6264 jobs found

About Us MedKoder, LLC is a full-service medical coding management services provider based in Mandeville, Louisiana, specializing in expert medical coding for health systems, providers, and payers. MedKoder delivers accurate, efficient, and ethical coding, aiming to ensure accurate payment and financial peace for clients. With a team of certified coders throughout the United States, MedKoder emphasizes coding excellence, remote-work flexibility, and a positive workplace culture, earning high employee satisfaction ratings and awards with Best Places to Work in Modern Healthcare and City Business Best Places to Work. Position Location: 100% Remote This is a full-time, remote position that offers a flexible schedule.   Description: Physician Coder: Neurosurgery is responsible for reviewing and accurately coding all professional services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare,...

The Revenue Integrity Manager will lead the development of the revenue integrity function and is responsible for the oversight and management of the revenue integrity team. This position is accountable for optimizing revenue by ensuring accurate, compliant, and efficient charge capture and billing practice. The Revenue Integrity Manager will improve the performance of revenue cycle processes including developing best practices, coordinating issue resolution, establishing proactive lost revenue prevention measures, and monitoring compliance. The ideal candidate has a strong understanding of EPIC systems, coding standards, and billing regulations across both physician and facility revenue streams. Utilize data analytics and process improvement techniques to identify potential revenue leakage and support accurate charge capture. Use EPIC reporting tools to extract and analyze charge data. Perform extensive data mining, develop reports, review trends, and recommend enhancements...

“Immediate opening – transition period available with current biller” Full-Time About Us We are a busy, multi-provider medical practice seeking an experienced Medical Biller/Coder to take ownership of our billing operations. This is a key role responsible for ensuring accurate coding, timely reimbursement, and effective denial management. We are looking for a highly skilled, self-directed professional who can confidently manage the full revenue cycle with minimal supervision in a Family Practice Setting. All qualified candidates must have a minimum of one year medical billing and A/R experience in a Family Practice setting .  Knowledge of Medi-Cal and Medicare a plus, as well as, OB- Comprehensive Perinatal Services Program (CPSP), Family Pact, Child Health and Disability Prevention Program (CHDP), and other FFS product lines within Medi-Medi.  CPC certification is strongly desired. Key Responsibilities Perform accurate CPT,...

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA This position is responsible for abstracting, coding, and interpreting of outpatient clinic and provider services for professional and/or facility billing. This position uses coding knowledge to abstract and record data from medical records and provides support to areas related to documentation and coding. This position codes and charges complex or specialty services and may serve as a resource for other coders. This position is not responsible for providing care to patients. Corporate Overview: The University of Utah is a...

We assist out of network surgeons who want to provide covered reconstructive surgery to patients. Insurers have approved these surgeons for care due to long in network wait times or lack of expertise with certain conditions. However, the surgery staff has little experience with insurance and great need for help submitting authorizations and claims based on the single case agreements. This is a super flexible and lucrative opportunity to spend a few hours a week helping these surgeons and patients. Could turn into a separate business opportunity for the right motivated person.   MUST HAVE EXPERIENCE WITH PHYSICIAN PROFESSIONAL PRIOR AUTHORIZATION W/ EXTENSIVE AVAILITY USE. 

(Location: SAN RAMON) About the Practice / Office: Bridge Medical Neurology Consultants is a comprehensive neurology practice that offers in-depth and personalized consultations and advanced in-house neuro-diagnostic procedures for the management and treatment of a range of conditions. Dr. Said Ibrahimi, M.D. Q.M.E, has over 14 years of experience as a leading board-certified neurologist with a subspecialty in Brain Injury Medicine, tending to his expansive cohort of Adult patients, and additionally providing care for Personal Injury (P.I.) and Worker’s Compensation cases. With his extensive training and sub-specialty, Dr. Ibrahimi specializes in the treatment and management of conditions such as strokes, TIAs, dementia, Parkinson’s and Alzheimer’s Disease, epilepsy, nerve and muscle dysfunction, and many more. As a Qualified Medical Examiner (Q.M.E.) Dr. Ibrahimi also offers medical-legal services such as Independent Medical Examinations, and Expert Witness Review....

