• Inpatient DRG Quality Auditor

    Humana (Nashville, TN)
    …materials. This is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from ... The Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper… more
    Humana (03/04/25)
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  • Inpatient Coding Quality Auditor

    HCA Healthcare (Nashville, TN)
    …be a part of our team. **Job Summary and Qualifications** As an Inpatient Coding Auditor , you will be responsible for performing internal quality assessment ... an organization that invests in you as an Inpatient Coding Quality Auditor ? At Work from Home,...policy + Demonstrates and applies expert level knowledge of medical coding practices and concepts + Participates… more
    HCA Healthcare (03/11/25)
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  • Coding Auditor I - (Inpatient)

    Baylor Scott & White Health (Nashville, TN)
    **JOB SUMMARY** The Coding Auditor 1 is proficient in various types of coding and is responsible for performing coding quality audits and providing ... feedback to coders. The Coding Auditor 1 utilizes the International Classification...and abstracting function. Strong knowledge of anatomy, physiology, and medical terminology. Demonstrated competency of the use of computer… more
    Baylor Scott & White Health (02/06/25)
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  • Coding Quality Auditor

    Houston Methodist (Nashville, TN)
    ** Coding Quality Auditor - 100% Remote (Must Live in FL, TN, GA, LA, WA State, or TX)** **$5,000 Sign-On Bonus** At Houston Methodist, the Coding Quality ... and/or inpatient encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory… more
    Houston Methodist (02/07/25)
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  • DRG Coding Auditor

    Elevance Health (Nashville, TN)
    …of one of our Elevance Health PulsePoint locations. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating high ... **DRG CODING AUDITOR ** **Location** : This position...**DRG CODING AUDITOR ** **Location** : This position will work a...and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending physician's… more
    Elevance Health (03/14/25)
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  • Coding Auditor Educator

    Highmark Health (Nashville, TN)
    …(Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or ... **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data… more
    Highmark Health (02/07/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Nashville, TN)
    …of one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure ... **Diagnosis Related Group Clinical Validation Auditor -RN** **Location:** This position will work a hybrid...an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and… more
    Elevance Health (03/04/25)
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  • Risk Adjustment Auditor I

    Baylor Scott & White Health (Nashville, TN)
    …tracks results and identifies trends and deficiencies for follow-up + Researches complex coding HCC issues and keeps abreast of coding and compliance changes ... knowledge with co-workers, as directed + Assists Risk Adjustment Auditor 2 or Manager with educator duties in the...**KEY SUCCESS FACTORS** + Knowledge of ICD-10-CM and CPT coding conventions, and clinical documentation + Knowledge of and… more
    Baylor Scott & White Health (03/13/25)
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  • Clinical Provider Auditor II

    Elevance Health (Nashville, TN)
    …related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. + ... Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II**...+ Requires a AA/AS and minimum of 4 years medical coding /auditing experience, including minimum of 1… more
    Elevance Health (03/13/25)
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  • Special Investigation Unit Manager Clinical…

    CVS Health (Nashville, TN)
    Coding Certification - Certified Professional Biller (CPB), Certified Professional Medical Auditor (CPMA), Certified Outpatient Coder (COC), Certified Risk ... Coders (CPC). The Manager is responsible for overseeing and managing coding reviews for fraud detection, investigation, and prevention efforts to safeguard… more
    CVS Health (12/25/24)
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