Job Search Results for coding

REMOTE - Coding Auditor

Insight Global is seeking an Auditor to accurately audit hospital inpatient, ambulatory surgery, observation, and outpatient encounters to ensure appropriate reimbursement, research accuracy, and... More compliance with federal and state regulations using ICD-10-CM/PCS and CPT-4 coding systems.Responsibilities include, but are not limited to:? Audit ICD-10 diagnostic codes and CPT-4 procedure codes for outpatient, ambulatory surgery, and observation encounters? Audit complex inpatient cases including trauma, rehab, neurology, and critical care? Ensure accurate APR-DRG, SOI/ROM, and POA assignment? Serve as a clinical coding subject matter expert and resource to coding specialists? Provide education, training, and guidance to coding staff? Monitor coding quality accuracy and productivity rates? Conduct specialized and focused audits as needed? Collaborate with CDI, medical staff, and clinical documentation specialists? Assist with writing appropriate coding queries? Ensure compliance with AHIMA ethical coding standards? Communicate coding accuracy issues and trends to managementWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Coding Educator

Insight global is seeking a Coding Educator for a healthcare system in Virginia. The educator will provide consulting services to physicians, residents, allied health professionals and billing staff... More to support patient care documentation, coding and billing practices according to federal, state and local regulatory compliance standards. Creates and delivers presentations to clinical faculty and billing staff.Develops training programs and delivers training and education sessions for physicians, allied health professionals, residents, and coding and billing staff to support compliance with third party documentation and billing regulatory standards, including but not limited to classroom training, web-based training and one-on-one provider observation and training sessions.Participates on clinical department Billing Quality Councils as a member of the respective councils and acts as the primary resource providing technical and regulatory expertise to the Councils.Presents findings and recommendations from internal and external audits to clinical departments and recommends solutions for implementing appropriate changes.Conducts internal reviews and provides quality review of external billing quality audits.Works with providers and department billing staff to address and resolve documentation deficiencies.Develops and implements Clinical Documentation Improvement Programs in partnership with the clinical departments.We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less

Remote Medical Coding Auditor

The Program Integrity Medical Coding Reviewer III generates comprehensive and concise in-depthreporting and analysis to track performance related to the Pre-Pay and Post-Paid Processes.Essential... More Functions? Provide Provider Pre Pay production and progress reports and coordinate with managementand team on recommendation for further actions and/or resolutions in order to increase teamperformance? Recommend process or procedure changes while building strong relationships with crossdepartmental teams such as Claims, Configuration, Health Partners, and IT on identifiedinternal system gaps? Demonstrate leadership ability, including mentoring Program Integrity Claims Analysts toidentify and perform oversight and monitoring of claims decisions based on documentation? Identify and assist in correction of organizational workflow and process inefficiencies? Serve as the primary resource for provider pre-pay team? Use concepts and knowledge of CPT, ICD10, HCPCS, DRG, REV coding rules to analyzecomplex provider claims submissions? Research, comprehend and interpret various state specific Medicaid, federal Medicare, andACA/Exchange laws, rules and guidelines? Maintain a working knowledge of all state and federal laws, rules, and billing guidelines forvarious provider specialty types along with documentation requirements? Responsible for making claim payments decisions on a wide variety of claims including highlycomplicated scenarios using medical coding guidelines and policies? Refer suspected Fraud, Waste, or Abuse to the SIU when identified in normal course ofbusiness? Responds to claim questions and concerns? Prepares claims for Medical Director review by completing required documentation andensuring all pertinent medical information is attached as needed? Ensure adherence to all company and departmental policies and standards for timeliness ofreview and release of claims? Build strong working relationships within all teams of Program Integrity? Work under limited supervision with considerable latitude for initiative and independentjudgement? Performs any other job related duties as requested.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Senior Profee Coding Auditor

