454 policy coding auditor jobs found

HCSC is seeking a skilled professional for a telecommute position focused on Reimbursement Policy review, creation, and publication. The role requires collaboration with multiple departments to ensure accurate documentation and policy updates. Ideal candidates will have a Bachelor's degree, relevant experience, and strong communication skills. Responsibilities include coordinating annual reviews and ensuring adherence to claims processes. The position offers a competitive salary in the range of $55,900.00 - $123,500.00. #J-18808-Ljbffr

HCSC is seeking a professional to take on the role of Reimbursement Policy Analyst in Nashville, TN. This position involves reviewing, creating, and publishing reimbursement policies, conducting thorough research, and coordinating with various departments. An ideal candidate should possess a Bachelor Degree, relevant experience in claims processing and auditing, along with proficient communication skills. The role is telecommute-friendly, allowing for convenient work-from-home arrangements. Competitive salary range offered is $55,900 to $123,500 annually. #J-18808-Ljbffr

HCSC is looking for a professional to conduct Reimbursement Policy reviews and coordinate with various departments. The role requires strong claims processing experience and research skills. Qualifications include a Bachelor's Degree, at least 3 years of claims processing operations, and excellent communication abilities. This telecommute role offers a base pay range of $55,900.00 - $123,500.00. HCSC is committed to equal opportunity employment. #J-18808-Ljbffr

Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team! Responsibilities The Inpatient Coder Auditor Trainee reviews and analyzes documentation present in the medical record for inpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor Trainee finalizes the coding and abstracting of the medical record upon ensuring the assignment of...

Job Description Required: Coding Auditor with inpatient hospital experience Experience coding and auditing ICD-10-PCS. Job Description Conducts coding audits to optimize diagnosis related groupings. Develops and implements coding instruction classes. Prepares coding guidelines; implements coding changes. Job Responsibility 1.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. 2.Demonstrates effective skills in validation; provides ad-hoc education to the coding staff. 3.Able to communicate effectively with coders and CDI staff. 4.Demonstrates knowledge of coding policy and procedures. 5.Maintains knowledge of all current Federal and State coding guidelines; remains up-to-date on system literature from all agencies. 6.Monitors and evaluates case mix index; demonstrates comprehensive knowledge of case mix indexing. 7.Reviews potential reassignments; demonstrates accurate and timely review of...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Join Optum Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. Positions in this function investigate Optum Waste and Error stopped claims by gathering information, researching state and federal guidelines, and following internal procedure to determine the viability of the claim for further review in a production environment. Primary Responsibilities Clinical Case Reviews - 75% Perform clinical review of professional (or facility) claims vs....

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Job Title Summary Performs validation reviews of Diagnosis Related Groups (DRG), Ambulatory Procedure Codes (APC), and Never Events (serious, preventable medical errors) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Position Purpose: Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Location: This is a remote position, Monday - Friday from 8:30am...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Responsibilities Artificial Intelligence; Advanced Technology; The very best in patient care. With decades of expertise, we are Leading Radiology Forward. With dynamic cross-training and advancement opportunities in a team-focused environment, the core of our success is its people with the commitment to a better healthcare experience. When you join us as a Compliance Auditor Analyst, you will be joining a dedicated team of professionals who deliver quality, value, and access in the 21st century and align all stakeholders- patients, providers, payors, and regulators to achieve the best clinical outcomes. You Will: Independently conducts and documents compliance audits of medical records, coding, and billing in accordance with regulatory requirements, internal policies, and audit standards. Analyzes audit results to identify trends, root causes, and systemic risks; develops recommendations for corrective action and process improvement. Interprets federal and state...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Join LMH Health You can't define it, but you know it when you see it: the difference between an average life and the good life. When your cup is full with joy, purpose and lifelong health it shows. At LMH Health, we are all about healthy people, healthy communities and healthy futures, and that makes us your destination for an exceptional career. From flexible, work-life harmony to competitive pay and great advancement potential, find everything you're looking for at LMH Health. You'll find everything you're looking for at LMH Health: Join a team that cares about the community Tuition reimbursement to support continuing education Professional development and recognition Excellent benefits We're looking for you. Job Description The Medical Coding Auditor is responsible for conducting prospective and retrospective compliance reviews of documentation supporting codes reported by providers or facility coding to ensure accuracy in billing, maximize charge capture, and...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Certified Medical Coding Auditor (Clinical Bill Review Analyst) V?lenz Health is the platform to simplify healthcare the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible. About This Opportunity: As a Certified Medical Coding Auditor (Clinical Bill Review Analyst), you'll review claims upfront and take a deeper dive to catch billing discrepancies, unbundled charges, and other errors...

