54 jobs found in Springfield

QA Nurse / Coder (RN) As a QA Nurse / Coder, you will ensure the accuracy, completeness, and regulatory compliance of Home Health documentationparticularly OASIS assessments, the Home Health Plan of Care (485), and face-to-face encounter noteswhile properly sequencing diagnoses according to federal/state standards and agency policy. Core responsibilities include: Review OASIS forms and Plans of Care for appropriateness, completeness, and compliance. Assign and sequence ICD?10 codes in line with current home health coding guidelines. Ensure consistency and compliance of face-to-face encounter documentation with OASIS and care plans. Conduct additional clinical record audits and OASIS reviews as assigned. Stay current on Medicare reimbursement policies, home health regulations, and compliance requirements. Maintain relevant certifications (HCS?D, HCS?O or COS?C). Participate in quality assurance and performance-improvement efforts. Coordinate with physicians, facilities,...

Medical Billing SpecialistA confidential healthcare billing organization is seeking an experienced Medical Billing Specialist. This role is fast-paced and high-volume, requiring exceptional accuracy, claim resolution skills, and a thorough understanding of insurance processes and coding guidelines.Key ResponsibilitiesWork aged accounts, verify insurance benefits, and resolve outstanding claimsReview, correct, and resubmit denied claims to ensure timely reimbursementManage unpaid patient balances and follow medical collection best practicesApply accurate ICD-10 coding for diagnoses and proceduresProcess daily medical billing for services rendered by providersHandle refund requests and maintain compliance with billing and coding regulationsCollaborate with clinical and administrative teams to ensure complete and accurate billing dataConfirm insurance coverage and obtain authorizations when neededRequired QualificationsProven success in claim resolution and follow-upMediClear...

Medical Billing SpecialistOur mission at Lifelong Access is to connect individuals with developmental disabilities to their community by helping them break down barriers through a lifetime of meaningful supports. From birth to end of life, Lifelong Access provides a continuum of services and supports for families, children, teens, and adults including residential housing, vocational development, supported employment, high school transition, behavioral health counseling and services, and a wide variety of pediatric therapy supports. Guided by our Core Values, our team members have a strong drive and big hearts for improving the lives of others; a place where we support each other and the individuals who put their trust in us.Full-time Medical Billing Specialist.Pay:$20/hr Job Type:Full-Time 40 hours/weekYour typical workweek will allow some flexibility in daytime work schedule, Monday thru Friday. While performing the duties of this job, the employee will typically work in an office...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

Job Description Job Description Job Summary Surgical practice is looking for a office supervisor to oversee the day-to-day operations and staff at its multiple offices. This person will actively promote high levels of patient relations and customer service in a cost-effective manner, as well as demonstrate and guide relationships among staff that promote professionalism and respect.  In this role, you will coordinate all administrative duties and office procedures, ensuring the workplace operates smoothly and efficiently. Your responsibilities will include scheduling meetings, paying invoices, negotiating with vendors, and maintaining office equipment. The ideal candidate is highly organized with excellent verbal and written communication skills and the ability to implement systems and procedures. Candidate Experience: Previous staff management and office operations experience in a large healthcare / medical group practice setting. Overall awareness of medical record...

Clinical Nursing SupervisorThe Clinical Nursing Supervisor supports administrative responsibility for the department service functions and works collaboratively with the unit Director and/or Manager. In the absence of the unit Director and/or Manager, the Clinical Supervisor may assume the administrative scope of the unit assigned. Develops and implements departmental plans, including performance improvement activities and compliance with current federal and/or state regulations. The Clinical Supervisor prepares, conducts and/or oversees department(s) orientation and training of personnel. Communicates with staff, physicians, and administration both written and verbally. The Clinical Supervisor is responsible and accountable for the quality of staff and functions during their shift. Assists the Department Director in the daily operations of the unit, directing, supervising, and evaluating personnel, ensuring the proper use of time, equipment and staff. Ensure the efficient...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

Find your calling at Mercy! The Clinical Supervisor ensures delivery of safe, high‑quality and cost‑effective nursing care. They collaborate with physicians, administrative personnel, and other nurses to improve processes across the continuum, manage staffing, assist in patient flow and bed management, and inspire a shared vision of change. Position Details Education: Graduate from an accredited nursing program. Preferred: Bachelor’s degree in Nursing. Licensure: Current RN license with the Board of Nursing in the applicable State of practice. Experience: 3‑5 years of hospital nursing experience. Certification: American Heart Association Healthcare Provider card or completed within probation period. Must also hold TNCC, ACLS and ENPC or PALS. Skills, Knowledge & Abilities: • Human relations and communication (written, verbal, electronic). • Clinical competence in patient care delivery. • Ability to assess data and guide personnel in providing appropriate level of...

Description: Are you interested in building a career with other TOP PERFORMERS? Effingham Health System is committed to providing exceptional care and services in an environment that supports professional growth, diversity, and inclusion. Every team member's experience and work-life balance are a priority in our organization. EHS culture encourages and supports individuals in pursuing their career goals and well-being by providing work-life balance, flexible scheduling, career development, and all the benefits and perks you need for yourself and your family. New Grads are welcome to apply. Benefits Retirement plans 403 (b) and 457 Health insurance Dental Insurance Vision insurance Prescription Drug Plan Hospital Discount Flexible spending account Paid time off Extended Days off (Sick time) Employee assistance program Strive365 Wellness Program Basic Life insurance (Employer Paid) Voluntary Life insurance/Accident/Critical Illness Disability (LTD and STD) Tuition...

