42 jobs found in Springfield

Become a part of our caring community and help us put health first 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. 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...

Essential Duties and Responsibilities: - Abstract and code clinical data. - Audit medical records to ensure compliance with the organization's coding procedures and standards. - Accurately enter coded data in a system and validate data entered. - Research correct coding practices, clearly document and share findings with others. - Review denials and recommend billing corrections. - Train staff members on the coding process. Minimum Requirements - High School diploma or equivalent with 0 - 2 years of experience. - Additional clinical licensure may be required based on project. - Must be a Certified Medical Coder, Certified Professional Coder, or a Certified Coding Specialist. - Knowledge of Medical Billing and Coding Systems such as CPT and HCPCS is essential. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday required. Additional Skills and Experience: - Familiarity with retrospective payment reimbursement highly preferred....

Mercy Health Nursing Position Thank you for considering a career at Mercy Health! Scheduled Weekly Hours: 40 Work Shift: Nights (United States of America) Summary of Primary Function: Delivers patient care utilizing the nursing process through data collection and assessment, identifies and determines the priority of patient's problems/needs, and evaluates the process and outcome of nursing care; coordinates, provides and directs patient teaching activities and coordinates the care provided by health team members. Essential Job Functions: In collaboration with the interdisciplinary care team, conducts initial and ongoing patient assessment, analyzes assessment data, creates a plan of care, implements treatment and evaluates treatment effectiveness; administers medications in a safe manner consistent with the State of Practice and organization policies and procedures; serves as point of contact for patients' care coordination throughout hospital departments. Acts as a patient...

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...

Become a part of our caring community and help us put health first 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,...

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:...

At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Summary of Primary Function Delivers patient care utilizing the nursing process through data collection and assessment, identifies and determines the priority of patient’s problems/needs, and evaluates the process and outcome of nursing care; coordinates, provides and directs patient teaching activities and coordinates the care provided by health team members. Essential Job Functions In collaboration with the interdisciplinary care team, conducts initial and ongoing patient assessment, analyzes assessment data, creates a plan of care, implements treatment and evaluates treatment effectiveness; administers medications in a safe manner consistent with the State of Practice and organization policies and procedures; serves as point of contact for patients'...

Thank you for considering a career at Mercy Health! Scheduled Weekly Hours: 40 Work Shift: Nights (United States of America) Summary of Primary Function Delivers patient care utilizing the nursing process through data collection and assessment, identifies and determines the priority of patient's problems/needs, and evaluates the process and outcome of nursing care; coordinates, provides and directs patient teaching activities and coordinates the care provided by health team members. Essential Job Functions In collaboration with the interdisciplinary care team, conducts initial and ongoing patient assessment, analyzes assessment data, creates a plan of care, implements treatment and evaluates treatment effectiveness; administers medications in a safe manner consistent with the State of Practice and organization policies and procedures; serves as point of contact for patients' care coordination throughout hospital departments. Acts as a patient safety advocate...

Coder IP/OP McKenzie-Willamette Medical Center is your community medical provider, serving the Willamette Valley and its residents. Our 113-bed hospital offers inpatient, outpatient, diagnostic, medical, surgical and emergency care. We are a family of caregivers offering care to our larger family - our community. Position Details: Hourly Base Rate: $29.54 - $37.60 Shift Hours Per Week: 40 hours SEIU Local 49 represented position Date Posted: 09/16/2025 Job Summary: Abstracts clinical information from a variety of medical records, charts and documents and assigns appropriate ICD-10 and/or CPT-4 codes to patient records according to established procedures. Works with coding databases and confirms DRG assignments. Relies on limited experience and judgment to plan and accomplish goals. Performs a variety of tasks. Works under general supervision. Reports to the Director of Health Information Management. Qualifications: Minimum, high School...

