Coding Auditor

Location

United States

Posted

32 days ago

Salary

0

Seniority

Mid Level

No structured requirement data.

Job Description

Coding Auditor

Elevance Health

Role Description The Coding Auditor is responsible for auditing diagnosis data collected from physician and hospital medical records to ensure proper ICD9 coding and compliance with risk adjustment requirements. - Collects and analyzes data to formulate recommendations and solutions based on audit trends and results. - Provides regular feedback to Operations leadership on performance improvement opportunities as a result of performance gaps. - Participates in and represents the department in business leadership groups. - Assesses and identifies training opportunities. - Assists the business with research and documentation of workflows, policies and procedures and other materials. - Maintains current knowledge of requirements and guidance required in the performance of audit duties. - Reviews medical records that have been reviewed and coded by the coding vendor. Qualifications - Requires a H.S. diploma or equivalent and minimum of 1 year of experience as a coder of medical records in a physician office, hospital, or insurance/coding office setting; or any combination of education and experience, which would provide an equivalent background. - Medical Coder certification from accredited source (e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) required. - Previous auditing experience is a must for this role! - BS in health sciences, health management or related field preferred. - CRC certification preferred. Requirements - This is a virtual eligible role. You should be within a reasonable proximity to one of our offices. - Hours: 8:00a - 5:00p, Monday through Friday (Eastern or Central time). - This role enables associates to work virtually full-time, with the exception of required in-person training sessions. - Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Benefits - Market-competitive total rewards including merit increases, paid holidays, and Paid Time Off. - Incentive bonus programs (unless covered by a collective bargaining agreement). - Medical, dental, and vision benefits. - Short and long term disability benefits. - 401(k) + match. - Stock purchase plan. - Life insurance. - Wellness programs and financial education resources.

Related Categories

Related Job Pages

More Auditor Jobs

Full TimeRemoteTeam 1-10H1B No Sponsor

• This role is all about keeping our management systems working effectively day in, day out, and making them even better. • You’ll plan, coordinate and deliver the Group’s internal audit programme, ensuring findings are clearly communicated to sites, departments and senior management, and that best practice is shared across the business. • You’ll conduct audits in line with ISO 9001, ISO 14001 and ISO 45001 requirements, as well as supporting FSC audits, BIM activities needed to maintain Kite Mark certification, and Responsible Sourcing requirements (including BES 6001). • You’ll also develop and maintain the annual audit schedule, making sure internal activity is well paced and aligned with external audit commitments. • On a day to day basis, you’ll use Outlook to plan monthly activities and keep on top of key meetings, produce a monthly summary report from BSI Connect, and pull together an annual audit report that brings the year to life – total audits completed, site-level analysis, attribute trends and year-on-year comparisons.

United Kingdom
Job Closed
Part TimeRemoteTeam 51-200H1B No Sponsor

• Conduct of on-site and remote Integrity Assessments and associated travel activities in coordination with the ISCC office in Cologne • Preparation and coordination of schedules/audit plans for Integrity Assessments • Conduct of ISCC Integrity Assessments at certified companies and certification bodies (CBs) and witness audits on CB auditors with a regional focus on Europe according to the ISCC standards in diverse markets: Covering diverse certification scopes such as points of origin and collecting points for waste and residues (used cooking oil, palm oil mill effluent, brown grease/grease trap fat), farms/plantations, traders, and processing facilities • Verification of incoming and outgoing traceability documents, mass balances, and other relevant sustainability criteria covered under the ISCC standards • Special focus might be put on social issues in the context of human rights (e.g. fair and safe working conditions) and the conservation of natural resources/biodiversity • Compilation of Integrity Assessment Reports • Contribution to the continuous development of the ISCC System and the ISCC Integrity Programme

Germany
Talkspace logo

Compliance Auditor

Talkspace

Behavioral health care from licensed clinicians, when and where you need it

Auditor33 days ago
Full TimeRemoteTeam 201-500Since 2011H1B Sponsor

• Conduct detailed audits of compliance concerns including medical records to ensure accuracy in coding and billing practices. • Review documentation to identify and correct coding and billing errors, ensuring compliance with medical necessity and regulatory guidelines. • Log and track audit results and documentation workflows. • Analyze trends and discrepancies in coding and billing practices, providing actionable insights and recommendations for improvement. • Collaborate with internal teams to improve documentation standards and ensure compliance with relevant regulations. • Independently organize and prioritize audit tasks to meet deadlines, adjusting priorities as necessary. • Participate in process improvement initiatives, team meetings, and department projects to enhance audit workflows and overall efficiency. • Maintain up-to-date knowledge of medical coding standards, HIPAA regulations, and compliance requirements. • Provide recommendations to management on improving coding accuracy, documentation standards, and operational processes. • Deliver adequate and timely reporting on the internal control framework and control deficiencies to ensure appropriate communication, documentation, escalation to the compliance officer. • Cross functionally collaborate with department heads and build strong communication lines to maintain engagement with process implementation. • Partner closely with Health Information Management and Quality Management teams to aid in audit efficiency and effectiveness, including the collection and delivery of information. • Assist the Chief Compliance Officer, Risk with the development of the annual audit program.

New York
$77K - $92K / year
Full TimeRemoteTeam 1,001-5,000

Role Description Wilson Elser is currently seeking a Legal Auditor to join a national team supporting Quality Assurance and Client Audit Services. In this role, you will review active files to capture key data points and address issues related to file handling. This position would be ideal for an experienced litigator who wants to phase out of an active practice. - Review files on our cloud based document management and time entry systems - Ability to capture data accurately - Ability to evaluate file handling, identifying both exceptional efforts and opportunities for improvement - Clear concise writing skills - Engage in calibration exercises Qualifications - J.D. from an accredited law school - 5+ years of litigation experience - Insurance defense preferred but not required - Auditing experience at an insurance carrier is a plus - Current license not required (but license must have been in good standing at the time license lapsed) - Self-starter with acute attention to detail is required - Comfortable working both independently and collaboratively - Strong analytical and communication skills both oral and written - Ability to exercise professionalism, integrity, and discretion with confidential and sensitive information is required - Experience with Electronically Stored Information and document management systems, including computer-assisted review technologies, is a plus Requirements - A variety of factors are considered in making compensation decisions, including but not limited to experience, education, licensure and/or certifications, geographic location, market demands, other business and organizational needs, and other factors permitted by law. - Final salary wages offered may be outside of this range based on other reasons and individual circumstances. - This position is considered full-time and therefore qualifies for benefits including 401(k) retirement savings plan, medical, dental, vision, disability, and life insurance. - Details of participation in these benefit plans will be provided if an employee receives an offer of employment. Benefits - Outstanding benefits package, including 401k match and generous PTO plan - Ample opportunities for professional development and advancement - Access to corporate discount plans and other benefits

United States
$90K - $135K / year