For over 30 years, Welter Healthcare Partners has collaborated with healthcare organizations across the US on the business of healthcare. Healthcare is complicated and ever-changing, and our services, solutions, highly specialized and collaborative teams are focused on helping drive results for the long-term success of our clients! We are looking for new team members that share the same passion for success!   We are looking for a 1099 Surgical Coding Expert, primarily Orthopedics, who seeks ownership of their craft, asserts their interpretation of guidelines and rules and who is extremely particular about the highest level of quality of their coding work! Skilled auditor preferred; however, a skilled and detail-oriented coder with the desire to transition to auditing will be highly considered.   We offer up to $4,000 flat fee per month and are flexible for more depending on the ability to organize and facilitate volume, but quality over quantity. Opportunity...

Accountable for conversion of outpatient diagnoses and treatment procedures into codes using an international classification of diseases, and HCPCS codes based on documentation in the patient’s record, are coded accurately and in a timely manner. Complies with government, insurance regulations and with medical coding guidelines and polices that all records are coded accurately and in a timely manner. CORE FUNCTIONS 1. Reviews and validates all diagnoses/procedures stated by physician and other healthcare providers. Ensures that records are coded within 48 business hours of discharge. Notifies director whenever work is more than 48 hours behind work deadline. Meets productivity standard of assigning codes to a minimum of 25 charts per hour. 2. Partners with charting physician if diagnosis is not transcribed to assure all required documentation is presented to meet compliance accuracy in coding and severity of illness is charted and coded. 3. Codes diagnoses and...

The Provider Education Auditor works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Responsibilities: Responsible for reviewing and analyzing all aspects of the department clinical documentation and care to ensure timely, accurate, and compliant charge capture and submission Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges Collaborates with Coding Supervisor and Regional Medical director to ensure clinical documentation in high-risk areas is consistent and complete Duties include charge entry, ensuring...

The Company:  Pulmonary Associates of Richmond (PAR) has been around since 1974. That's 50 years of serving the greater Richmond community. We specialize in pulmonary medicine, sleep disorders and research. Our staff cares about our patients and delivers the utmost excellence in quality care and customer service. The Position:  PAR seeking three dynamic and enthusiastic full-time AR Billing Specialists for the Boulders location, to perform all aspects of the revenue cycle, and other tasks related to medical billing claims for the practice. THIS IS NOT A REMOTE POSITION.       Benefits 401(k) Dental insurance Employee assistance program Employee discount Flexible spending accounts Employee referral program Health insurance Employer Paid Life insurance and LTD. Paid time off Vision insurance   Job Responsibilities Revenue Cycle Process. Apply Private Payer Policies. Apply Government Payer Policies....

The Senior Medical Director serves as a pivotal clinical leader within Lyric, providing strategic oversight for the development, validation, and continuous improvement of pre-payment edits to ensure robust payment integrity. In this capacity, the Senior Medical Director partners with executive leadership, clinical teams, and external stakeholders, acting as a trusted advisor on complex clinical scenarios and claims outcomes. As the primary liaison between Lyric and its customers, this role represents the organization in industry forums and payer-provider collaborations, fostering strong relationships and advancing Lyric’s reputation as an industry leader. The Senior Medical Director is also responsible for remaining at the forefront of evolving healthcare trends, regulatory requirements, and advancements in medical practice, ensuring that Lyric’s strategies and solutions consistently reflect best practices and support organizational objectives. Role Responsibilities:...

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary: We are seeking a talented individual for a Clinical DRG Auditor who is responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to validate the conditions that were documented in the medical record, the ICD-10-CM/PCS code assignments and determine the accuracy of DRG assignment that is clinically supported as defined by review methodologies specific to the...

