26 registered nurse crc coding auditor jobs found

Data Quality Senior Medical Coder - Remote Full-time Shift: Day Shift Status: Full Time More Than Just Care,It’sCommunity Imagine doing meaningful work in a place where peoplevacation. That’slife at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties. If you want a career in healthcare and alifestylemost people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just beMunson Material. To us, that means teammates who live by our values of excellence,teamness, positivity, creativity,and a commitment to creating exceptional experiences for our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country. Invested in You Grow: Tuition reimbursement, in-person and onlinedevelopment,and access to ourcareer hubto help...

Risk Adjustment Nurse/Coder AvMed, a division of Sentara Health Plans in the Florida market, is hiring a Risk Adjustment Nurse/Coder (RN/CPC, COC, CIC, CCS-P, CCS, RHIT, RHIA) in Doral, FL! Full-time permanent position (40 hours) Standard working hours: 8am to 4:30pm EST, M-F This is a hybrid position, 2 days onsite in AvMed Doral Office, 3470 NW 82nd Ave Suite 1100, Doral, FL 33122, and 3 days remote. Job Profile Summary The Risk Adjustment Clinical Coder/Nurse performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories...

Position Description: This position is responsible for reviewing, prioritizing, and analyzing adverse medical events related to medical devices that are submitted on MedWatch reporting forms via hard copy or electronically to our customer, the Food and Drug Administration (FDA). Additionally, this position is responsible for processing and coding a variety of reports from device manufacturers (MFR), importers, user facilities, health care professionals, and customers. While Analyst Coders may be assigned to perform the primary functions shown above, they will also be cross-trained to perform secondary duties according to business needs. Required Qualifications: Must Possess a Bachelor's degree in related health science fields such as nursing, pharmacy, veterinary, and/or certified licensed technicians as appropriate for each center. Good telephone etiquette. Clinical experience in the different medical specialties. Team player, good organizational skills,...

Coding Compliance & Education Coordinator You'll be diving into clinical documentation and coding records, performing detailed audits to ensure every code is accurate, complete, and compliant with regulatory standards. You'll analyze patterns, identify discrepancies, and provide actionable feedback that supports optimal reimbursement and quality reporting. You'll assist with developing and delivering training sessions for coding staff, clinical providers, and other stakeholders. You'll serve as the go-to expert for ICD-10-CM, ICD-10-PCS, CPT, and sequencing guidelines, helping teams stay current with evolving standards. You'll work closely with the Coding Manager and other leaders, ensuring coding practices align with organizational goals. Whether you're refining audit processes, answering complex coding questions, or creating educational materials, your work directly impacts compliance, revenue integrity, and patient care quality. Why Work at Regional West Health...

Overview USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community. USA Health is changing how medical care, education and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists and researchers provide the region's most advanced medicine at multiple facilities, campuses, clinics and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall wellbeing of our community. Responsibilities Performs correct coding (CPT4/ICD10) for provider services; audits services billed without prior coding review to ensure accuracy; provides education, payer coding updates and documentation to leaders and providers to ensure coding is being performed based on current guidelines; performs periodic reviews and ongoing audits of claims to ensure accuracy of coding/billing and sufficiency of...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from...

Positions Location: Lansing, MI Job Description General Purpose of Job :   Ensure Revenue Cycle Coding and Billing are compliant with State and Federal regulations.  Respond to and Investigate compliance issues within Revenue Cycle.   Lead and/or coordinate audit activity with governmental audits.   Essential Duties : This job description is intended to cover the minimum essential duties assigned on a regular basis.  Team members may be asked to perform additional duties as assigned by their leader.  Leadership has the right to alter or modify the duties of the position. Ensures conformance with applicable laws, regulations and Medicare/Medicaid reimbursement rules to ensure UMHS is in compliance with federal, state and/or local regulations. Monitors, analyzes and reports on laws, regulations, audits and industry standards that impact the organization. Develops and maintains Professional and Hospital billing issues on the Revenue Cycle Compliance Work Plan....

Job Opportunity Job ID:52414 Description: Positions Location: Lansing, MI Job Description General Purpose of Job : Ensure Revenue Cycle Coding and Billing are compliant with State and Federal regulations. Respond to and Investigate compliance issues within Revenue Cycle. Lead and/or coordinate audit activity with governmental audits. Essential Duties : This job description is intended to cover the minimum essential duties assigned on a regular basis. Team members may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position. Ensures conformance with applicable laws, regulations and Medicare/Medicaid reimbursement rules to ensure UMHS is in compliance with federal, state and/or local regulations. Monitors, analyzes and reports on laws, regulations, audits and industry standards that impact the organization. Develops and maintains Professional and Hospital billing issues on the...

