38 jobs found in Delaware

Medical Coding Auditor Become a part of our caring community and help us put health first. Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. This role focuses on Durable Medical Equipment (DME) auditing and is part of the PPI Coding Disputes Team with Humana. The Disputes Auditor DME Outpatient Coding on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Required Qualifications: CPC or CCS Certification CPT/HCPCS auditing experience 1+ years' work experience reading and interpreting claims 3+ years' experience performing DME coding audits in health insurance and/or hospital settings and working coding-related disputes and trending results Working knowledge of Microsoft Office Programs Word,...

Inpatient Coder Opportunity Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our...

Job Details ChristianaCare is searching for a Compliance Auditor to support the Office of Compliance & Privacy through assigned compliance activities and audits to ensure effective clinical documentation that meets regulatory guidelines. Responsibilities Helps the Office of Compliance & Privacy adhere to assigned audit schedule and reviews as outlined in the Departmental Compliance Workplan and as assigned. Assists with reviewing internal and external inquiries regarding compliance and privacy matters, including government and third?party payor requests. Conducts audits and focused reviews to ensure compliance with government and payor guidelines. Assists with maintaining regular and consistent governance?level reporting and metrics for the Compliance department, including dashboards, board reporting, weekly, monthly, and annual compliance & ethics reporting. Reviews documentation to ensure appropriate assignment of facility?based and provider?based...

Coding And Billing Auditor Job Coding and billing auditor job is fully onsite.

Job Title: Clinical Floor Supervisor / Medical Assistant Location: Dover, DE 19904 Duration: 1 Year with possible extension Shift: 08:00 AM - 05:00 PM Job Description: Direct the daily activities of the Medical Assistant staff, including the assignment and completion of tasks, quality oversight and readiness, and preparation. Ensure work is completed efficiently and in accordance with Westside's standards, policies, and procedures. Delegate tasks to MAs as appropriate. Resolve coverage issues related to scheduled and unscheduled absences. Provide support to site MA team, including supporting orientation and ongoing training when needed, and continuously practicing, enforcing, and educating the MA team regarding workflows and workflow changes resulting from the addition or revision of policies and processes. Work in conjunction with the Nurse Manager to maintain vaccine and supply inventory and serve as a main contact for Vaccines for Children/317 programs,...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator 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. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures,...

Job Description: The HIM Hospital Inpatient & Same Day Surgery Coding Analyst deciphers and interprets provider documentation in the health record and assigns diagnostic information using ICD-10-CM/PCS and CPT codes for a complex range of acute care services for Intermountain Health. The caregiver provides specific coding expertise in the various fields of NCCI edits, Drugs and Biologicals, Revenue Codes, Current Procedural Terminology (CPT) codes, ICD-10 & CPT codes, DRGs, anatomy and physiology, pharmacology. The analyst also performs audits, provides feedback, and advanced training to clinical teams and physicians on ICD-10 and CPT coding best practices. Essential Functions Reviews and analyzes inpatient medical records for completeness, accuracy, and compliance for Same Day Surgery, Observation and Inpatient acute services at Intermountain Health. Performs coding at an advanced level of complexity for inpatient hospitals including governmental and/or...

This is a remote based position. Applicants can be located nationwide Back Medical Coder #2621 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who has Profee Outpatient Coding experience. We need someone who is responsible for assignment of accurate Evaluation and Management (E&M) ICD-10-CM, ICD-10- PCS, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, modifiers and quantities derived from medical record documentation (paper or electronic) for encounters dependent upon record type. Tell us about your experience with Profee Outpatient Coding. Are you a team player and a self-motivator? What is your experience with conducting business in a way that is credit to a company? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you...

Job Type Full-time Description WESTSIDE IS LOOKING FOR A SUPERVISOR TO LEAD THE MEDICAL ASSISTANT TEAM! JOIN THE TEAM TAKING CARE OF THE COMMUNITY! The MA Supervisor, (Clinical Floor Supervisor) (CFS) coordinates and supervises the care provided by a designated group of Medical Assistants (MAs), ensuring that they adhere to Westside's standards and procedures in all aspects of their work. The CFS may also assess patient health problems and needs, maintain medical records, advise patients on health maintenance and disease prevention, coordinate with other members of the patient care teams and act as a clinical resource for the team. Since opening our doors in 1988, Westside has been driven by our mission to improve the health of our communities by providing equal access to quality healthcare, regardless of ability to pay. With 240 team members, five health centers, one mobile health unit and over 27,000 patients all across Delaware, Westside is committed to...

