$56K - $70K/yr
The Senior Coding Compliance Specialist will investigate, implement, and audit the outcomes of ... Review and resolve appeals in system(s) by reviewing medical documentation and making determination.
$56K - $70K/yr
The Senior Coding Compliance Specialist will investigate, implement, and audit the outcomes of ... Review and resolve appeals in system(s) by reviewing medical documentation and making determination.
The Coding Quality Analyst position is full time 40hours/week Monday - Friday. Employees are ... Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent ...
The Coding Quality Analyst position is full time 40hours/week Monday - Friday. Employees are ... Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent ...
The Coding Quality Analyst position is full time 40hours/week Monday - Friday. Employees are ... Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent ...
The Coding Quality Analyst position is full time 40hours/week Monday - Friday. Employees are ... Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent ...
The Coding Quality Analyst position is full time 40hours/week Monday - Friday. Employees are ... Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent ...
The Coding Quality Analyst position is full time 40hours/week Monday - Friday. Employees are ... Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent ...
The Coding Team Member will provide CPT, HCPCS and ICD-10-CM coding a minimum of 1-4 specialties ... The company has reviewed this to ensure that the essential functions and basic duties have been ...
The Coding Team Member will provide CPT, HCPCS and ICD-10-CM coding a minimum of 1-4 specialties ... The company has reviewed this to ensure that the essential functions and basic duties have been ...
We are looking for a detail-oriented Professional Medical Coder to help streamline our charge review coding workflow for Adult and Pediatric Evaluation and Management services and Minor Procedures ...
We are looking for a detail-oriented Professional Medical Coder to help streamline our charge review coding workflow for Adult and Pediatric Evaluation and Management services and Minor Procedures ...
$95K - $110K/yr
Reviews provider appeals and redeterminations using approved clinical and coding guidelines and documents appeal determinations clearly and concisely. * Analyzes and reviews appeal documentation to ...
$95K - $110K/yr
Reviews provider appeals and redeterminations using approved clinical and coding guidelines and documents appeal determinations clearly and concisely. * Analyzes and reviews appeal documentation to ...
Reviews all assigned edits within prescribed timeframe and routes to appropriate owner for resolution. Provides regulatory (coding and billing) support to clinical charge capture specialists to ...
Reviews all assigned edits within prescribed timeframe and routes to appropriate owner for resolution. Provides regulatory (coding and billing) support to clinical charge capture specialists to ...
Review, analyze, and code patient medical records based on client specific guidelines. * Follow ICD-10-CM Coding Guidelines and interpret coding guidelines for accurate code assignment. * Follow Risk ...
Review, analyze, and code patient medical records based on client specific guidelines. * Follow ICD-10-CM Coding Guidelines and interpret coding guidelines for accurate code assignment. * Follow Risk ...
Compliance Specialist - Coding
Lexington, KY · On-site
Reviews all relevant programs and activities affected by industry regulations and recommends ... Maintains coding certification. * Provides education on coding and reimbursement updates as ...
New
Compliance Specialist - Coding
Lexington, KY · On-site
Reviews all relevant programs and activities affected by industry regulations and recommends ... Maintains coding certification. * Provides education on coding and reimbursement updates as ...
New
Review, analyze, and code patient medical records based on client specific guidelines. * Follow ICD-10-CM Coding Guidelines and interpret coding guidelines for accurate code assignment. * Follow Risk ...
Review, analyze, and code patient medical records based on client specific guidelines. * Follow ICD-10-CM Coding Guidelines and interpret coding guidelines for accurate code assignment. * Follow Risk ...
They are responsible to investigate, review and provide clinical and/or coding expertise in a review of claims. They need to effectively manage their caseload and monthly metrics in a production ...
They are responsible to investigate, review and provide clinical and/or coding expertise in a review of claims. They need to effectively manage their caseload and monthly metrics in a production ...
$70K - $85K/yr
Review provider documentation of diagnostic data from medical records to verify that all Medicare ... Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes ...
$70K - $85K/yr
Review provider documentation of diagnostic data from medical records to verify that all Medicare ... Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes ...
