Skills and abilities: • Auditing experience on IP DRG. • Knowledge in Microsoft outlook/excel/word. • Exposure on 3M software and NLP tool. ADDITIONAL AND ESSENTIAL RESPONSIBILITIES: • Follow every aspect of SOP without fail • Complete
Skills and abilities: Must be CPC/CRC/CCS certified with a minimum of 2-3 years’ experience in HCC Risk Adjustment coding. Must have thorough knowledge in ICD 9 & ICD 10 Coding Should have sound experience in Risk adjustment coding (Prospective/Concurrent/Retrospective)
Update and maintain SOPs, ensuring proper version control and standardization of all process documents. Monitor and maintain key metrics including KRA updates, KAT reports, calibration data, and team performance dashboards. Track and analyze production, quality, attendance,
Perform accurate CPT / ICD-10-CM coding with appropriate modifier usage Review and analyze denied claims and identify root causes Initiate outbound calls to provider offices for denial clarification and resolution Document call outcomes and update claim status
Overview Experienced Surgery Coder with 3+ years of multi-specialty outpatient surgery coding experience, including IVR and General Surgery Currently seeking experienced E&M coders who are CPT coding experts of E&M cases performed ED Facility, IP EM. CPC certification.
Overview CPC certification. Overall 3+ years of coding experience Specialty worked: Outpatient surgery APC Facility coding is an added advantage Good communication, flexibility reliability Responsibilities and Essential Functions: Follow every aspect of SOP without fail Complete received Audits
Team & Operations Management: Supervise and manage the daily activities of the surgery coding and audit teams, including in-house and contract auditors. Allocate workload, monitor performance, and ensure timely completion of assigned tasks in alignment with project timelines.
Overview CPC certification. Manadtory 3+ Years of experience After Certification Overall 3+ years of coding experience Specialty worked: Outpatient surgery APC Facility coding is an added advantage Good communication, flexibility reliability Responsibilities and Essential Functions: Follow every aspect
Certification- Mandatory CCS - Certified Coding Specialist, CIC - Certified Inpatient Coder 1. Coding Audit and Review Conduct detailed DRG validation audits on selected inpatient medical records to ensure coding accuracy, completeness, and compliance with ICD-10-CM/PCS, AHA Coding Clinic, and
Perform detailed auditing of coded medical records as per client-specific guidelines to ensure accuracy and completeness. Meet defined quality benchmarks (including 98% ATA quality) and productivity targets while maintaining required audit samples. Record audit findings, provide
Review and audit medical claims against patient medical records to ensure accuracy and completeness of documentation. Identify discrepancies between clinical documentation and billed services, highlighting variances and potential billing errors. Perform detailed clinical reviews to validate
Medical Coding Team Lead – Surgery & Payment Integrity is responsible for overseeing a team of medical coding specialists to ensure accurate, compliant, and timely auditing of surgical procedures across multiple specialties. This role demands strong technical expertise
Join our team as a Medical Coding Auditor, specializing in ED & E/M coding. Responsibilities include reviewing medical charts, assigning accurate CPT and ICD-10 codes, ensuring compliance, and supporting billing teams. Knowledge in CPT and ICD-10 guidelines, with high
Perform accurate outpatient surgery coding, including IVR, general surgery, infusion and injection, and radiation oncology. Apply APC facility coding knowledge as applicable. Review and complete assigned audits with accuracy, adhering strictly to SOPs. Meet daily/weekly production and quality
Let’s talk about Responsibilities Manage and oversee the revenue cycle process for DME/HME services, ensuring timely and accurate billing, claims submission, and payment posting. Conduct thorough AR follow-up and denial management, working closely with the billing
Job Description Purpose of the role To oversee the financial aspects of trading activities, ensuring the accuracy and integrity of the banks trading book, maintenance of compliance with regulatory requirements, and provision of insights into trading
Job Title: Quality Auditor - Coding Job Summary: We are seeking a detail-oriented Quality Auditor to evaluate and ensure the accuracy and quality of coding practices within our organization. The ideal candidate will have a strong background in coding standards, auditing
Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers
Conduct comprehensive reviews of inpatient medical records to validate that assigned ICD-10-CM/PCS codes and DRG classifications accurately reflect the documented clinical conditions and procedures. Ensure compliance with IPPS (Inpatient Prospective Payment System) methodology, CMS
We are seeking an experienced and certified Medical Coding Trainer to facilitate training programs focused on Denial Management. The ideal candidate will possess strong analytical skills, expertise in medical coding using ICD-10-CM, CPT conventions, and HCPCS codes, and