36 sr medical coding auditor jobs found

Description The Sr Billing Compliance Auditor serves as the liaison responsible for monitoring and auditing NCPS coding and documentation functions for professional fee services. Conducts independent ongoing reviews of vendor and provider-coded professional fee services to ensure practices meet federal requirements. Works closely with NCPS to communicate monitoring / auditing results and provide feedback to support necessary actions taken accordingly. Functions as the subject matter expert for professional fee coding and documentation, and partners with NCPS administrators to ensure consistent, compliant, and accurate coding practices. Job Summary Conducts audits of NCPS professional fee encounters to validate accuracy of CPT, HCPCS, ICD-10-CM, and modifier assignment. Serves as the coding, documentation, and billing expert for NCPS, ensuring focused expertise on pediatric, Fl AHCA / Medicaid, and CMS regulatory requirements. Monitors professional fee vendor‑coding services to...

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As an Inpatient Coding Auditor with Parallon you can be a part of an organization that is devoted to giving back! Job Summary and Qualifications As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. What you will do in this role: Leads,...

Program Integrity Clinical Compliance Auditor This position is remote in Massachusetts. You will have the flexibility to work remotely as you take on some tough challenges. 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 Program Integrity Clinical Compliance Auditor will be responsible for performing compliance reviews of medical and administrative documentation to identify instances of healthcare fraud and/or wasteful and abusive conduct by health care providers who submit claims for payment. This position will utilize information from claims data...

Job Description - Sr Compliance Auditor (301657) Job Description Sr Compliance Auditor - 301657 Description Job Summary The Sr Billing Compliance Auditor serves as the liaison responsible for monitoring and auditing NCPS coding and documentation functions for professional fee services. Conducts independent ongoing reviews of vendor and provider‑coded professional fee services to ensure practices meet federal requirements. Works closely with NCPS to communicate monitoring / auditing results and provide feedback to support necessary actions taken accordingly. Functions as the subject matter expert for professional fee coding and documentation, and partners with NCPS administrators to ensure consistent, compliant, and accurate coding practices. Job Specific Duties Conduct audits of NCPS professional fee encounters to validate accuracy of CPT, HCPCS, ICD‑10‑CM, and modifier assignment. Serves as the coding, documentation, and billing expert for NCPS, ensuring focused expertise...

Overview Compliance Auditor Sr. Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region’s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times. Position Summary: Performs complex-level professional internal auditing. Work involves leading or conducting compliance audit projects for Covenant Health entities as they relate to charging, coding, documentation and billing compliance....

Job Description Job Description Overview The Sr Compliance Coding Auditor performs complex coding audits across a range of services, including those delivered in correctional settings and through third-party billing vendors. This role serves as a subject matter expert on coding and documentation guidelines, identifying risks and preparing detailed audit findings. The position works closely with leadership to develop corrective actions and deliver education to providers and coders. This role also supports regulatory audits and provides guidance and mentorship to compliance staff. Responsibilities Plan and conduct complex coding audits using risk-based sampling and established methodologies. Review provider documentation, coding, and modifier usage to ensure compliance with coding standards and payer rules. Analyze findings, prepare detailed audit reports, and present results to providers, coders, and leadership. Support corrective action planning, education efforts,...

Sr Billing Compliance Auditor The Sr Billing Compliance Auditor serves as the liaison responsible for monitoring and auditing NCPS coding and documentation functions for professional fee services. Conducts independent ongoing reviews of vendor and provider-coded professional fee services to ensure practices meet federal requirements. Works closely with NCPS to communicate monitoring / auditing results and provide feedback to support necessary actions taken accordingly. Functions as the subject matter expert for professional fee coding and documentation, and partners with NCPS administrators to ensure consistent, compliant, and accurate coding practices. Job Specific Duties: Conducts audits of NCPS professional fee encounters to validate accuracy of CPT, HCPCS, ICD‑10‑CM, and modifier assignment. Serves as the coding, documentation, and billing expert for NCPS, ensuring focused expertise on pediatric, Fl AHCA / Medicaid, and CMS regulatory requirements. Monitors...

You Matter • Make a difference every day in the lives of the underserved • Join a mission driven organization with a people first culture • Excellent career growth opportunities Join us and find a career that supports: • Caring for overlooked, underserved, and vulnerable patients • Diversity, equity, inclusion, and belonging • Autonomy in a warm team environment • Growth and training Perks and Benefits In addition to comprehensive benefits including medical, dental, vision, paid time off, and 401k, we foster a work, life balance for team members and their family to support physical, mental, and financial wellbeing including: • DailyPay, receive your money as you earn it! • Tuition Assistance and dependent Scholarships • Employee Assistance Program (EAP) including free counseling and health coaching • Company paid life insurance • Tax free Health Spending Accounts (HSA) • Wellness program featuring fitness memberships and product discounts • Preferred...

Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Coding Auditor Job Summary and Qualifications The Coding Auditor is responsible for performing quality reviews and audits of the assigned staff. This includes coordination with the department managers to ensure standards are met in accordance with department and organization policy. Additionally, this team member contributes to improving the processes and infrastructure of the department. Proficient in facilitation and interpersonal communication, this team member also consistently demonstrates skills in organization, prioritization, professionalism and coaching others. What you will do in this role: Perform regularly-scheduled quality reviews...

