22 jobs found in Providence

Medical Records Technician 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.

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. We’re looking for experienced and credentialed outpatient 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 you to help shape the...

Primary Health Solutions in Rhode Island seeks a Billing and Coding Specialist responsible for ensuring accurate coding of patient services for insurance submissions. The role involves reviewing provider documentation, coding claims accurately using various systems, and assisting with coding guidance. Candidates should possess a CPC certificate, experience with Microsoft Office 360, and strong medical terminology knowledge. This position helps to promote thorough documentation and compliance in the healthcare billing process. #J-18808-Ljbffr

Humana Inc. is seeking a Senior Medical Coding Professional, Inpatient to support payment integrity by reviewing inpatient claims for coding accuracy, DRG assignment, and compliance with official guidelines. You will report to the Manager, Payment Integrity. The role requires reviewing records, applying ICD-10-CM/PCS guidelines, and collaborating with clinical reviewers to ensure accurate reimbursement and DRG logic. #J-18808-Ljbffr

Job Description Oracle Health is a comprehensive suite of healthcare technology solutions designed to help organizations advance patient care, improve operational efficiency, and enhance caregiver experiences. Building on Oracle's global expertise in cloud technology, data management, and analytics, Oracle Health delivers integrated electronic health records (EHR), population health tools, and data-driven insights for hospitals, clinics, and health systems. By connecting data and workflows across the continuum of care, Oracle Health empowers providers to make informed decisions, streamline processes, and drive better health outcomes. The Senior Compliance Specialist provides guidance to cross-functional teams on medical device quality system compliance, with a focus on quality system support for CE marking processes and requirements under the EU Medical Device Regulation (EU MDR). Responsibilities The Senior Compliance Specialist will provide quality system support...

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:...

We meet people where they are and partner with them on their journey towards wellness. Our Vision The destination for servant leaders to provide comprehensive and exceptional care. Our Values R – Respect S – Stewardship Billing and Coding Specialist Summary Responsible for entering/auditing/coding patient services to ensure encounters transfer properly for submission to insurance payers. Analyze coding related claim issues, process gaps and denials to trend feedback for providers by location and/or specialty. A Day in the Life Review provider documentation (including hospital procedures) and translate services into correct codes. Append payer specific modifiers and claim criteria when applicable. Review incomplete encounters and code based on available documentation in EHR systems. Know and understand several different coding systems, including ICD-10-CM, ICD-10-PCS, CPT, Level 1 HCPCS and Level 2 HCPCS. Use computers / billing software to create and bill encounters that generate...

A leader in health data exchange is seeking experienced inpatient coders to join their remote team. This role requires expertise in ICD-10 diagnostic and procedural coding, with a focus on maintaining high accuracy and auditing duties. Ideal candidates have over 3 years of inpatient coding experience, preferably within a Level I Trauma Center, and strong communication skills. Benefits include a 401k plan and comprehensive training. #J-18808-Ljbffr

Outpatient Coding Specialist Reports to the Coding Manager. Reviews the outpatient clinical documentation of extract data and assign appropriate ICD-10-CM and CPT codes in accordance with the outpatient ICD-10-CM Official Guidelines for Coding and Reporting and the AHA HCPCS Coding Clinics. Reviews the medical records to ensure the documentation supports the code assignment. Utilizes 3M 360 Finder for code assignment and appropriate resolutions of claim edits (CCI, NCD, OCE, etc.) Confer with physician for clarification as needed. Monitors outpatient uncoded report to ensure timely coding and billing process. Maintains and meets HIS quality and productivity standards. 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...