They are responsible to investigate, review and provide clinical and/or coding expertise in a review of claims. They need to effectively manage their caseload and monthly metrics in a production ...
They are responsible to investigate, review and provide clinical and/or coding expertise in a review of claims. They need to effectively manage their caseload and monthly metrics in a production ...
Acts as a resource person for questions regarding coding and billing procedures. Key Responsibilities: * Review and code medical records using ICD-10-CM and CPT-4 coding systems. * Sequence diagnoses ...
Acts as a resource person for questions regarding coding and billing procedures. Key Responsibilities: * Review and code medical records using ICD-10-CM and CPT-4 coding systems. * Sequence diagnoses ...
$20 - $22.75/hr
... completes performance reviews and overall staff morale. Recommends hiring, terminations ... Coding certifications specific to outpatient professional coding required * Associate's Degree ...
$20 - $22.75/hr
... completes performance reviews and overall staff morale. Recommends hiring, terminations ... Coding certifications specific to outpatient professional coding required * Associate's Degree ...
Coder
Louisville, KY · On-site
Coder The Coder reviews, analyzes, and codes diagnostic and procedural information that determines Medicare, Medicaid and private insurance payments. This role is responsible for coding, charge entry ...
Quick apply
Coder
Louisville, KY · On-site
Coder The Coder reviews, analyzes, and codes diagnostic and procedural information that determines Medicare, Medicaid and private insurance payments. This role is responsible for coding, charge entry ...
Responsibilities The Coder I reviews, analyzes and codes diagnostic and procedural information using ICD-10-CM diagnosis and procedures and CPT coding for reimbursement. Assign and sequence ICD-10-CM ...
Responsibilities The Coder I reviews, analyzes and codes diagnostic and procedural information using ICD-10-CM diagnosis and procedures and CPT coding for reimbursement. Assign and sequence ICD-10-CM ...
Review hospital OP facility OBS and Ambulatory Surgery medical records and properly code the charts* Meet or exceed high quality and productivity standards, to provide exceptional coding services to ...
Review hospital OP facility OBS and Ambulatory Surgery medical records and properly code the charts* Meet or exceed high quality and productivity standards, to provide exceptional coding services to ...
Coder I, (Hospital Billing/Inpatient Coding) Revenue Integrity/Coding, Fully Remote
Louisville, KY · On-site +1
Responsibilities The Coder I reviews, analyzes and codes diagnostic and procedural information using ICD-10-CM diagnosis and procedures and CPT coding for reimbursement. Assign and sequence ICD-10-CM ...
Coder I, (Hospital Billing/Inpatient Coding) Revenue Integrity/Coding, Fully Remote
Louisville, KY · On-site +1
Responsibilities The Coder I reviews, analyzes and codes diagnostic and procedural information using ICD-10-CM diagnosis and procedures and CPT coding for reimbursement. Assign and sequence ICD-10-CM ...
Coding Reviewer information
What is a coding reviewer?
Coding Reviewers are professionals responsible for evaluating, analyzing, and verifying code written by other developers to ensure it meets established standards and best practices. They check for errors, maintainability, security vulnerabilities, and adherence to coding guidelines. Their feedback helps improve code quality, reduce bugs, and facilitate team collaboration. Coding Reviewers often participate in code walkthroughs, pull request reviews, and may also mentor junior developers.
How does a coding reviewer typically collaborate with software development teams during the review process?
Coding Reviewers work closely with developers by examining code for quality, consistency, and adherence to best practices before it is merged into the main codebase. They often provide constructive feedback through code review tools or meetings, helping developers understand and resolve issues. Effective collaboration also involves clear communication to ensure that suggested changes are well-understood and implemented, fostering continuous improvement and knowledge sharing within the team.
What are the key skills and qualifications needed to thrive as a coding reviewer, and why are they important?
To thrive as a Coding Reviewer, you need in-depth knowledge of medical coding standards (such as ICD-10, CPT, and HCPCS), healthcare regulations, and relevant clinical terminology, typically supported by a certification like CPC or CCS. Familiarity with electronic health records (EHR) systems, coding audit tools, and healthcare compliance software is essential. Strong attention to detail, analytical thinking, and effective communication skills help Coding Reviewers identify errors and provide clear feedback. These skills ensure accurate billing, regulatory compliance, and optimized revenue cycles in healthcare organizations.