Insight Global is seeking a Senior Profee Coding Auditor to support a healthcare consulting organization that partners with providers nationwide to improve coding accuracy, compliance, and revenue... More integrity through auditing and education services. This individual will perform physician-side (profee) coding audits within EMR systems, ensuring compliance with CMS, OIG, and industry standards. This is a high-level, production-driven consulting role requiring strong critical thinking, independent decision-making, and the ability to clearly explain audit findings and rationale to clients. The ideal candidate has extensive experience across multi-specialty profee coding and auditing and can confidently operate in a fast-paced, autonomous environment. The annual salary for this role ranges from 85k-93k depending on the candidates years of experience. KEY RESPONSIBILITIES:Perform profee coding audits (CPT, ICD-10, HCPCS) in EMR systems to ensure accuracy and complianceEvaluate documentation and identify coding errors, compliance risks, and documentation gapsDevelop detailed audit reports with clear rationale and supporting referencesApply CMS, OIG, and coding guidelines to make independent compliance decisionsRespond to client inquiries and provide subject matter expertise on coding and compliance issuesResearch coding scenarios and draft responses to complex client questionsCollaborate with internal team members and participate in biweekly team meetingWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

PB/ProFee Coding Educator

Sutter Health is seeking experienced Professional Fee (Pro Fee)?focused Coding Educators to support large-scale chart review, coding accuracy validation, physician education, and documentation... More improvement initiatives. These roles are high-visibility and require strong communication and presentation skills to engage directly with clinicians and support Sutter?s revenue cycle, audit, and education functionsWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Inpatient Coding Specialist

A Brief Overview:Requires review of medical record documentation to accurately assign International Classification of Diseases (ICD-10-CM/PCS), as well as to assign Medicare Severity Diagnosis... More Related Group (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) and abstract specific data elements for each account in compliance with federal and state regulations. This position codes various (most) patient types of inpatient records and follows the Official Guidelines for Coding and Reporting, the American Health Information Management Association (AHIMA) Code of Ethics, as well as all American Hospital Association (AHA) Coding Clinic guidance. Reviews, abstracts and assigns accurate and ethical ICD-10-CM and ICD-10-PCS codes to inpatient services. Ensures compliance with third party, State and Federal regulations. Reviews, analyzes and abstracts physician/other documentation for diagnoses, procedures and other services provided. Obtains missing information and/or clarifies existing information. Completes volume of work from work queues per departmental productivity standards. Groups codes and completed product into payment group. Analyzes information for optimal and appropriate reimbursement. Ensures compliance with all appropriate coding, billing and data collection regulations and procedures. Uses appropriate software to validate information. Utilizes Epic, 3M Coding and Reimbursement System (Encoder), 3M CDIS, 3M Audit Expert, MS Office, and other software as appropriate to compile and validate medical information.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Inpatient Coder

Insight Global is seeking 1 Inpatient Coder to support a large healthcare system based out of Annapolis, MD. The Inpatient Medical Coder under the supervision of the Manager of Coding and Data... More Quality accurately codes hospital inpatient accounts for the purpose of appropriate reimbursement, research, statistics and compliance to federal and state regulations in accordance with established ICD-10-CM/PCS coding classification systems.Essential Job Duties:The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.- Analyzes inpatient cases, identifies and assigns ICD-10 diagnostic and PCS procedural codes for the purpose of reimbursement, research and compliance with federal and state regulations. - Demonstrates comprehensive knowledge of coding nomenclature to ensure accurate APR-DRG/SOI/ROM and POA assignment.- Utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed.- Monitors assigned work on a daily basis in order to facilitate the billing process within the established timeframes. - Codes and abstracts records within timeframes established for each patient type.- Maintain a high level of accuracy in code assignment to prevent claim denials, billing errors, and potential legal issues.- Review medical records, including patient histories, examination findings, diagnoses, and treatment plans, to extract pertinent information for code assignment.- Communicates with various departments within the hospitals regarding billing and registration issues. - Refers any problems to management timely, providing clear details.- Complies with AHIMA standards of ethical coding and coding compliance guidelines, including adherence to HIPAA (Health Insurance Portability and Accountability Act) privacy regulations.- Utilizes coding references, software tools, and electronic health records (EHR) to facilitate accurate and efficient code assignment.- Participate in ongoing education, training, and certification programs to enhance coding proficiency and maintain credentials.- Demonstrates support and compliance with Luminis Health Medical System mission, vision, values statement, goals and objectives and policies. - Performs other duties or projects such as coding corrections as assigned by the manager.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Profee Coder (CPC)

Day to DayInsight 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... More 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) 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 KPIsWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Profee Coder (CPC)

Day to DayInsight 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... More 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) 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 KPIsWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Profee Coder (CPC)

Day to DayInsight 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... More 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) 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 KPIsWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less