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law. Description Medical Coder and Auditor - Family Care Practice Full-Time Monday - Friday Flexible Schedule $22.00 -$28.00 per hour (depending on experience) Medical Coder and Auditor Benefits: Annual performance review, performance-based merit increase Health, dental and vision benefits available with coverage effective the first of the month following date of hire Full complement of voluntary benefits $1,000 annual employer HSA contribution for employees enrolled in CNYFC high deductible health plan Free office visits with NP or PA employees who are patients of the practice and enrolled in CNYFC high deductible health plan Waiver program for health benefits ($3,000...

Location: Virtual Employee PRIMARY PURPOSE Conducts audits of medical record coding to ensure compliance with established guidelines, provides results of audits, and assists with educational activities related to findings to promote adherence to state/federal laws and regulatory requirements. MINIMUM SPECIFICATIONS Education: - Must be a graduate of a Health Information Management program or must have successfully completed an approved Coding educational program. Experience - Must have six (6) years of proven coding experience in an acute care setting. Equivalent Education and/or Experience - May have an equivalent combination of education and experience in lieu of specified requirements. Certification/Registration/Licensure - Because of the lag in SCCE, HCCA, NCRA, and AHIMA updating the status of certifications, current employees whose certification is granted through one of these associations are allowed up to seven (7) calendar days, after expiration, to...

Ankura is a team of excellence founded on innovation and growth. Practice Overview Ankura's Health Care Disputes, Compliance and Investigations practice advises outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters involving research...

Job SummaryWe are seeking an experienced Certified RN Medical Coder to support a full-time COC / SPD project focused on building out coding for benefit plans.This role combines clinical knowledge with technical coding expertise to ensure accuracy, consistency, and compliance across plan documentation.You'll work closely with a team of certified coders and business analysts in a collaborative, fast-paced environment where precision and partnership drive success.Why this Opportunity?Top ranked company in Fortune's 2024 World's Most Admired Companies for over a decade consecutively.This healthcare client is ranked number one in key attributes of reputation :Innovation People management Social responsibility Quality of Management Financial soundness Long-term investment value Quality of products Services and global competitiveness.Job Responsibilities :Determine and assign appropriate codes to benefit plan language as part of the COC / SPD project.Review coding selections made by peers...

Job SummaryWe are seeking an experienced Certified RN Medical Coder to support a full-time COC / SPD project focused on building out coding for benefit plans.This role combines clinical knowledge with technical coding expertise to ensure accuracy, consistency, and compliance across plan documentation.You'll work closely with a team of certified coders and business analysts in a collaborative, fast-paced environment where precision and partnership drive success.Why this Opportunity?Top ranked company in Fortune's 2024 World's Most Admired Companies for over a decade consecutively.This healthcare client is ranked number one in key attributes of reputation :Innovation People management Social responsibility Quality of Management Financial soundness Long-term investment value Quality of products Services and global competitiveness.Job Responsibilities :Determine and assign appropriate codes to benefit plan language as part of the COC / SPD project.Review coding selections made by peers...

Screen reader users may encounter difficulty with this site. For assistance with applying, please contact hr-accessibleapplication@osu.edu. If you have questions while submitting an application, please review these frequently asked questions. Current Employees and Students: If you are currently employed or enrolled as a student at The Ohio State University, please log in to Workday to use the internal application process. Welcome to The Ohio State University's career site. We invite you to apply to positions of interest. In order to ensure your application is complete, you must complete the following: Ensure you have all necessary documents available when starting the application process. You can review the additional job description section on postings for documents that may be required. Prior to submitting your application, please review and update (if necessary) the information in your candidate profile as it will transfer to your application. Job Title:...

Currently recruiting an REMOTE Medical Coding Compliance Specialist to provide support to Active Duty heroes, their families, and retirees. The full-time position is Monday-Friday, 8 hours shifts between 7: 30am and 4: 30pm. DUTIES OF THE MEDICAL CODING COMPLIANCE SPECIALIST: Evaluate and identify root causes of non-compliance with official coding policies, regulations, requirements, and standards. Perform and report investigations related to noncompliance in a fair, objective, and discrete manner. Review encounter and/or record documentation to identify inconsistencies or discrepancies that may cause inaccurate coding, medico-legal repercussions or impacts quality patient care, identifying any problems with legibility, abbreviations, etc., proper sequence of documents, presence of authorized signatures, and sufficient data is documented that supports diagnosis, treatment administered, and results obtained. Researches questions from staff regarding regulatory...

