Top 22 Coding quality auditor Jobs in Tn

Claims Auditor
American Health Plans —Franklin, TN
- Remote
- Mid-level
- Office
- 2 years
- Paid holidays
- Disability insurance
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12d
Inpatient Coding Auditor
Huron Managed Services LLC —Nashville, TN
- $38.46 - $52.40 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Dental insurance
Quick Apply
10d
HIM Inpatient Coding Manager-Day Shift-Remote-Full-time
Erlanger Health System —Chattanooga, TN
- Full-time
- Remote
- Bachelor of Science
- Bachelor's degree
- Human resources
Hospital Coding Auditor
Ardent Health —Brentwood, TN
- Full-time
- Microsoft Excel
- Microsoft Outlook
- RN License
7d
Inpatient Coding Auditor
Parallon —Nashville, TN
- Full-time
- Mid-level
- Employee stock purchase plan
- Disability insurance
Quick Apply
Compliance Auditor
Mental Health Cooperative —Nashville, TN
- Full-time
- Nursing
- Mid-level
- Office
- Health savings account
- AD&D insurance
7d
Supervisor, Revenue Operations (ROPS)
DAVITA —Brentwood, TN
- $62,353.20 - $85,000.00 a year
- Full-time
- Mid-level
- Travel
- Mentoring
- Health insurance
- Dental insurance
Lead, Supply Chain & Logistics Operations
Bridgestone Americas —Nashville, TN
- Full-time
- Customer service
- Mid-level
- 3 years
- Flexible spending account
Coding Auditor - University Health Network
University Physicians' Association —Knoxville, TN
- Full-time
- Hybrid work
- Microsoft Word
- Microsoft Excel
- HIPAA
- Continuing education credits
Quick Apply
Profee Coding Auditor
Parallon —Brentwood, TN
- Full-time
- Mid-level
- Organizational skills
- 2 years
- Employee stock purchase plan
- Disability insurance
Quick Apply
23h
COMPLIANCE AUDITOR SR
Covenant Health —Knoxville, TN
- Full-time
- RN License
- 5 years
- Word processing
CDI Auditor & Educator
Covenant Health —Knoxville, TN
- Full-time
- 5 years
- Word processing
- Windows
RISK ADJUSTMENT CODING ASSOCIATE II
GALEN MEDICAL GROUP PC —Hixson, TN
- Full-time
- OSHA
- Customer service
- Computer literacy
- Paid holidays
- Disability insurance
Quick Apply
8d
Oasis Auditor Home Health - Home Health
Maury Regional Health —Columbia, TN
- PRN
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Senior Accountant
Agentis Longevity —Nashville, TN
- $90,000 - $110,000 a year
- Email
- Bachelor of Science
- Office
- Finance
- Paid training
- Paid time off
Quick Apply
8d
Director of Case Management and Revenue Integrity
QHCCS, LLC —Brentwood, TN
- Full-time
- Nursing
- RN License
- 3 years
- Loan repayment program
- Health insurance
Quick Apply
1d
Physician Coding Auditor
Ensemble RCM LLC —Memphis, TN
- $57,400 - $99,000 a year
- Full-time
- HIPAA
- English
- 3 years
- Tuition reimbursement

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Inpatient Coding Auditor
Huron Managed Services LLC —Columbus, OH
This role requires remaining seated at a desk/computer for 8 hours daily; repetitive use of computer keyboard and mouse; use of computer monitors for 8 hours…
$38.46 - $52.40 an hour
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Claims Auditor

American Health Plans -
Franklin, TN

Quick Apply

Job Details

12 days ago

Benefits

Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Employee assistance program
Vision insurance
Referral program

Qualifications

Medicare
Managed care
Managed care organization experience
CMS
Regulatory compliance in claims processing
Medical claims processing software
CMS regulatory compliance
Health insurance knowledge
Medicare regulations
Centers for Medicare & Medicaid Services (CMS) billing regulations
Medicaid
Quality audits
Insurance (Financial sectors)
Healthcare claims compliance audits
Audit support
Healthcare coding compliance audits

Full Job Description

American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations. This division currently operates in Tennessee, Georgia, Missouri, Kansas, Oklahoma, Utah, Texas, Mississippi, Louisiana, Iowa, and Idaho with planned expansion into other states in 2024. For more information, visit AmHealthPlans.com (https://amhealthplans.com/).

If you would like to be part of a collaborative, supportive and caring team, we look forward to receiving your application!

Benefits and Perks include:

Affordable Medical/Dental/Vision insurance options
Generous paid time-off program and paid holidays for full time staff
TeleMedicine 24/7/365 access to doctors
Optional short- and long-term disability plans
Employee Assistance Plan (EAP)
401K retirement accounts
Employee Referral Bonus Program

ESSENTIAL JOB DUTIES:

To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.

Conduct pre-pay and post-pay audits to ensure accurate claims payments and denials
Ensure regulatory compliance and overall quality and efficiency by utilizing strong working knowledge of claims processing standards
Work closely with delegated claim processor to ensure errors are reviewed and corrected prior to final payment
Work assigned claim projects to completion
Provide a high level of customer service to internal and external customers; achieve quality and productivity goals
Escalate appropriate claims/audit issues to management as required; follow departmental/organizational policies and procedures
Maintain production and quality standards as established by management
Participate in and support ad-hoc audits as needed
Other duties as assigned

JOB REQUIREMENTS:

Proficient in processing/auditing claims for Medicare and Medicaid plans
Strong knowledge of CMS requirements regarding claims processing, especially regarding skilled nursing facilities and other complex claim processing rules and regulations
Current experience with both Institutional and Professional claim payments
Knowledge of automated claims processing systems
Hybrid role that may require 2-3 days per week onsite at the Franklin, TN office.

REQUIRED QUALIFICATIONS:

Experience:
- Two (2) years’ experience with complex claims processing and/or auditing experience in the health insurance industry or medical health care delivery system
- Two (2) years’ experience in managed healthcare environment related to claims processing/audit
- Two (2) years’ experience with standard coding and reference materials used in a claim setting, such as CPT4, ICD10 and HCPCS
- Two (2) years’ experience with CMS requirements regarding claims processing; especially Skilled Nursing Facility and other complex claim processing rules and regulations
- Two (2) years’ experience processing/auditing claims for Medicare and Medicaid plans
License/Certification(s):
- Coding certification preferred

EQUAL OPPORTUNITY EMPLOYER

Our Organization does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Organization will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made.

This employer participates in E-Verify.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

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Refine Your Search

coding quality auditor jobs in tn

Claims Auditor

Inpatient Coding Auditor

HIM Inpatient Coding Manager-Day Shift-Remote-Full-time

Hospital Coding Auditor

Inpatient Coding Auditor

Compliance Auditor

Supervisor, Revenue Operations (ROPS)

Lead, Supply Chain & Logistics Operations

Coding Auditor - University Health Network

Profee Coding Auditor

COMPLIANCE AUDITOR SR

CDI Auditor & Educator

RISK ADJUSTMENT CODING ASSOCIATE II

Oasis Auditor Home Health - Home Health

Senior Accountant

Director of Case Management and Revenue Integrity

Physician Coding Auditor

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