Job Description Job Description Why Professionals Love Theoria Medical At Theoria Medical, accuracy, integrity, and collaboration matter. Our compliance and coding professionals play a critical role in supporting quality patient care while ensuring our clinical and billing practices remain aligned with evolving industry standards and regulations. We believe meaningful work should come with flexibility, support, and opportunities for growth. Our teams are empowered with advanced technology, collaborative leadership, and a mission-driven culture that values expertise and innovation. Build a career where your knowledge drives impact across a growing national healthcare organization. About Theoria Theoria Medical is leading the charge in healthcare innovation and quality of care — offering a unique blend of medical excellence and technological advancement, serving the post-acute sector. Our network includes multispecialty physician services covering skilled nursing...

Job Description Primary Duties And Responsibilities The Coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM, ICD-10-PCS, and CPT codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Abides by the standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to all official coding guidelines. Verifies that all ICD-10-CM and CPT codes are correctly captured. Verify that physician is correctly abstracted. Keeps abreast of coding guideline changes by self-study, assigned education, coding meeting attendance or related in-services. Participates in internal and external quality review meetings. Performs other duties as assigned. Medical Coding - Hoag Hospital Resolves billing related errors and assists with workflow changes and process improvement...

Summary The VISN Consolidated Coding Unit Auditor is a position located within the Business Office Support Services (BOSS), Health Information Management (HIM) section, within VISN 19, Rocky Mountain VA Network. Auditors serve as experts of current coding conventions and regulations related to professional and facility coding. Learn more about this agency Duties Help Major duties include but are not limited to: Responsible for performing audits of coded data, developing criteria, collecting data, graphing and analyzing results, creating reports and communicating in writing and/or in person to appropriate leadership and groups. Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection. Selects and assigns codes from the current...

Job Description Job Description Description: A Certified Professional Medical Auditor is responsible for reviewing and auditing medical documentation, including patient records, charts, and clinical notes, to ensure accuracy, compliance with regulations, and adherence to industry standards. This role is crucial in maintaining the integrity of medical records, billing processes, and healthcare facilities' compliance with applicable laws and regulations. Requirements: Key Responsibilities: Medical Documentation Review: Conduct thorough audits of patient medical records, including physician notes, progress notes, discharge summaries, and other relevant documentation. Examine medical records to verify their completeness and conformity with established standards, ensuring they accurately reflect the patient's condition, diagnosis, treatment, and other pertinent information. Verify that documentation adheres to established coding guidelines, such as ICD-10 and CPT, and...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Outpatient Coding Auditor Cedar Park Group is hiring an Outpatient Coding Auditor for a remote, short-term summer assignment supporting annual outpatient audits across ED, Same Day Surgery (SDS), and Observation. If you're looking for flexible hours, competitive pay, and focused audit work with clear deliverables, this is a strong opportunity. Assignment length is 36 months with possible extension. Shift / Schedule Remote Flexible schedule Part-time to full-time Minimum 20 hours per week 36 month assignment (possible extension) Position Overview As an Outpatient Coding Auditor, you will lead annual outpatient coding audits, including chart review, scoring, rebuttals, and executive-level reporting. You'll analyze trends and error patterns, present findings to leadership, and deliver group and 1:1 education sessions to strengthen coding accuracy and documentation quality across ED, SDS, and Observation services. Responsibilities Complete annual outpatient coding...