What is the difference between Coding Reviewer vs Medical Coder?
| Aspect | Coding Reviewer | Medical Coder |
|---|---|---|
| Credentials | Certification in coding (e.g., CPC, CCS) | Certification in coding (e.g., CPC, CCS) |
| Work Environment | Reviewing medical codes, often in healthcare settings | Assigning medical codes from patient records |
| Industry Usage | Used in hospitals, clinics, insurance companies | Used in hospitals, clinics, billing companies |
| Primary Role | Review and validate coding accuracy | Assign and input medical codes |
Both Coding Reviewers and Medical Coders require similar certifications and work in healthcare environments. Coding Reviewers focus on verifying the accuracy of codes assigned by others, ensuring compliance and correctness. Medical Coders are responsible for assigning the initial codes based on medical records. While their roles are interconnected, Coding Reviewers primarily audit and validate, whereas Medical Coders handle the coding process itself.
Senior Coding Compliance Specialist
On-site
Quartz
$56K - $70K/yr
Other
Posted 9 days ago
Key responsibilities
Research and validate coding decisions, conduct testing, and provide education to support claims processing outcomes.
Analyze billing and coding patterns to identify outliers and resolve appeals by reviewing medical documentation.
Collaborate with multidisciplinary teams to ensure coding compliance and conduct data analysis to support claim edits and denial trend insights.
Job description
Overview
#J-18808-LjbffrQuartz is seeking a skilled coding professional to support accurate, compliant, and high-quality claims processing as a Senior Coding Compliance Specialist This position will apply regulatory coding guidance, resolving complex claims and appeals, analyzing billing trends, and collaborating across teams to strengthen payment integrity and reimbursement accuracy.
The Senior Coding Compliance Specialist will investigate, implement, and audit the outcomes of coding and regulatory guidelines. This position will serve as a subject matter expert for coding inquiries from internal and external customers.
Benefits:
- Collaborate with a team that respects and values your coding expertise
- Access professional development opportunities to support your long-term career growth
- Starting salary based upon skills and experience: $56,600 - $70,600 plus robust benefits package
- Research and validate business decisions and system rationales to support edits and conduct testing to validate outcomes. Provide education as appropriate to providers and leadership.
- Analyze billing and coding patterns and identify outliers with potentially high-risk practices.
- Review and resolve appeals in system(s) by reviewing medical documentation and making determination. Work with Clinical Services teams as needed to resolve appeal cases.
- Research and respond to customer inquiries and tickets routed for coding expertise.
- Review, edit, and adjudicate claims that are pended and/or assigned in systems.
- Collaborate across multi-disciplinary teams to assure coding compliance.
- Conduct data analysis and reporting to support claim edits, denial trends, and leadership insights.
- Associate’s degree in medical coding with 5+ years of medical coding experiences
- OR high school equivalency with 8+ years of medical coding experience
- Completion of medical coding program
- Certification in CPC, COC, RHIT, RHIA, CCA, and/or CCS
- Strong working knowledge of medical coding, fee and reimbursement mechanisms
- Strong understanding of medical coding and regulatory guidelines, which include- CPT, HCPCS, ICD-10, OPPS, IPPS, DRGs
- Epic healthcare software and/or Optum claims edit system knowledge
- Strong understanding of governmental medical payment policies/regulations and their updates processes
- Knowledge of HIPAA regulations
- Strong analytical and problem-solving skills using critical thinking
- Strong verbal and written communication skills
- Intermediate level of proficiency with Microsoft Office
- Ability to multi-task, prioritize, and manage time wisely
- Self-motivated, ability to work independently to successfully investigate complex issues
Hardware and equipment will be provided by the company, but candidates must have access to high-speed, non-satellite Internet to successfully work from home.
We offer an excellent benefit and compensation package, opportunity for career advancement and a professional culture built on the foundations of Respect, Responsibility, Resourcefulness and Relationships. To support a safe work environment, all employment offers are contingent upon successful completion of a pre-employment criminal background check.
Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified person with disability.