Coder OP McKenzie-Willamette Medical Center is your community medical provider, serving the Willamette Valley and its residents. Our 113-bed hospital offers inpatient, outpatient, diagnostic, medical, surgical and emergency care. We are a family of caregivers offering care to our larger family — our community. Position Details Hourly Base Rate: $18.28 - $26.37 Shift: Days Hours Per Week: 40 hours Date Posted: 02/20/2026 Job Summary Certified Coder required. Working knowledge of basic medical terminology, ICD-10, CPT and HCPCS codes. Preferred experience in multiple specialties including: Cardiology, Cardiology diagnostic testing, Cardiothoracic Surgery, Critical Care, General Surgery, Gastroenterology, Pulmonology, Vascular Surgery and Vascular Imaging services. Ability to assign codes to diagnoses, procedures, E&M visits, and diagnostic testing. Ability to research and analyze clinical documentation as well as produce reports from a variety of sources. Ability to work...

Join Datavant, the leading data collaboration platform in healthcare. Our mission is to make health data secure, accessible, and actionable, providing vital data solutions for healthcare providers, health plans, researchers, and life sciences companies. Whether it’s managing a patient’s medical records or advancing AI in healthcare, our collaborative team is dedicated to significantly transforming the industry. We are seeking experienced and credentialed outpatient coders to enhance our team. The ideal candidate will demonstrate exceptional attention to detail and possess a comprehensive understanding of medical terminology. Enjoy the flexibility of this fully remote role while helping to shape the future of healthcare! Preferred: Outpatient coder specializing in Cath coding, Endo, Observation coding, and OP Surgery is highly desired. Experience with Cerner/3M is a plus. Key Responsibilities: Review medical records and accurately assign codes for diagnoses and...

I. Job Summary Under minimal supervision, plans and conducts environmental compliance audits of various entities to determine compliance with Federal and State regulatory requirements, programs and internal policies with a focus environmental regulations and capacity. II. Essential Duties and Responsibilities To perform this job successfully, an individual must be able to perform each of the following essential duties satisfactorily. Other minor duties may be assigned. Plan and conduct internal audits to determine compliance with Federal and State regulations. Review facility operations and records to ensure adequacy of internal controls, compliance with procedures, consistency with established laws, rules and regulations and guidelines applicable to overall compliance for the operation. Prepare audit reports, and implement administrative and technical audit procedures for audit program activities. Review and verify audit corrective actions and...

Become a part of our caring community and help us put health first 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. 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...

We recommend using the following browsers to complete the application: Desktop: Google Chrome, Edge with Chromium Mobile: Google Chrome, Safari Description The Revenue Cycle Coding Auditor will perform reviews for employees in the Coding department. Audits will include, but are not limited to; employee productivity and quality based on proper documentation, accuracy and coding guidelines. The Auditor will also provide feedback and support relating to departmental/role specific productivity and quality expectations. The incumbent for this position will utilize a high level of in-depth knowledge of the coding role to perform all audits based on specific departmental need. Examples of Duties PBS Auditor: 100% Conduct quality and productivity reviews of coding staff using structured and consistent review programs and methods. Demonstrate in-depth knowledge and experience with SIU-HC supported applications, including but not limited to Athena IDX, TouchWorks,...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Sutter Health System Office-Valley Position Overview: This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines. Performs medical record reviews to ensure accurate assignment of medical diagnoses and procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage encounters, to ensure accurate reporting of diagnoses and to alert the physician of potential clinical conditions that may require review. Job Description : EDUCATION: HS Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE: CRC-Certified Risk Adjustment Coder OR CPC-Certified Professional Coder OR AHMA or AAPC Coding Certification...

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 an Omnichannel Data Scientist , Medical Omnichannel with strong expertise in artificial intelligence, encompassing...

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...

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 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 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 guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

Your Future Evolves Here Evolent is dedicated to transforming health care by partnering with health plans and providers to improve outcomes for individuals with complex and high-cost health conditions. We aim to bridge the gaps in the fragmented health care system, ensuring every person receives the compassionate care we would wish for our own loved ones. At Evolent, we prioritize work/life balance and provide the flexibility to allow our employees to tailor their work to fit their lives. We believe that the best work happens in an environment that supports personal well-being and encourages authenticity. This commitment to diversity and inclusion is at the heart of our organization. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Medical Coder - FWA Auditor plays a vital role in ensuring the accuracy of complex claim reviews, coding, and billing in alignment with the Plans' provider agreements and National Healthcare...