113 senior specialist coding auditor jobs found

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,...

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...

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...

About the role The Senior Specialist works to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to audit prepayment and/or post payment claims. The Senior Specialist runs and coordinates activities across Oscar to reduce the incidence and effect of fraud, waste, and abuse (“FWA”) on all our operations. You will report to the Manager, SIU Coding Audit Post-Pay. 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. This is a remote position, open to candidates who reside in the following location(s): Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina,...

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...

A healthcare provider organization in Valhalla, NY is seeking a Coder to audit medical records for accuracy and compliance with coding guidelines. The ideal candidate will train healthcare providers on proper documentation methods. This role requires a minimum of three to four years of coding experience and a current coding certification. Health insurance, retirement plans, and paid time off are provided as benefits. #J-18808-Ljbffr

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...

Medical Group Compliance Auditor Senior The Medical Group Compliance Auditor Senior is responsible for providing audit, coding support, and guidance to physicians, APPs, residents, and support staff. This role ensures that all coding, billing, and documentation complies with federal and/or state regulations, private payer health care program requirements, as well as the Compliance and Operations Policies of the organization. This job assists with the development and implementation of educational and training programs as well as coding tools and resources to help achieve the organizations goal of consistent, complete, and accurate coding and documentation. Conducts regularly scheduled compliance reviews for assigned providers within designated time frames. Performs reviews of clinical documentation to verify accuracy of CPT/HCPSC and ICD.10 codes and modifier assignments. Provides written report of findings to the provider and select administrative personnel along with...

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...

Title - Inpatient Facility Medical Coder (40h Day) Location - Clackamas, OR, US Job Type - Permanent | Remote Required: Minimum five (5) years experience in coding with four (4) years inpatient facility coding The candidate must have 1 from the following list: Registered Health Information Technician Certificate Certified Coding Specialist Registered Health Information Administrator Certificate Advanced knowledge of medical terminology, pharmacology and medial coding principles for ICD-10-CM, ICD-10-PCS, HCPCS/CPT and coding. Advance knowledge of disease processes, diagnostic and surgical procedures, ICD-10-CM, ICD-10-PCS, HCPCS/CPT classification systems, health information/medical record department responsibilities with knowledge of government regulations and areas of scrutiny for potential fraud and abuse issues. Job description Candidates must reside either in Washintgon or Oregon to be considered for this position. To independently and efficiently...

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...

The Medical Group Compliance Auditor Senior is responsible for providing audit, coding support and guidance to physicians, APPs, residents and support staff. This role ensures that all coding, billing and documentation complies with federal and/or state regulations, private payer health care program requirements as well as the Compliance and Operations Policies of the organization. This job assists with the development and implementation of educational and training programs as well as coding tools and resources to help achieve organization's goal of consistent, complete and accurate coding and documentation. Capable of working independently to conduct regularly scheduled compliance reviews for assigned providers, practices, and focused review areas within designated time frames. Provides mentorship and guidance to the more junior Medical Group Compliance Auditor during the audit completion process. Performs Reviews clinical documentation to verify accuracy of CPT/HCPSC and...

Coding Compliance Auditor - Coding Services - Full Time 8 Hour Days (Non-Exempt) (Non-Union) In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD‑10‑CM, and HCPCS assignments and accuracy and completeness of all codes assigned by professional revenue coders and providers. All assigned codes must be supported by professional documentation within the medical record and must comply with federal coding regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant. The Auditors also provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics regarding coding accuracy rates, compliance rates, denial analytics, etc. The Auditor recommends education topics based on audit findings and assists in the continuing education of professional coders and providers. Keeps coding systems such as Cerner,...

Job Description The Compliance Auditor, Billing and Coding Compliance is responsible for the oversight and management of auditing and monitoring billing and coding compliance activities, assist with internal compliance policies and procedures, completing compliance risk assessments, and developing risk-based educational materials to ensure compliance with federal/state laws and regulations, and UT Health San Antonio policies. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Responsibilities Provide oversight on billing compliance auditing, monitoring, and educational activities within the compliance department. Performs audits of electronic and manual documentation, coding, and billing systems. Conducts close-out meetings with senior management of audited departments. Maintain current knowledge of changes in federal and state coding and billing regulations/guidelines...

Enterprise Provider Compliance Auditor-Educator Join to apply for the Enterprise Provider Compliance Auditor-Educator role at WVU Medicine Overview The Enterprise Compliance Auditor/Educator will assist with the implementation and facilitation of ongoing compliance auditing, monitoring, and education associated with all provider services across WVUHS and its affiliates. The duties of this position will help ensure that all healthcare provider (MD/DO, APP, and other non-physician practitioners) organizations remain in compliance with all federal healthcare program rules, regulations, administrative requirements and guidance. Minimum Qualifications High School Diploma or Equivalent AND Seven (7) Years of extensive experience in multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines” Associate’s Degree AND Five (5) years extensive experience in...