A Day in the Life of the Coding Compliance & Education Coordinator: You'll be diving into clinical documentation and coding records, performing detailed audits to ensure every code is accurate, complete, and compliant with regulatory standards. You'll analyze patterns, identify discrepancies, and provide actionable feedback that supports optimal reimbursement and quality reporting. You'll assist with developing and delivering training sessions for coding staff, clinical providers, and other stakeholders. You'll serve as the go-to expert for ICD-10-CM, ICD-10-PCS, CPT, and sequencing guidelines, helping teams stay current with evolving standards. You'll work closely with the Coding Manager and other leaders, ensuring coding practices align with organizational goals. Whether you're refining audit processes, answering complex coding questions, or creating educational materials, your work directly impacts compliance, revenue integrity, and patient care quality. Why Work...

Company Description More Than Just Care, It's Community Imagine doing meaningful work in a place where people vacation. That's life at Munson Healthcare - northern Michigan's largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties. If you want a career in healthcare and a lifestyle most people only dream about - with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be Munson Material. To us, that means teammates who live by our values of excellence, teamness, positivity, creativity, and a commitment to creating exceptional experiences for our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country. Invested in You Grow: Tuition reimbursement, in-person and online development, and access to our career hub to help you advance. Thrive: Full benefits,...

Position Description This position is responsible for reviewing, prioritizing, and analyzing adverse medical events related to medical devices that are submitted on MedWatch reporting forms via hard copy or electronically to our customer, the Food and Drug Administration (FDA). Additionally, this position is responsible for processing and coding a variety of reports from device manufacturers (MFR), importers, user facilities, health care professionals, and customers. While Analyst Coders may be assigned to perform the primary functions shown above, they will also be cross‑trained to perform secondary duties according to business needs. Required Qualifications Must possess a Bachelor's degree in related health science fields such as nursing, pharmacy, veterinary, and/or certified licensed technicians as appropriate for each center. Good telephone etiquette. Clinical experience in the different medical specialties. Team player, good organizational skills, flexible, open to...

Scope of Position The Associate Director of Outpatient Coding Services performs at an expert level sustaining responsibility for timely and accurate coding of all facility outpatient visits and outpatient coding audits for The Ohio State University Wexner Medical Center (OSUWMC) including James Hospital. This position oversees the operations of denials, edits, and charge capture for reimbursement purposes. In this role, the Associate Director of Outpatient Coding Services serves as a liaison and coordinator for special projects regarding the coding of medical records. This position develops and implements policies and procedures to achieve organizational goals; and assists in the development of operational strategy. This position also re-evaluates processes to keep staff engaged and to assist in meeting department and organizational goals for OSUWMC. This position is critical to the financial and legal standing of the hospital for compliance and legal purposes. The director shall...

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,...

Scope of Position The Associate Director of Outpatient Coding Services performs at an expert level sustaining responsibility for timely and accurate coding of all facility outpatient visits and outpatient coding audits for The Ohio State University Wexner Medical Center (OSUWMC) including James Hospital. This position oversees the operations of denials, claim edits, and charge capture for reimbursement purposes. In this role, the Associate Director of Outpatient Coding Services serves as a liaison and coordinator for special projects regarding the coding of medical records. This position develops and implements policies and procedures to achieve organizational goals; and assists in the development of operational strategy. This position also re-evaluates processes to keep staff engaged and to assist in meeting department and organizational goals for OSUWMC. This position is critical to the financial and legal standing of the hospital for compliance and legal purposes. The director...

Accessibility Statement Screen reader users may encounter difficulty with this site. For assistance with applying, please contact hr-accessibleapplication@osu.edu. If you have questions while submitting an application, please review these frequently asked questions. Current Employees & Students If you are currently employed or enrolled as a student at The Ohio State University, please log in to Workday to use the internal application process. Application Instructions Welcome to The Ohio State University's Career Site. We invite you to apply to positions of interest. In order to ensure your application is complete, you must complete the following: Ensure you have all necessary documents available when starting the application process. You can review the additional job description section on postings for documents that may be required. Prior to submitting your application, please review and update (if necessary) the information in your candidate profile as it will transfer to...

Overview Ankura is a team of excellence founded on innovation and growth. Practice Overview Ankura’s Health Care Disputes, Compliance and Investigations practice advises outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters involving...