CNY Family Care's commitment to excellence sets us apart and guides us as we provide care for our community. The Medical Coder and Auditor will be responsible to conduct prospective audits of coding and billing; analyze physician and provider documentation in outpatient office health records; correct evaluation and management (E/M) service levels, appropriate procedure codes, and any necessary modifiers.  Medical Coder and Auditor Responsibilities: Navigate the patient health record, office visit notes, and procedure reports in the determination of diagnoses, reason for visit, procedures, and modifiers to be coded. Code outpatient records utilizing coding books, online tools, and references, in the assignment of ICD, CPT, and HCPCS codes and modifiers. Document individual encounter audit findings and communicates results to providers. Access charge work queues to validate and assign charges. Perform all required EMR functions as efficiently as possible and according...

Position Summary Performs coding and documentation quality audits, providing feedback and education to coding and reimbursement specialists, coders, and providers.   Minimum Qualifications ·       High School graduate or equivalency and five years of coding and reimbursement experience of which 1 year may be as a coding auditor. ·       Additional job-specific education may substitute for the experience. ·       Active professional coding certification from an accredited organization, e.g., American Association of Professional Coders (AAPC), American Health Information Management Association (AHIMA). ·       Certification to remain current during term of employment. ·       Knowledge of CPT, ICD-CM, ICD-10, and HCPCS nomenclature.   Position Specific Qualifications •        Billing and coding experience in a multi-specialty group practice and/or academic practice setting is preferred. •        Five...

Riverside University Health System (RUHS)   is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience in an acute care hospital...

The University of Missouri School of Medicine is seeking an experienced and strategic Supervisor, Coding & Data Management to lead our Professional Coding and Revenue team. This role is critical to ensuring accurate medical coding that directly translates into clinical revenue integrity, regulatory compliance, and operational excellence. If you are a certified coding professional who thrives in leadership, process improvement, and complex reimbursement environments, we invite you to apply. Why Join Us? At the School of Medicine, our coding leadership team plays a vital role in supporting clinical operations, optimizing reimbursement, and maintaining compliance with federal and commercial payer regulations. You will collaborate with physicians, administrators, and revenue cycle professionals in a mission-driven academic healthcare setting. Position Overview The Supervisor, Coding & Data Management is responsible for overseeing coding accuracy, reimbursement...

SCOPE: Under minimal supervision performs periodic, comprehensive coding audits for all assigned regional oncologists (medical, radiation and surgical oncology).   Verifies charge documentation and charge submission processes are in compliance with Federal and State regulations, as well as payer guidelines. Coordinates efforts with manager and front office managers to ensure optimal revenue cycle processes and adherence to compliance and revenue cycle policies and procedures.  Provides effective educational feedback to physicians and staff on findings from audits and updates in Payer billing regulation . ESSENTIAL DUTIES AND RESPONSIBILITIES: Develops Audit and Education Programs Abstracts relevant clinical and demographic information from the medical record to assign current ICD and CPT codes in accordance with coding and reimbursement guidelines. Codes with an accuracy of 97% based on QA internal reviews Performs Evaluation and Management (E&M)...

Are you a detail-driven coding professional who thrives on accuracy, compliance, and making an impact behind the scenes of patient care? If so, we want to hear from you! We are currently hiring Medical Coding Specialists – (certified or non-certified) to join our dynamic and collaborative team supporting University Physicians. This is your opportunity to work in a mission-driven environment where your expertise directly supports quality care and operational excellence. 💼 What You’ll Do Review complex clinical documentation and diagnostic results to accurately assign: ICD-10-CM (diagnoses) CPT codes (procedures) Modifiers for services Ensure maximum reimbursement and regulatory compliance Assist with audits to identify coding issues, denials, and reimbursement opportunities Serve as a liaison between departments and third-party payers Support providers, residents, and staff with documentation and coding guidance Help...

