- Kaiser Permanente (Portland, OR)
- …or anesthesia. Working knowledge of the KPHC/EpicCare system. COMPANY: KAISER TITLE: Certified Coding Auditor II (Must reside in KPNW region) LOCATION: Portland, ... Certified Professional Coder OR Registered Health Information Technician OR Certified Coding Associate OR Certified Professional Medical Auditor OR Certified… more
- Elevance Health (Mason, OH)
- DRG Coding Auditor Principal ** Virtual: _** _ ? This role enables associates to work virtually full-time, with the exception of required in-person training ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical… more
- Elevance Health (St. Louis, MO)
- DRG CODING AUDITOR Virtual **_: _** _ _ ? This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG CODING AUDITOR is responsible for auditing inpatient medical records… more
- Cognizant (Little Rock, AR)
- About the role As an Inpatient Medical Coding Auditor , you will make an impact by auditing consultant inpatient. You will be a valued member of the Cognizant ... Provide ICD-10-CM and ICD-10-PCS education and mentoring to Company's clients in coding , billing and compliance Perform Peer Reviews of Company Health Information… more
- Highmark Health (Harrisburg, PA)
- …Professional Medical Auditor (CPMA) 5 years with hospital or physician coding and/or auditing, as well as, education techniques and methods. (Internal transfer ... GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality… more
- WellSpan Health (York, PA)
- …employees. Duties and Responsibilities Essential Functions: Performs proactive or reactive coding compliance reviews as needed to identify or quantify potential ... action and performs follow up reviews where necessary. Assists with coding compliance implementation throughout the WellSpan. Assists in the development and… more
- UnitedHealth Group (Minneapolis, MN)
- …scale. Join us to start Caring. Connecting. Growing together . In this position as a Coding & Clinical Auditor / DRG Specialist RN , you will apply your expert ... knowledge of the MS-DRG and APR-DRG coding /reimbursement methodology systems, ICD-10 Official Coding Guidelines, and AHA Coding Clinic Guidelines in the… more
- Geisinger (Danville, PA)
- Job Summary The Compliance Auditor position is responsible for supporting the organization's Revenue Management Compliance department in developing, implementing, ... non-physician practitioners, leadership, and administrative staff on documentation and coding requirements. Determines the adequacy of medical record documentation, … more
- Capital One (Charlotte, NC)
- Principal Auditor - Cyber, Risk and Analysis Technology Audit (Hybrid) Capital One's Audit function is a dedicated group of professionals focused on delivering ... information, issues and audit progress to teammates, clients and auditor -in-charge. Perform various aspects of engagement administration, including hours and… more
- Robert Half (Boston, MA)
- Description Job Title: Medical Claims Auditor - RN Auditor Location: Massachusetts - 90% Remote Job Type: 1 Year Contract - Potential for Perm Hire Hours: 40 ... Start Date: December 1, 2025 Job Description We are seeking a qualified Auditor with healthcare experience to support Program Integrity activities for a state… more
- UnitedHealth Group (Minnetonka, MN)
- …challenges. Primary Responsibilities: Assesses and interprets the needs of the Ambulatory Coding Team by prioritizing work to meet deadlines. This can include ... assisting with coding duties and managing work queues Identifies solutions to...conducts analysis of trends to provide education for the coding staff and clients including physicians/providers Provides detailed education… more
- Datavant (Raleigh, NC)
- …will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, ... own workspace! What You Will Do: Performs Inpatient Facility coding audits according to scope of work, for the...of reviews, using appropriate assignment of codes and other coding -related elements using MS DRG or APR DRGs. Provides… more
- Amergis (Cleveland, OH)
- …& Preferred) IP auditing Minimum of 2 years of inpatient facility coding experience Minimum of 2 years inpatient facility auditing experience Excellent oral ... and written communication skills Knowledge of Microsoft Word and Excel Computer savvy and ability to shift priorities to meet tight deadlines Systems (Required & Preferred) Prefer well rounded system experience. Epic, Cerner, 3M, Optum 360 AHIMA and/or AAPC… more
- BJC HealthCare (St. Louis, MO)
- …giving instruction on federal and state regulations, documentation guidelines, and coding training in a way that ensures compliance with governmental regulations. ... Responsibilities Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding , denials, and billable services identified as part of the… more
- Datavant (Columbus, OH)
- …a profee auditor proficient in multi-specialty including procedure and E/M coding in multiple settings What You Will Do: Performs Professional Fee coding ... Seeking a profee auditor proficient in multi-specialty including procedure and E/M coding in multiple settings What You Need to Succeed: 5+ years of Professional… more
- Datavant (Oklahoma City, OK)
- …will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, ... the future of healthcare from your own workspace! Inpatient auditor with 3-5 years of experience at a Trauma...experience strongly encouraged to apply You Will: Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and… more
- Catholic Health Initiatives (Little Rock, AR)
- …for all things quality and risk for the value hub. Through Risk Management/ Auditor Manager, implements a risk adjustment coding department in appropriate ... travel may be involved. Supports quality, clinical practice, safety, risk coding , compliance, patient experience and Health Information Management functions within… more
- Commonwealth Care Alliance (Boston, MA)
- …the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective claims auditing ... and clinical coding and reimbursement edits and necessary coding ...Coder (CPC) Certified Inpatient Coder (CIC) Certified Professional Medical Auditor (CPMA) Desired Education (nice to have): Masters Degree… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …and targeted monitoring. This role conducts complex, risk-based audits across coding , charge capture, and documentation to assess adherence to government, payer, ... and institutional billing guidelines as well as national coding guidelines. The Senior Reviewer will assist in the development and execution of the annual Billing… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …Compliance Reviewer plans and executes risk-based audits, analyzes documentation and coding for medical necessity and regulatory adherence, and recommends corrective ... ensure compliance with federal and state regulations, payer requirements, national coding guidelines, and internal policies. The Billing Compliance Reviewer is… more
