43 jobs found in Raleigh

Position Summary The RCS Medical Coding Auditor is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback. The ideal candidate brings strong hands-on experience with professional fee coding , deep knowledge of E/M, surgical, and modifier use , and the ability to translate audit findings into actionable insights. Key Responsibilities Perform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedback Validate ICD-10-CM, CPT®, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelines Conduct medical chart audits of professional services across multiple specialties...

Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry-standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana's internal standards. The Medical Coding Auditor Evaluation & Management will report to the Manager, Medical Coding. WORK STYLE: Remote/Work at home WORK HOURS: Associates will work on EST, regardless of where the associate resides. All associates must start between 6AM-9AM EST, Monday - Friday as a dedicated schedule. Work...

Supervisor Clinical Nurse IV - Medical Stepdown This position qualifies for our UNC Rex Incentive Program, which includes up to $20,000 commitment incentive or up to $25,000 tuition loan forgiveness. In addition, this position is also eligible for up to $10,000 in relocation assistance (based on location) and our employee referral program. Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary: Serves as nursing Team Leader. Provides education, training, and oversight to assigned nursing staff. 4 East is a 31 bed pulmonary and nephrology intermediate care unit. Nurses on this unit care for patients with lung, kidney and heart related illness or diagnoses. Nurses monitor and manage patients with ventilators, peritoneal dialysis, arrhythmias and cardiac drips. We provide an exceptional level of care, continuously utilizing critical thinking and a wide range of clinical...

Job Description The Air Medical Coding Coordinator codes Air Medical outpatient billing for government and private payers. The coordinator reviews patient transport records and assigns CPT and ICD‑10 codes in compliance with payer guidelines. The role completes post‑service audits and works with providers and other internal departments to ensure accurate assignment of charges and timely billing for the Emergent, Air Medical Charter and Donor Services programs. The position works with providers, payers, hospital case managers and Medical Transport leadership to approve and collect for the medical transport system. The coordinator completes daily, weekly and monthly analytics for the Medical Transport Service line, serves as team expert in revenue cycle, finance and payer contracting, and educates internal clinical staff in documentation and appropriate billing practices. Essential Functions Serves as a coding expert for Air Medical, coordinating all coding components, researching...

Intermountain Health is seeking an Air Medical Coding Coordinator responsible for coding outpatient billing for government and private payers. The coordinator will review patient transport records, assign CPT and ICD‑10 codes, and ensure timely billing for Air Medical services. With responsibilities including auditing and collaborating with providers, this role demands a certified coding professional skilled in medical terminology and regulatory policies. The position offers a full-time schedule with a competitive salary range from $22.64 to $34.48 per hour. #J-18808-Ljbffr

Become a part of our caring community The Inpatient Medical Coding Auditor 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. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

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...

Orthos Inc is seeking a Billing Specialist responsible for managing patient inquiries, reviewing insurance claims, and ensuring timely resolution of accounts receivables. The ideal candidate has a strong background in medical billing, especially in orthopedic settings, and possesses excellent communication skills. This role offers the flexibility of remote work but requires candidates to reside in specific states, including North Carolina. #J-18808-Ljbffr

A leading health data platform company is seeking experienced inpatient coders to join their team. This role requires a minimum of 3 years of inpatient coding experience along with strong knowledge of medical terminology. The position is fully remote, allowing for a flexible schedule. The ideal candidate will excel in coding accuracy, maintain communication with team members, and support documentation improvement initiatives. #J-18808-Ljbffr

A leading pharmaceutical company located in Raleigh, North Carolina is seeking an Associate Director, Scientific Communications. In this role, you will manage the execution of the scientific communications strategy, oversee global publication plans, and ensure all materials are scientifically accurate and compliant. The ideal candidate will have an advanced scientific degree and extensive experience in medical communications. This position offers a competitive salary ranging from $164,530 to $245,985, plus incentives and comprehensive benefits. #J-18808-Ljbffr

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

Ultimate Staffing - - Responsibilities: Perform completion of claims to payers; Submit billing data to the appropriate insurance providers; Process claims; Resolve denial instances; Deploy, maintain and report on various programs

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...

A leading health insurance company is seeking an Inpatient Medical Coding Auditor to work remotely. This role involves reviewing inpatient hospital claims and ensuring accurate coding and reimbursement. Candidates should hold an RHIA, RHIT, or CCS certification with substantial experience in coding audits. Strong attention to detail, excellent communication skills, and the ability to manage multiple priorities are essential. The job offers competitive compensation and various benefits to support overall well-being. #J-18808-Ljbffr

A healthcare data solutions provider is seeking an Inpatient Auditing Specialist who will perform audits on medical records and ensure compliance with DRGs. This fully remote role requires 3+ years of coding and auditing experience and offers a flexible schedule. Responsibilities include conducting audits, providing education, and maintaining communication with healthcare staff concerning clinical issues. Competitive salary and generous benefits are included in the role's compensation package. #J-18808-Ljbffr

A healthcare organization seeks an Oncology Data Specialist for remote work focusing on cancer data abstraction and coding. The role requires a minimum of one year in a Cancer Registry position, adaptability to a changing work environment, and knowledge of coding in cancer registry software such as EPIC and CRStar. Ideal candidates will possess an Associate or Bachelor degree in an accredited program. #J-18808-Ljbffr

Woven Health Collective is seeking an Account Supervisor I to oversee day-to-day operations of medical communications accounts. This role serves as the primary client contact, managing multiple projects, ensuring high-quality delivery and mentoring junior staff. Ideal candidates have 4-6 years of account management experience in healthcare marketing, strong communication skills, and a solid understanding of project and account budgets. Join us in revolutionizing healthcare through innovation and collaboration. #J-18808-Ljbffr

Job Title Physician Coder I Overview The Physician Coder I has a background in and experience with coding inpatient and outpatient Evaluation and Management (E/M) services, bedside and/or clinic procedures, and ancillary procedures/testing for all specialties within WakeMed. Strong interpersonal and communication skills are required to ensure timely identification and resolution of coding-related issues. The Physician Coder I will complete tasks in accordance with designated assignments and will be subject to productivity and quality reviews. Department Description Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org. EOE Licensure Certified Coding Specialist Or Certified Professional Coder Or Certified Outpatient Coder...

Overview Serves as the senior member of the corporate coding team by providing extensive knowledge for timely and accurate coding and DRG assignment. Performs the function of coding, DRG assignment, collection of predefined indicators, and abstracting medical records. Provides timely and accurate ICD-10-CM and ICD-10-PCS codes for reimbursement and specific information for statistical purposes. Serves as a liaison between coders and CDS team on coding and documentation issues. Reviews SMART accounts on a daily basis as assigned. **Eligible remote states include NC, FL, GA, SC, SD, TN, TX and VA.** Department Description Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org. EOE Licensure Registered Health...

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...