- Houston Methodist (Austin, TX)
- At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in code assignment of diagnosis and procedure to outpatient and/or ... based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory body guidelines. This position… more
- Nuvance Health (Danbury, CT)
- …closely with all business units and provides recommendations toward continuing improvement of coding compliance and coding denial management, while ensuring ... *Responsibilities:* 1. Under the leadership of the SACO, conducts high volume of coding compliance audits across all Nuvance Hospitals in accordance with the… more
- Dignity Health (Rancho Cordova, CA)
- …and service. **Responsibilities** This position is remote .** **Position Summary:** The Coding Compliance Auditor conducts professional fee audits on ... **Overview** This position is remote .** Dignity Health Medical Foundation established in 1993...audit schedule. - Educates all new providers on proper coding and documentation prior to auditing and provides feedback… more
- Northwell Health (Lake Success, NY)
- … compliance risk. Job Responsibility + Reviews data, such as claims detail, coding and medical record documentation to determine compliance with appropriate ... regulatory risk assessments. + Acts as the internal expert on coding issues to ensure compliance with state and federal regulations. + Research, interpret and… more
- BayCare Health System (FL)
- …+ **Shift:** 7:00 AM to 3:30 PM + **Days:** Monday - Friday The **Inpatient** ** Coding Auditor ** is a full-time remote position. This team member must ... Georgia, or North Carolina. **Responsibilities** + The Inpatient Coding Auditor performs inpatient encounter audits and evaluates compliance related… more
- Hackensack Meridian Health (Hackensack, NJ)
- …and serve as a leader of positive change. The ** Coding Quality Auditor ** is responsible for monitoring compliance with applicable clinical documentation to ... hours every weekend.** **Responsibilities** A day in the life of an ** Coding Quality Auditor ** at **Hackensack Meridian** **_Health_** includes: + Reviews… more
- WelbeHealth (Los Angeles, CA)
- …is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring ... ( Remote , CA residents only) WelbeHealth PACE (All-Inclusive Care...audits and participate in provider education programs to ensure compliance with CMS risk adjustments diagnosis coding … more
- UNC Health Care (Chapel Hill, NC)
- …other applicable codes. Analyzes information for optimal and proper reimbursement, including coding denial resolution. Ensures compliance with all appropriate ... coded records for multiple specialties. Analyzes coded records for compliance with federal, state and third party insurer rules...to physicians and other health care staff regarding current coding practices and changes in 3rd party, state and… more
- Geisinger (Danville, PA)
- … committees. Job Duties + Responsible for reviewing the reliability and integrity compliance and coding information and the means used to identify, measure, ... and evaluations of the adequacy and effectiveness of the organization's compliance initiatives. Participates in reviews related to performance quality of assigned… more
- UNC Health Care (Chapel Hill, NC)
- …appeals insurance coding denials. This position analyzes coded records for compliance with federal, state and third party insurer rules and regulations and note ... . **Knowledge/Skills/and Abilities Requirements:** * Strong knowledge of ICD-10/PCS/CPT/HCPCS coding and billing compliance (MS-DRGs/IPPS, APC/OPPS) with… more
- Insight Global (Charlottesville, VA)
- Job Description Insight global is seeking a remote Professional Coding Educator for a healthcare system in Virginia. The educator will provide consulting ... training and education sessions for physicians, allied health professionals, residents, and coding and billing staff to support compliance with third party… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …_Experience_ + 2 years \- Professional/ancillary or facility inpatient/outpatient coding and/or auditing experience in an applicable setting\. ... _Skills\\Certifications_ + Current AHIMA or AAPC coding certification preferably CPC or CCS, will consider candidate who does not currently hold certification with… more
- Rising Medical Solutions (Chicago, IL)
- …reviewing medical bills from a nurse perspective, including appropriate billing, coding and treatment, fee schedule compliance , over-utilization, and erroneous ... thrive. Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the...CPC-H certification(s) strongly desired + Specialized training in hospital coding , ortho, neuro, rehab, or ER procedures + 3-5… more
- Sevita (Baltimore, MD)
- …for the people we serve and for our employees. **Summary** The Clinical Compliance Auditor is responsible for collaborating with Operations and Revenue Cycle ... Supports the leadership of the Company and the Chief Compliance Officer. This position is remote and...Contributes to the identification and reduction of the Company's coding compliance risks, billing inaccuracies, and/or denials… more
- Elevance Health (Columbus, OH)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** _Location: This position will work a hybrid model ( remote and office). The ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- CIBC (Chicago, IL)
- …**What you'll be doing** As a member of CIBC's team, the Senior Auditor is responsible for conducting risk-focused audits; advising business units on the design, ... implementation, and maintenance of internal controls; and promoting compliance with CIBC policies and procedures, accounting standards, control policies, and… more
- MD Anderson Cancer Center (Houston, TX)
- …educational needs 5. Evaluate correct code assignments to verify accuracy consistent with coding rules and regulations 6. Identify compliance risks and financial ... other official sources; keeps staff up to date with coding regulations to ensure compliance 11. Create...users 14. Ability to cover for other trainer(s) and/or auditor (s) 15. All other assigned duties **Working Conditions** This… more
- Commonwealth Care Alliance (Boston, MA)
- …Working under the direction of the Sr. Director, TPA Management and Claims Compliance , Healthcare Medical Claims Coding Sr. Analyst will be responsible for ... health care programs and reimbursement methodologies (Medicaid and Medicare) + Medical Coding , Compliance , Payment Integrity and Analytics + Direct and relevant… more
- R1 RCM (Chicago, IL)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse** , you will help review and interpret medical ... and underpaid claims. Every day you will review medical records to ensure appropriate coding of removed or revised diagnosis and procedure codes. Then you will draft… more
- Providence (OR)
- …action completion and behavior change + Provide education related to coding , medical record documentation requirements, healthcare compliance and fraud, ... such as Accredited Healthcare Fraud Investigator (AHFI), Certification as an Internal Auditor (CIA), Healthcare Compliance certification (CHC), or equivalent +… more