Datavant is a leading data platform company specializing in health data exchange, dedicated to empowering healthcare decisions with timely and accurate data. We harness the power of the largest health data network in the U.S. to ensure data is secure and effectively used to enhance health outcomes. Joining Datavant means becoming a vital part of a high-performing, values-driven team that is addressing complex healthcare challenges with innovative solutions. Our team members come from diverse professional, educational, and personal backgrounds to pursue our ambitious vision for healthcare. We are actively seeking skilled and credentialed outpatient coders to enhance our team. The ideal candidate will demonstrate exceptional attention to detail and possess a profound understanding of medical terminology. This remote position offers flexibility, allowing you to contribute significantly to the future of healthcare from your own home! What You Will Do: Review medical records...

Become a part of our caring community and help us put health first 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. 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...

Become a part of our caring community and help us put health first Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Durable Medical Equipment (DME) auditing and is part of the PPI Coding Disputes Team with Humana. The Disputes Auditor - DME Outpatient Coding on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient DME coding disputes and expertise in...

This is a remote-based position open to candidates across the nation. About You Are you an experienced coder with a specialty in Profee Outpatient Coding? If so, we would love to have you join our team! As a vital part of our organization, you will be responsible for the timely and accurate assignment of Evaluation and Management (E&M) ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes from both paper and electronic medical records. We want to hear about your Profee Outpatient Coding experience! Are you a proactive team player who thrives in a collaborative environment? What unique qualities make you stand out as a professional? Do you possess problem-solving skills to effectively manage multiple projects? Bring your exceptional talents to our team and help us excel! If you value teamwork, integrity, and professionalism, we are eager to connect with you! About The Position Conduct thorough reviews of medical documentation to accurately assign principal...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the...

DRG Coding Auditor Principal Virtual:? ?? This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. 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...

Job Details ChristianaCare is searching for a Compliance Auditor to support the Office of Compliance & Privacy through assigned compliance activities and audits to ensure effective clinical documentation that meets regulatory guidelines. The Compliance Auditor performs a variety of audits to investigate and monitor compliance with federal and state laws, as well as Centers for Medicare and Medicaid Services (CMS) regulations, billing, coding and medical necessity documentation guidelines, and HIPAA Privacy standards. They perform financial, operational and compliance audits for the Office of Compliance & Privacy. Work is diverse and assignments could include a wide array of business areas such as inpatient and outpatient services, physician practices, and contracts. An individual with clinical/medical necessity expertise is preferred. The successful candidate must have clinical chart review experience, in addition to broad knowledge of medical claims billing/payment...

Day to Day Insight Global is hiring several CPC, Certified Professional Coders to join a large healthcare client in Southern NJ. This role focuses on multi-specialty professional fee coding in a high-volume, production-driven environment. Candidates will work remotely but must reside in approved states and be available for occasional onsite visits. Responsibilities Abstract billing for outpatient evaluation and management (E/M) codes, minor surgical procedures, and HCPCS codes (including supplies and pharmaceuticals), and others from provider documentation. Assign CPT-4 and ICD-10-CM codes with appropriate modifiers. Investigate coding and billing questions to determine the best approach. Analyze medical records to verify coding accuracy and detect potential misuse. Collaborate with Coding, Charge, and Audit Analysts to resolve discrepancies. Work across multiple Epic work queues for different specialties. Meet productivity expectations and KPIs Must Haves: 2 years of Coding...

Job Description Manage environmental compliance related tasks, programs and plans Inspect facilities, based on requirements, track date of audit, follow up and corrective action. Responsible for maintaining Intellex Program and producing monthly updates Duties/Activities Required by Job Monitoring environmental compliance, i.e, permits, licenses, applications and records to ensure compliance with licensing requirements. Identifying compliance issues and developing corrective action plans, act as a technical resource to address and resolve inquiries and problems regarding production, quality and work problems as appropriate. Compliance inspections- determine the nature of code violationsand actions to be taken, develop corrective course of action. Update Intellex Program Provides technical support to internal customers related to environmental projects, processes audits and compliance. Provide compliance training to internal customers, offer guidance and support to...

Job Details Do you want to work at one of the Top 100 Hospitals in the nation? We are guided by our values of Love and Excellence and are passionate about delivering health, not just health care. Come join us at ChristianaCare! ChristianaCare, with Hospitals in Wilmington and Newark, DE, as well as Elkton, MD, is one of the largest health care providers in the Mid-Atlantic Region. Named one of "America's Best Hospitals" by U.S. News & World Report, we have an excess of 1,100 beds between our hospitals and are committed to providing the best patient care in the region. We are proud to that Christiana Hospital, Wilmington Hospital, our Ambulatory Services, and HomeHealth have all received ANCC Magnet Recognition. Primary Function: ChristianaCare is looking for a full-time Sr. Coder who will be responsible for accurate and timely assignment of ICD 10 CM/PCS and HCPCS/CPT codes, payment group classification assignment and data abstraction for reimbursement purposes and...