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As an Inpatient Coding Auditor with Parallon you can be a part of an organization that is devoted to giving back! Job Summary and Qualifications As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. What you will do in this role: Leads,...

Sr. Auditor Project Lead The Sr. Auditor Project Lead will report to the Manager with a direct line of communication to the Directors. Responsibilities will include but not be limited to: Oversee the management of multiple projects. Manage client needs and expectations to ensure projects meet scope, requirements and deliverables are on-time and of high quality. Perform production work in addition to project management, meeting department's quality and production standard thresholds. Responsible for maintaining department audit standards, clinical documentation standards, protocols and guidelines. Review auditor work for accuracy and provide feedback written and verbally to auditors. Audit medical records to validate clinical documentation to support evaluation and management services, ancillary services, procedures, and diagnoses and meet department quality and production standards. Research regulatory guidelines for supporting documentation. Prepare audit summary...

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 These are 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 patient medical records....

DHR Health - US:TX:Edinburg - Days Summary: FLSA STATUS: ☐ Exempt ☒ Non-Exempt MISSION STATEMENT: Our Mission is to improve the well-being of those we serve with a commitment to excellence: every patient, every encounter, every time. VISION: Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence. POSITION SUMMARY: Under general supervision, analyzes patient medical records to assure that documentation by providers conforms to legal and procedural requirements. Assigns specified codes to medical diagnoses and/or clinical procedures. Interacts with physicians and other providers regarding billing and documentation policies and procedures. Audits medical charts and records for compliance with federal coding regulations and guidelines. Provides a second level review of codes assigned to medical...

Job Details Sr. Coder Job Description REMOTE Sr. Certified Coding Medical Records : Review patient medical records and assign appropriate codes using systems like ICD-10-CM, CPT, and HCPCS for diagnoses and procedures. Claims Processing: Prepare and submit claims to insurance companies, ensuring compliance with regulations and accuracy in coding to facilitate reimbursement. Collaboration: Work closely with healthcare providers, billing specialists, and other staff to clarify documentation and ensure accurate coding practices. Auditing and Compliance: Conduct audits of medical records to ensure coding accuracy and compliance with federal regulations and insurance standards. Training and Support: Provide training and support to healthcare staff on coding practices and documentation requirements. Required Qualifications Certification: Must hold a certification from recognized organizations such as AAPC (CPC) Experience: Typically requires a minimum of 2-3...

Sr. Coder REMOTE Job Description Sr. Certified Coding Medical Records: Review patient medical records and assign appropriate codes using systems like ICD-10-CM, CPT, and HCPCS for diagnoses and procedures. Claims Processing: Prepare and submit claims to insurance companies, ensuring compliance with regulations and accuracy in coding to facilitate reimbursement. Collaboration: Work closely with healthcare providers, billing specialists, and other staff to clarify documentation and ensure accurate coding practices. Auditing and Compliance: Conduct audits of medical records to ensure coding accuracy and compliance with federal regulations and insurance standards. Training and Support: Provide training and support to healthcare staff on coding practices and documentation requirements. Required Qualifications Certification: Must hold a certification from recognized organizations such as AAPC. Experience: Typically requires a minimum of 2-3 years of experience in...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Sr. Associate, Health Care Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute....

Sr. Associate, Health Care Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute....

Sr. Coder REMOTE Job Description Sr. Certified Coding Medical Records: Review patient medical records and assign appropriate codes using systems like ICD-10-CM, CPT, and HCPCS for diagnoses and procedures. Claims Processing: Prepare and submit claims to insurance companies, ensuring compliance with regulations and accuracy in coding to facilitate reimbursement. Collaboration: Work closely with healthcare providers, billing specialists, and other staff to clarify documentation and ensure accurate coding practices. Auditing and Compliance: Conduct audits of medical records to ensure coding accuracy and compliance with federal regulations and insurance standards. Training and Support: Provide training and support to healthcare staff on coding practices and documentation requirements. Required Qualifications Certification: Must hold a certification from recognized organizations such as AAPC. Experience: Typically requires a minimum of 2-3 years of experience in medical...

340B Health in Miami, Florida is seeking a Sr Billing Compliance Auditor responsible for monitoring coding and documentation functions. This role includes auditing professional fee services to ensure federal compliance and working closely with NCPS administrators. The ideal candidate will have extensive experience in physician billing and coding, with a focus on CMS and Medicaid regulations. Strong communication skills and the ability to analyze data are essential. #J-18808-Ljbffr

Ankura is a team of excellence founded on innovation and growth.**Practice Overview:**Ankura’s Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura’s health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Job Details Sr. Coder Job Description Key Responsibilities: Coding Medical Records : Review patient medical records and assign appropriate codes using systems like ICD-10-CM, CPT, and HCPCS for diagnoses and procedures. Claims Processing: Prepare and submit claims to insurance companies, ensuring compliance with regulations and accuracy in coding to facilitate reimbursement. Collaboration: Work closely with healthcare providers, billing specialists, and other staff to clarify documentation and ensure accurate coding practices. Auditing and Compliance: Conduct audits of medical records to ensure coding accuracy and compliance with federal regulations and insurance standards. Training and Support: Provide training and support to healthcare staff on coding practices and documentation requirements. Required Qualifications Certification: Must hold a certification from recognized organizations such as AAPC (CPC) Experience: Typically requires a minimum of 2-3 years of experience in...