56 (CCS) Certified Coding Specialist jobs

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....

Overview Top candidates will have experience with Oncology Coding.   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...

About the role We run a fast-growing care management program billed under partner clinic TINs across a mixed payer population. We need an expert to tighten CoCM billing yield while keeping documentation audit-proof as we scale from ~24 clinics to 100+. The right candidate will be able to convert this into a full-time role with equity, and grow with the company. Looking to hire ASAP. What you’ll own Design and audit CoCM and CCM billing workflows , including appropriate patient stratification between programs. Define clear, defensible criteria for assigning patients to CoCM vs CCM (and transitions over time). Build “gold standard” documentation templates and checklists for 99492/99493/99494, 99490, 99439 , and related codes as applicable. Design simple, audit-proof time capture and attribution workflows across care team members. Create and run a QA sampling plan with feedback loops for care teams and clinic billers. Partner with...

Adventist HealthCare seeks to hire an experienced Lead Coding Specialist for our Medical Coding Department who will embrace our mission to extend God’s care through the ministry of physical, mental, and spiritual healing. As a Lead Coding Specialist, you will: Conduct reviews to validate I-10-CM diagnosis codes and PCS procedure codes for inpatient bill hold related to PSI, PPC & other reimbursement conventions to be resolved prior to final coded data. Manages daily DNFB and DNFC reports and work queues for un-coded or outstanding records. Under the direction of the coding manager, the coding specialist lead should be proficient in communicating with the coding team. Oversees coding corrections, abstracts elements for HSCRC submissions, and ensures coding compliance with coding standards. Liaison between coding and other departments, managing coding-related tasks and denials. Provides mentoring support to coders on coding...

Help safeguard accuracy, integrity, and regulatory compliance across our organization. We are seeking a skilled Compliance & Coding Audit Specialist to support the Corporate Compliance Program through detailed auditing, monitoring, and provider education related to coding, billing, and clinical documentation practices. What You’ll Do Conduct ongoing coding, billing, and documentation audits to ensure compliance with hospital policies and federal and state regulations Interpret medical records and related documentation using advanced coding knowledge to assess accuracy and risk Execute compliance audit assignments with a high degree of independence, confidentiality, and professional judgment Analyze findings, prepare audit documentation, and identify trends or improvement opportunities Present audit results directly to physicians and providers, delivering clear feedback and education on documentation and coding best practices...

JOB LOCATION:   Remote (Considering applicants residing in Georgia, Florida, Ohio, North Carolina, South Carolina, West Virginia, Utah, Arizona, and Missouri.) DEPARTMENT:   REVENUE CYCLE MEDICAL GROUP, SGMC Health SCHEDULE:   Full Time, 8 HR Day Shift, 8-5 Abstracts ICD-10 and CPT codes for Diagnosis and Procedures on professional services. Reviews and analyzes medical records verifying and coding the diagnosis, evaluation and management service, minor procedures, or other codes required for the completeness and accuracy of the record. Additionally, will code and/or review principal diagnosis, co-morbidities, complications, therapeutic and diagnostic procedures, any applicable supply, medication, and injectable drugs. Maintains communication with Management, Practice Manager, and Provider to ensure timely notification of identified documentation issues. Interact with other team members of the revenue cycle and provider clinics. Responsible for continuing education of...

Physician Medical Coder Job Listing   PLEASE READ JOB DESCRIPTION    Profee coder to review coding denials and correct/validate CPT, ICD-10, HCPCS and modifiers for physician services.  Our coders will review medical records, research payer policy, and NCDs to make coding corrections and resubmit corrected claims in an accurate and timely manner. We work closely with other team members and management to translate clinical documentation consistently and accurately into ICD-10 and CPT codes with proper sequencing and modifiers. Through these efforts, the individual within this role will identify and report error patterns, resolve errors or issues associated with coding and billing processes, and when necessary, assist in the design and implementation of workflow changes to reduce billing errors.     Job Requirements     At least one active certification is required. Additional certifications a plus. Accepted certifications...

Join Team Tidelands and help people live better lives through better health! Supervisor Provider Coding Specialist Are you passionate about quality and committed to excellence? Consider joining our Tidelands Health team. As our region's largest health care provider, we are also one of our area's largest employers. More than 2,500 team members at more than 70 Tidelands Health locations bring our healing mission to life each day. A Brief Overview The Supervisor, Provider Coding Specialist under the general supervision of the Coding Manager, is responsible for overseeing daily coding workflow in the assignment of ICD-10 CM, CPT, and HCPCS codes. Accountable for quality, timeliness, completeness, and accuracy of the coding team to ensure optimal reimbursement and goal attainment. The coding supervisor performs quality reviews and provides education and training when deficiencies are identified, or new processes are implemented. Incorporates initiatives that improve compliance...

The Manager holds a key leadership role in ensuring the accuracy, compliance, and efficiency of provider coding and documentation practices. This position is responsible for directing all aspects of provider coding operations and clinical documentation improvement initiatives to support accurate reimbursement and maintain data integrity across the organization. The Manager leads a team of certified coders and charge coordinators, partnering closely with providers, compliance, and revenue cycle teams to enhance documentation quality, strengthen coding accuracy, and drive continuous improvement in clinical and financial performance. Required Knowledge & Skills Education: Associate Degree or 2 years of college coursework Experience: Five years of related experience. Requires broad knowledge of complex systems and procedures. Licenses and Certifications *CERTIFIED CODING SPECIALIST Qualifications *Associate or bachelor's degree. RN preferred. *Five...

Position: Mid-Level Medical Coder Location: Full-Time Remote Clearance: No Secret Clearance Required Starting Salary: $37.00/Hour   “Candidates must hold valid credentials from either AAPC or AHIMA to be eligible to apply.” We cannot accept candidates with a CPC-A designation! Please indicate the position(s) you’re applying for. Include your  full mailing address (for equipment shipment), desired start date, and AAPC and/or AHIMA certification number(s) (with expiration date). Assessment Protocol The assessment is  strictly timed  and must be completed within  1 hour . Once the link is opened, the timer is automatically activated. The assessment  cannot be paused, reopened, or restarted .  Only the initial attempt  will be accepted for scoring. Candidates are provided with a  24-hour window  to complete the assessment upon receipt of the email from our team. Please ensure appropriate preparation and a suitable testing environment...