reports, presentations, and educational materials...

Are you an experienced Medical Coder seeking a career growth? Are you a Certified Auditor interested in a new work opportunity? If so, then we want to connect with you! MAHEC is now accepting candidates for Medical Auditor. This integral role supports MAHEC's mission of educating the next generation of healthcare professionals by completing internal quality assessment reviews on Care Provider coding and effectively builds relationships with MAHEC Care Providers to educate and foster complete, accurate, timely, and consistent coding. The Auditor/Provider Educator is responsible for documentation to ensure compliance with national coding guidelines and MAHEC policies. We welcome experienced Medical Coders interested in becoming a Certified Professional Medical Auditor, and MAHEC offers an employer-sponsored pathway to CPMA certification if hired for the position! This is a hybrid work opportunity, with roughly 50-60% onsite work to support in-person collaboration and Medical...

Lead Coder Inpatient- (10k Sign-On Bonus Available) Join to apply for the Lead Coder Inpatient- (10k Sign-On Bonus Available) role at Wellstar Health System Continue with Google Continue with Google Lead Coder Inpatient- (10k Sign-On Bonus Available) 3 days ago Be among the first 25 applicants Join to apply for the Lead Coder Inpatient- (10k Sign-On Bonus Available) role at Wellstar Health System Continue with Google Continue with Google Continue with Google Continue with Google How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Job Summary...

Join to apply for the HIM - INPATIENT HOSPITAL CODER (Exp.) role at LifeBridge Health Join to apply for the HIM - INPATIENT HOSPITAL CODER (Exp.) role at LifeBridge Health REMOTE WORK OPPORTUNITY Competitive Benefits REQUIRED CERTIFICATIONS - CCS or CCA with 5+ years’ experience or RHIT or RHIA Summary REMOTE WORK OPPORTUNITY Acceptable remote locations: District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia Competitive Benefits REQUIRED CERTIFICATIONS - CCS or CCA with 5+ years’ experience or RHIT or RHIA JOB SUMMARY: Following established conventions and guidelines, codes and abstracts the medical records of inpatients. Groups codes to determine diagnosis related groupings (DRGs-CMS and/or APR). May be asked to code day surgery, emergency and outpatient records. Meets departmental accuracy and production standards. Essential Functions Codes Reviews medical records to determine the physicians diagnosis/procedures for the patient and assigns...

Overview Medical Coder Auditor role at Sierra7, Inc. The Auditor will support the Department of Veterans Affairs in inpatient and/or outpatient coding audits. The Auditor will have expertise in ICD, CPT, and HCPCS, and will serve as an expert on current coding conventions and guidelines related to professional and facility coding, performing audits of encounters to identify areas of non-compliance in coding. This is a part-time opportunity, with a minimum commitment of 20 hours per week, scheduled at your discretion from Monday through Sunday. Responsibilities Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures, and the principles of health services to ensure proper code selection. Reviews codes from ICD-10-CM/ICD-10-PCS, CPT, and HCPCS for accuracy and completeness. Applies guidelines specific to certain diagnoses, procedures, and other criteria used to classify...

Join to apply for the Coder III Outpatient IR Cardiology role at HonorHealth 5 days ago Be among the first 25 applicants Join to apply for the Coder III Outpatient IR Cardiology role at HonorHealth Get AI-powered advice on this job and more exclusive features. This range is provided by HonorHealth. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $64,147.00/yr - $81,785.00/yr 8:00 am to 4:30 pm (negotiable) Job Summary Specialized coding of one or more of the following work types: Outpatient Interventional radiology, or procedural cardiology. Specialized coding may also include Claims Edit Review and Reconciliation. Reviews, assigns, and sequences ICD-10-CM, ICD-10-PCS, CPT and HCPCs codes through review of Inpatient and/or Outpatient clinical documentation and diagnostic results as appropriate for billing, internal and external reporting, research, and regulatory compliance. Essential Functions Assigns and...