Acadia Healthcare in Providence, RI, is seeking a dedicated Administrative Assistant specializing in Medical Billing. This full-time role involves essential administrative functions including preparing reports, scheduling appointments, and handling billing information for patients. Ideal candidates will have a high school diploma and at least 2 years experience in medical billing, especially in addiction treatment settings. We offer a competitive benefits package, including medical coverage and a semi-annual bonus program. If you’re passionate about making a difference, we encourage you to apply to join our compassionate team! #J-18808-Ljbffr

Brown University Health seeks a Claims Follow-up Specialist in Providence to review and correct denied claims for a physician multi-specialty practice. The role involves analyzing denial trends, maintaining compliance, and collaborating with internal departments. Candidates should possess strong communication skills, critical thinking abilities, and knowledge of third-party billing processes. This full-time position works Monday through Friday. #J-18808-Ljbffr

Brown University Health is looking for a qualified coder to review outpatient clinical documentation and assign appropriate ICD-10-CM and CPT codes based on the established guidelines. This role requires a strong understanding of medical record documentation and effective coding practices. The ideal candidate should possess a high school diploma, relevant coding certification, and one to two years of experience in outpatient coding or billing. Responsibilities include ensuring accurate coding for claims, meeting productivity standards, and engaging with physicians for clarification when necessary. #J-18808-Ljbffr

Blue Cross & Blue Shield of Rhode Island is seeking a Risk Adjustment Medical Coder to perform medical record reviews to ensure accurate risk adjustment payments for Medicare Advantage members. Responsibilities include coordinating physician chart reviews, validating medical codes, and analyzing audit results. This position offers remote, hybrid, or in-office work arrangements, along with competitive pay ranging from $65,600 to $98,400. #J-18808-Ljbffr

## Risk Adjustment Medical CoderApplyremote type: Remotelocations: US Remote: Providence, RItime type: Full timeposted on: Posted Yesterdayjob requisition id: JR100322**Pay Range:**$65,600.00 - $98,400.00Please email **HR\_Talent\_AcquisitionTeam@bcbsri.org** if you are a candidate seeking a reasonable accommodation for the application and/or interview process.**At BCBSRI, our greatest resource is our people.**We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.**We recognize that to do your best work, you have to be your best self.** It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We...

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...

Job Summary The HIM Certified Coder reviews medical records and appropriately assigns Diagnosis and Procedure codes. Classification systems include ICD-9CM, CPT, HCPCS as well as other specialty systems as required by diagnostic category and current coding standards. All work carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic), ICD9 (ICD10 when applicable), AMA CPT and CMS coding guidelines. Specifications High school graduation plus active certification as a Certified Coding Specialist (CCS) with evidence of additional education in Medical Terminology and Anatomy & Physiology required. Minimum of 2 year’s experience in a hospital inpatient or outpatient setting required. Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and our...

Oversee the EMT’s for the Office of Public Safety and provide support for policy and procedure development and accreditation management. Support comprehensive Emergency Management operations for the campus community. Serve as the state recognized PC EMS Service Chief and have responsibility for all Rhode Island licensed ambulance service requirements as defined by Rhode Island Department of Health (RIDOH) regulations. Attend all required RIDOH Center for Emergency Services (CEM) leadership trainings, policy meetings, compliance sessions, and related activities to ensure ongoing licensure and alignment with statewide standards. Develop and manage EMT skills instructors. Manage all course assessments, evaluations, and documentation. (40%) Ensure compliance with national and state regulations (RIDOH, CEMS), and college EMS policies and procedures governing patient care, transport decisions, and documentation for the EMT staff. Provide guidance, mentorship, and feedback that supports...

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...

A healthcare organization seeks a HIM Certified Coder to review medical records and assign appropriate Diagnosis and Procedure codes following established guidelines. The ideal candidate will hold an active Certified Coding Specialist (CCS) certification and have a minimum of 2 years of experience in both inpatient and outpatient hospital settings. This role is crucial in ensuring accurate coding compliant with American Hospital Association standards and contributes significantly to the healthcare system's efficacy and patient care. #J-18808-Ljbffr

Become a part of our caring community The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate DRG and ICD-10-CM/ PCS coding assignments for accuracy within the coding disputes team from a variety of medical records. The Disputes Auditor - MSDRG Inpatient Coding on the Disputes Team consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality. Will be an experienced medical coding auditor with in-depth experience in inpatient coding audits (MSDRG/APDRG) Ensures overall accuracy and compliance of coding disputes reviews by adhering to all appropriate coding guidelines and communicates disputes outcomes to providers in a professional and concise manner. Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices Manages multiple...