Datavant is seeking experienced outpatient coders to join their remote team. This role requires a keen attention to detail and at least 3 years of outpatient coding experience, including expertise in Emergency Department coding. Candidates must be AHIMA or AAPC certified, with the ability to maintain high accuracy and productivity standards. Datavant offers a collaborative work environment aimed at transformative change in healthcare. #J-18808-Ljbffr

The Cigna Group is hiring a Medical Coder in Springfield, IL, responsible for conducting outpatient claims and appeals determinations under regulatory requirements. Candidates should have a high school diploma/GED and coding certification (CPC or CCS-P) with coding experience and research skills. The position offers an hourly rate of $19-$29 and an annual bonus plan, along with comprehensive health benefits and 401(k). This role supports the company’s commitment to enhancing client health and vitality. #J-18808-Ljbffr

About Otsuka We defy limitation, so that others can too. In going above and beyond—under any circumstances—for patients, families, providers, and for each other. It’s this deep-rooted dedication that drives us to uncover answers to complex, underserved medical needs, so that patients can push past the limitations of their disease and achieve more than they thought was possible each day. About the Role The Omnichannel Center of Excellence is dedicated to driving innovation, building, and delivering capabilities that enhance Otsuka’s opportunity to make an impact in the lives of those we serve. We achieve this through our relentless focus on customer centricity, patient empathy, expertise in enabling pathways for disease education and awareness of management options, and our unwavering commitment to supporting access to treatment. We are looking for a Medical Omnichannel Data Scientist , with strong expertise in artificial intelligence, encompassing machine learning, data mining,...

Candidates for this position may work out of our Florham Park, NJ, or Mettawa, IL offices. The Associate Director of Psychiatry Marketing Promotional Medical Education reports to the Director of Promotional Medical Education, External Engagement and RMM team. This role supports the development of the strategy and direction of a peer‑to‑peer learning program to address HCP educational needs in a fast‑changing, highly competitive market. It is responsible for developing innovative content and learning experiences, partnering cross‑functionally with medical, marketing, field leadership, operations, compliance, finance, and sales leadership to deliver high‑impact educational programming. The role also owns annual speaker training strategy, program planning, and budget management while using insights and field feedback to continuously improve speaker effectiveness and program performance. The role combines strategic leadership, execution, and collaboration to elevate the peer‑to‑peer...

Coding Auditor - Professional Department: Physician coding Hours: Full-Time (40 hours per week) Location: Remote or onsite. Must reside in one of the following states: Alabama, Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, New Mexico, Ohio, Oklahoma, South Carolina, Tennessee, Texas. Pay: Starts at \$23.87/hour, based on experience. Estimated compensation range \$23.87 - \$37.00. Responsibilities Assist coders with coding questions. Conduct collection and reporting of provider and coder audit results and education. Work with coders and providers to ensure appropriate documentation for clinic services. Report results to Coding Supervisor – Professional. Demonstrate ability to code all types of encounters. Maintain 95% accuracy in diagnoses and procedures coding. Ensure data quality and optimum reimbursement under federal and state payment systems. Identify and refer trend patterns of coding and...

A leading health data company is seeking experienced inpatient coders to join their remote team. Candidates must have a minimum of 3 years coding experience and a deep understanding of medical terminology. Responsibilities include coding patient records accurately and overseeing other coders. The company offers comprehensive benefits, including medical, dental, and 401k plans, along with flexible working schedules. Successful applicants will contribute to improving healthcare delivery through precise data management. #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...

Coder Auditor-Professionals are responsible for auditing coding assignments with providers and coders, training coding professional staff, and pro‑fee based coding which includes the assignment of ICD‑CM, CPT, HCPCS codes, E&M assignment, modifiers, and charge posting. They interact with medical staff, nursing, ancillary departments, provider offices, and outside organizations. At this time, we are only able to consider applicants who reside in the following states: Alabama, Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, New Mexico, Ohio, Oklahoma, South Carolina, Tennessee, Texas. Responsibilities Assists coders with coding questions. Conducts the collection and reporting of provider and coder audit results and education. Works with coders and providers to ensure appropriate documentation for clinic services. Reports results to Coding Supervisor - Professional. Demonstrates ability to code all...

A leading healthcare data platform seeks experienced inpatient coders to join their remote team. The role requires accuracy in coding using ICD-10 standards, along with significant experience and certifications such as CCS or RHIT. Ideal candidates should communicate effectively and possess strong attention to detail. As part of the team, you'll contribute to improving healthcare decisions and outcomes. This remote role offers flexibility and competitive pay within a collaborative work environment. #J-18808-Ljbffr

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...

Sr Med Bill Examiner - CJ10DN We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals - and to help others accomplish theirs, too. Join our team as we help shape the future. We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals - and to help others accomplish theirs, too. Join our team as we help shape the future. Successful candidates will be responsible for performing Medical Bill review and investigation of medical invoices to determine reimbursement based on applicable workers compensation statues and/or regulations including: -Analyzing of bill for proper assignment of detailed medical coding information -Interpreting workers compensation rules for repricing -Entering/correcting data of medical...