. Experience We Love: 5-7 years of previous experience in a Coding Educator, Auditor Educator, Facility Educator role 5-10 years... of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups...
that all coding and billing remains compliant and meets all federal and state guidelines (i.e. Medicare/ Medicaid). Assist... to guidelines in order to validate billing assignments and resolve potential errors. Reviews coding of claims generated by LMC...
collaboration with the Claim Editing Manager, Physician, Specialty Coder, AR specialist or Auditor/Educator. Demonstrate the... of root cause issues. Performs searches of governmental, payor-specific, guidelines to identify and coding and billing...
to coding questions. 11. Research updated coding information and communicate changes to physicians and billing staff. 11... between hospital and physician-based practices. 1717. Supervises Coding Quality Specialists II and I including the following...
sessions on current billing and coding information in the medical field. 8. Develop curriculum and training handbook... to physicians and billing staff. 11. Provide continual coding and payer updates. 12. Maintain knowledge of (ICD-10) and CPT...
, Medicare, and Medicaid claims, including a thorough understanding of billing, coding rules, and claim forms (UB04 and HCFA 1500... As a Reimbursement Auditor, you will play a pivotal role in ensuring our clients claims are processed accurately and identifying areas...
activities to ensure accuracy of related medical record documentation, coding, billing and policies. Provides written audit... Specialist (CCS) or Certified Coding Specialist - Physician (CCS-Phy) or Certified Professional Coder (CPC) or Registered Health...
, physician and ancillary services against medical record documentation. Researches CPT codes to clarify coding issues... Auditor II performs detailed medical record and chart audit review of the health plan’s inpatient, outpatient, professional...
, billing requirements and applicable industry based standards Remain current on ICD and CPT/ HCPC coding requirements...ABOUT THIS POSITION We are looking for a Revenue Integrity DRG Auditor who has a comprehensive understanding...
when performing audits. Works with various staff and departments such as Health Information Management, coding and billing... areas of concern. Conducts medical necessity reviews in a timely manner, working with coding, billing, and CDI...
/quality monitoring performed by PHS/PMG departments while serving as a resource on documentation, coding, billing, and coding.... Provides support via auditing and training the enterprise-wide corrective action plans for coding, audit, physician...
and coding/billing audits assessing the accuracy of CPT codes, diagnoses, and modifier assignments, determining compliance... and procedures and Maintain a current working knowledge on regulatory requirements associated with professional coding, billing...
Position Summary The Revenue Integrity Nurse Auditor will be responsible for performing pre-billing and post-billing... charge capture. Conducts pre-bill and post-billing audits of charges and coding to ensure accuracy, compliance...
trials billing, privacy, conflict of interest, and anti-kickback and physician relationships. Exercise independent decisions... cycle compliance, Medicare/Medicaid regulations, including billing, coding, and documentation requirements. Knowledge...
: The Catholic Health (CH) Health Information Management (HIM) Educator/Auditor is responsible for providing Provider Coding... that are provided. The Educator/Auditor will introduce new providers to the coding program requirements across CHS/Trinity and provide...
QUALIFICATIONS Education/Licensure/Certification: Experience with Health Information Management (HIM), Facility/Physician Billing..., Physician (CCS-Phy) or Certified Professional Coder (CPC) or Certified Professional Coder – Hospital (CPC-H) or Certified Coding...
and to help defend external coding audits when requested. As the Senior Medical Auditor, you will provides technical expertise... to review staff to ensure that all physicians, clinical, billing and coding staff are adhering to all guidelines for compliance...
while serving as a resource on documentation, coding, billing, and coding compliance questions. Works on special coding compliance... corrective action plans for coding, audit, physician and clinician personnel identified as low performers; perform medical record...
-physician providers, professional fee billing staff, clinic staff, administrators, and other affected personnel on documentation... and billing requirements. Using auditing and analysis techniques, determines the adequacy of medical records documentation, coding...
, compliance, billing, coding, and reimbursement processes Responsibilities Using audit tools, authoritative references, CMS... hospitals and multispecialty physician practices in six states. Ardent includes 30 hospitals, 4,423 patient beds...