The Medical Policy Manager is responsible for overseeing all cap thresholds and medical review triggers, ensuring they are routed either for administrative evaluation by the vendor or referred to the state’s Utilization Management (UM) vendors for clinical review. Qualifications Certified Coding Specialist credential issued by the American Health Information Management Association (AHIMA) Minimum of five years’ experience creating and administering medical and/or Utilization Management (UM) policies for state Medicaid programs or Medicare Strong working knowledge of Centers for Medicare & Medicaid Services (CMS) procedure and diagnosis coding, including dental and Current Dental Terminology (CDT) codes Bachelor’s degree in a related discipline

Position Summary At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare.  As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. Under the direction of the DRG Operations Department leaders, the DRG Reviewer will conduct reviews of inpatient claims for both coding accuracy as well as perform screening referrals for clinical support of coded diagnoses. Responsibilities: Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing. Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides. Collaborates with physician reviewers, as needed. Ability to prioritize and organize workload and complete tasks independently....

Billing & Coding Integrity Specialist Full Time (Benefit Eligible) Monday - Friday (No weekends or holidays), 8:00 am - 5:00 pm  This role is an on‑site position and is not eligible for remote work. The Patient Financial Services Department is seeking a full time Billing and Coding Integrity Specialist to join the team. Under the direction of the Director of Patient Financial Services the specialist is responsible for implementing and promoting consistent revenue integrity practices that will improve compliance, accurate billing, and charge capture at the point of service to ensure optimal reimbursement for Keystone Health.  The specialist is responsible for auditing and monitoring appropriate coding guidelines and regulations. Recommending any corrective action and assists with implementing the corrective action.  This position is also responsible for providing billing/coding training and education to providers and staff and maintaining a current...

Physicians' Choice is currently seeking a highly proficient and seasoned Medical Coding Auditor specializing in Evaluation and Management (E/M) services, with a comprehensive understanding of Emergency Medicine, to join our esteemed team. If you possess extensive expertise in current E/M coding guidelines and have a strong background in auditing, we invite you to apply for this exceptional opportunity. Job Description:  As a Medical Coding Auditor you will play a vital role in ensuring accurate and compliant coding practices within our organization. You will be responsible for conducting detailed audits of medical records, coding documentation, and related billing processes to verify compliance with established coding guidelines, regulatory requirements, and internal policies. Responsibilities: Perform comprehensive audits of medical records, coding documentation, and billing processes. Evaluate the accuracy, completeness, and appropriateness of medical...

Are you an experienced and motivated Medical Biller specializing in Home Infusion Therapy? The ideal candidate would have experience in billing for implanted pain pumps. We are seeking a skilled 1099 contractor with experience in billing for Florida-based home infusion services and in Payer credentialing. This is a remote contract position offering flexibility and competitive compensation. Expericence in Billing  Key Responsibilities: Experience in credentialing and billing with CareCentrix BCBSFL- UB-04 Claim Submission: Efficiently and accurately prepare, review, and submit Home Infusion claims using the UB-04 and EDI Formats as required by payers. Payer Credentialing: assist with credentialing and re-credentialing processes with various commercial and government payers, specific to the state of Florida. A/R Management: Follow up on outstanding claims, denials, and appeals to ensure timely and maximum reimbursement. Compliance:...

Billing Specialist Seeking a detail-oriented and dependable Billing Specialist to join our integrated care team in Newton, Kansas. This is a full-time position offering the opportunity to support patient care in a collaborative, mission-driven environment. We value collaboration, open communication, and a positive environment where everyone's input counts. As a vital member of the billing team, you play a critical role in the financial health of the organization and supporting access to care for our patients. We value the unique expertise each team member brings and are committed to supporting ongoing learning and professional development within the organization. What You'll Do Review charges for correct coding prior to claim submission, ensuring compliance with all federal and state regulations. Prepare and submit clean claims timely to insurance companies, electronically, via paper and through insurance portals. Resolve clearinghouse and payer...