14 jobs found in Providence

Summary: Under the general supervision of the Coding Manager and according to established procedures, accountable for assignment of diagnoses and procedures for outpatient surgical and other services. Interprets clinical and diagnostic documentation and assigns appropriate ICD-10 (current edition) and / or CPT codes as well as modifiers, ED facility levels, Infusions/Injections and other charges as appropriate adhering to official coding guidelines. Requires knowledge of hospital coding, ambulatory classifications and coding guidelines. Abstracts required data into hospital information system. Ensure records are coded in an accurate and timely manner. Education: High School diploma or equivalent required. Licensure: Medical coding certification and training in medical terminology from an accredited program preferred. Recognized programs include: American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC). Must complete and pass...

Full-Stack AI DeveloperBrown University Health is seeking a highly motivated Full-Stack AI Developer to join a government-funded research team working at the intersection of artificial intelligence, digital health, and public health interventions. The ideal candidate will play a key role in the development and optimization of multimodal AI models, AI-driven chatbots, and agent-based modeling frameworks, contributing to research on HIV prevention, sexually transmitted infection (STI) prevention, nutrition counseling, overdose prevention, and opioid use disorder (OUD) treatment.ResponsibilitiesAI and Software Development: Design, develop, and optimize multimodal AI models, AI-based chatbots, and modify existing agent-based modeling frameworks.Full-Stack Engineering: Develop and maintain both front-end and back-end components of AI-driven applications, ensuring seamless user experiences.Cloud-Based Deployment: Deploy and maintain AI solutions on cloud platforms (e.g., AWS, Azure, or...

SUMMARY: Under general supervision of the Follow-up Supervisor, performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician multi-specialty practice. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: Review all denied claims, correct them in the system and send correctedppealed claims asbr / written correspondence, fax or via electronic submission. Identify and analyze denials and enact corrective measures as needed to effectivelybr / communicate and...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

Claims Follow-Up SpecialistUnder general supervision of the Follow-up Supervisor, performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician multi-specialty practice. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate.Responsibilities:Review all denied claims, correct them in the system and send corrected appealed claims as written correspondence, fax or via electronic submission.Identify and analyze denials and enact corrective measures as needed to effectively communicate...

**Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. **ESSENTIAL RESPONSIBILITIES** + Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (65%) + Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) + Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) + Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources and...

Become a part of our caring community Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and...

Job Title Help Job Description Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final diagnoses accurately reflect care provided. Reviews provider documentation to ensure appropriate Evaluation and Management (E/M) levels and correct CPT code assignment. Assigns and sequences ICD, CPT, HCPCS, CDT, and DSM codes based on documented diagnoses and procedures. Ensures diagnostic and procedural terminology aligns with current medical nomenclature and official coding guidelines.

Eastgate Nursing and Rehab is a 5-star facility located in East Providence. Eastgate has a long history of delivering outstanding care and services to the East Bay community. We are in search of a dedicated, detail-oriented, friendly and compassionate person to join our business office! If you are looking for a wonderful work environment, come join our business office team today! Qualifications and Experience : Long Term Care Medicaid Experience Third-party insurance billing (Medicare/Medicaid) and A/R experience a plus Other Qualifying attributes : Self-motivated and ability to multi-task Proficient in Excel Proven organizational skills Strong communication and interpersonal skills Accounts Receivable responsibilities : Reconciliation of nursing home Census Prepares, submits and follows up on monthly billing for private accounts, Medicare, Medicaid & 3rd party Insurance Communicates with involved parties including residents, families, DHS...

Salary: $83,000.00 - $88,000.00 Annually Location : Providence College Job Type: Full-time Staff Job Number: PC00233 Division: Student Affairs Department: Public Safety Opening Date: 05/07/2026 FLSA: Exempt Bargaining Unit: NU Conducted under the auspices of the Dominican Friars, Providence College is a Catholic, Dominican, liberal arts institution of higher education and a community committed to academic excellence in pursuit of the truth, growth in virtue, and service of God and neighbor. We seek candidates who can affirm and contribute to our Providence College is also an equal opportunity employer and is committed to fostering a - an environment that reflects the rich diversity of the human family and is marked by justice, charity and the promotion of the common good and flourishing of all. We invite applications from qualified individuals who possess the experience, knowledge and commitment to develop the diverse learning environment envisioned as...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU). The role ensures coding accuracy and compliance by auditing CPT/HCPCS and modifiers against medical records. You will discuss findings with investigators and regulators, identify billing errors and potential fraud, and maintain up-to-date knowledge of coding guidelines across CMS and payer requirements. #J-18808-Ljbffr

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Women & Infants Hospital in Providence, RI is hiring a HIM Certified Coder to review medical records and assign Diagnosis and Procedure codes using ICD-9CM/ICD10, CPT, and HCPCS according to coding conventions. The role requires CCS certification with related education in medical terminology and anatomy, plus at least 2 years of hospital coding experience. CPC candidates may be considered but must complete the CCS exam within one year. #J-18808-Ljbffr