FM Approvals Quality Assurance Compliance Auditor - Manufacturing 1 day ago Be among the first 25 applicants This range is provided by FM. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Sr. Talent Consultant at FM I Certified Diversity Recruiter (CDR)Certified Internet Recruiter (CIR) FM Approvals is an international leader in third-party testing and certification services. We test property loss prevention products and services—for use in commercial and industrial facilities—to verify they meet rigorous loss prevention standards of quality, technical integrity and performance. How? By employing a worldwide certification process that’s backed by scientific research and testing, and over a century of experience. FM Approvals is an international leader in third-party testing and certification services. We test property loss prevention products and services—for use in commercial and industrial facilities—to verify they meet...

Join to apply for the Compliance Auditor Analyst role at Upstate Medical University 5 months ago Be among the first 25 applicants Join to apply for the Compliance Auditor Analyst role at Upstate Medical University Get AI-powered advice on this job and more exclusive features. Job Summary Position Summary: Under the direction of the Compliance Officer the main duties for this position include: analysis of professional coding and billing data, review of applicable regulations or guidelines and professional coding and billing audits. Duties/Responsibilities Analysis of coding and billing data, identification of trends and aberrations. Performance of routine and investigatory audits evaluating compliance with applicable laws, regulations, coding, and billing guidelines. Interpretation of coding, billing, and regulatory standards. Preparation and completion of audit reports including recommendations, education and corrective action. Knowledge, Skills and Abilities: Strong...

Position Title: Healthcare Compliance Auditor (Healthcare Transaction & Strategy) Location: Remote - USA Position Type: Full time Requisition ID: JR100430 We do Consulting Differently The Healthcare Compliance Auditor position is a staff consulting position within the Healthcare Transactions and Strategy (HTS) group. HTS is currently seeking a Healthcare Compliance Auditor at either the Consultant or Managing Consultant level. HTS performs regulatory, reimbursement, data analytics, and compliance auditing for healthcare providers, healthcare payers and healthcare investors. Compliance audit deliverables include assessment of provider compliance programs and auditing of billing and coding of clinical documents and claims documents. This position requires a highly motivated problem solver with strong analytical ability, solid organizational skills, and a desire to advance within the organization. The work of a Healthcare Compliance Auditor will involve execution of...

Title: Certified Coding Specialist - Auditor Location: Novant Health Urgent Care (Columbia, SC) Status: Full-Time Part of the Novant Health family based in North Carolina, Novant Health Urgent Care (formerly Doctors Care) provides exceptional healthcare through our network of more than 50 urgent care centers and 20 physical therapy facilities across South Carolina. Our Columbia‑based headquarters delivers non‑medical management and administrative services to support these locations, and for decades we have been committed to delivering convenient, affordable healthcare experiences to families and communities throughout the Palmetto State. What We Offer Competitive wages with annual market data review Incentive Pay Program Continuing Education Reimbursement Eligible employer under the Public Service Loan Forgiveness (PSLF) Program UpToDate Subscription Generous PTO 403(b) with 100% vested match Health, dental, vision insurance Health Reimbursement Account Flexible...

Lead Certified Coding Specialist - Auditor Join to apply for the Lead Certified Coding Specialist - Auditor role at Doctors Care Urgent Care (Now Part of Novant Health) Lead Certified Coding Specialist - Auditor 1 month ago Be among the first 25 applicants Join to apply for the Lead Certified Coding Specialist - Auditor role at Doctors Care Urgent Care (Now Part of Novant Health) Get AI-powered advice on this job and more exclusive features. Title: Lead Certified Coding Specialist - Auditor Location: Novant Health Urgent Cares (Columbia, SC) Status: Full-Time Who Are We? Part of the Novant Health family based in North Carolina, Novant Health Urgent Care (formerly Doctors Care) provides exceptional healthcare through our network of more than 50 urgent care centers and 20 physical therapy facilities across South Carolina. Our Columbia-based headquarters delivers non-medical management and administrative services to support these locations. For decades, we have been...

Join to apply for the Coding Auditor & Education Advisor role at Phoebe Putney Health System Overview Position: Coding Auditor & Education Advisor at Phoebe Putney Health System. Responsibilities The original description does not list explicit day-to-day responsibilities. Please provide a clear responsibilities section if needed for candidates. Qualifications Education Requirements 4 year / Bachelor\'s Degree in Health Information Management or related medical degree (Required); In lieu of a Bachelor\'s Degree, an Associate Degree and a Minimum of 4 years additional relevant experience is acceptable. Experience Requirements 4 - 5 years experience with ICD-9, ICD-10, and HCPCS coding including hospital inpatient medical records (Required). 4 - 5 years extensive knowledge of medical terminology, pathophysiology, and pharmacology (Required). 4 - 5 years experience calculating and analyzing MS-DRG, DRG, APC, and other payer reimbursement methodologies (Required)....