18 jobs found in Trenton

Certified Professional Coder (CPC)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.Position SummaryThe Certified Professional Coder (CPC) will perform medical claim reviews 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.Activities...

Certified Professional Coder/ PIP AdjusterMedlogix, LLC delivers innovative medical claims solutions through a seamless collaboration of our medlogix® technology, our highly skilled staff, access to our premier health care provider networks, and our commitment to keeping our clients' needs as our top priority. Medlogix has a powerful mix of medical expertise, proven processes and innovative technology that delivers a more efficient, disciplined insurance claims process. The result is lower expenses and increased productivity for the auto insurance and workers' compensation insurance carriers; third party administrators (TPAs); and government entities we serve.Exciting opportunity with the possibility for growth!This division of Medlogix is positioned for significant growth in the near future. We are actively hiring to expand the team and as the department grows, there may be opportunities for future advancement into leadership roles individuals who demonstrate mastery of the...

Job TitleRemote... need NY/NJ PIP experience and Certified coder from AAPCResponsibilities:Review medical bills submitted by insurance companies related to MVA injuries sustained for NJ and or NY-covered insuredsInterpret medical documentation ensure accuracy of billed services IE: CPT, HCPCs codesAssign proper CPT, HCPCs codes based on the review outcomeReview CPT codes for unbundled servicesReview billed modifiers for accuracy of useCrosswalk CPT codes per regulatory requirements to ensure correct reimbursementInterpret fee schedule guidelines and apply those guidelines in daily reviewsDocument review outcomes for customers in a professional easy to understand mannerUse various resources, IE: eBooks, 3M software to support reviewsParticipate in conference calls as needed with customers and/or attorneysParticipate in virtual and in-person testimony or trial when neededAssist with various special projects and other duties as assignedQualifications and Experience:3-5 years...

Urgent Requirement - Certified Professional Coder Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow. We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity. Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right...

Certified Professional Coder/ PIP Adjuster Medlogix, LLC delivers innovative medical claims solutions through a seamless collaboration of our medlogix technology, our highly skilled staff, access to our premier health care provider networks, and our commitment to keeping our clients' needs as our top priority. Medlogix has a powerful mix of medical expertise, proven processes and innovative technology that delivers a more efficient, disciplined insurance claims process. The result is lower expenses and increased productivity for the auto insurance and workers' compensation insurance carriers; third party administrators (TPAs); and government entities we serve. Exciting opportunity with the possibility for growth! This division of Medlogix is positioned for significant growth in the near future. We are actively hiring to expand the team and as the department grows, there may be opportunities for future advancement into leadership roles individuals who demonstrate mastery of the...

Job Title Remote... need NY/NJ PIP experience and Certified coder from AAPC Responsibilities: Review medical bills submitted by insurance companies related to MVA injuries sustained for NJ and or NY-covered insureds Interpret medical documentation ensure accuracy of billed services IE: CPT, HCPCs codes Assign proper CPT, HCPCs codes based on the review outcome Review CPT codes for unbundled services Review billed modifiers for accuracy of use Crosswalk CPT codes per regulatory requirements to ensure correct reimbursement Interpret fee schedule guidelines and apply those guidelines in daily reviews Document review outcomes for customers in a professional easy to understand manner Use various resources, IE: eBooks, 3M software to support reviews Participate in conference calls as needed with customers and/or attorneys Participate in virtual and in-person testimony or trial when needed Assist with various special projects and other duties as assigned Qualifications...

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. Position Summary The Certified Professional Coder (CPC) will perform medical claim reviews 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. Activities include: Conduct a...

**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...

Client Overview Our client is a long-standing and well-respected non-profit healthcare organization looking for an experienced Medical Billing Specialist to join and assist their ever-growing team! Salary $23/hr - $25/hr Position Overview The Medical Billing Specialist will be responsible for the accurate application of all payments promptly. Candidates must be motivated and able to work in a high-volume, fast-paced environment. Medicare and Medicaid experience is needed. CPC and experience with Athena software are huge pluses. Responsibilities Prepare and submit clean claims to various insurance companies. Research and perform all secondary billing. Ensure appropriate supporting documentation is received and completed. Review and recommend claims for adjustment/write off to management. Accurate and timely processing of claims. Analyze and update claims submitted and rejected. Assist with payment posting. Insurance follow-ups. Required Experience/Skills 2+ years of...

Atrium is seeking an experienced Medical Billing Specialist in Trenton, New Jersey, to join their non-profit healthcare organization. The specialist will ensure accurate application of all payments in a fast-paced environment. Ideal candidates have 2+ years in medical billing, with Medicare and Medicaid experience, and must be familiar with Athena software. The position offers various benefits such as healthcare plans and paid time off. #J-18808-Ljbffr

Capital Health is a regional leader in progressive, quality patient care, providing services through two hospitals, an outpatient center, satellite ED, and an extensive primary and specialty care network. The Medical Group employs over 600 physicians and other providers who deliver primary, specialty, and hospital‑based care to patients throughout the region. Pay Range: $25.49 - $33.16 per hour (full‑time equivalent 1.0 FTE). Scheduled Weekly Hours: 40 hours. Position Overview This is a full‑time, remote physician coding position open to candidates residing in New Jersey, Pennsylvania, or Alabama. The role requires accurate assignment of CPT, HCPCS, and ICD‑10‑CM codes for professional claims from Capital Health Medical Group for both hospital and outpatient procedures. Essential Functions Review procedure documentation to assign accurate CPT‑4 procedure codes and appropriate modifiers for OR and procedure room cases. Validate provider‑selected ICD‑10‑CM diagnosis codes....

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...

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...

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....

Fully Remote Lake Park Building Full time R180631 Job Description: The Med Grp Professional Billing (PB) Coder II is responsible for accurately resolving coding edits in assigned Epic WQ's and assigning ICD-10, CPT, and HCPCS coding classifications and modifiers based on clinical documentation and/or physician orders. This role ensures the integrity of data for both internal and external reporting, maintains work queues within processing timeframes, responds to inquiries related to billing codes, and adheres to compliance guidelines. Essential Functions Evaluates and resolves all types of coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic. Assigns ICD, CPT, and HCPCS coding classifications based on clinical documentation and/or physician orders. Accurately evaluates and resolves assigned coding edits in Charge Review, Claim Edit, and Follow-up work queues in Epic within assigned timeframes. Appropriately...

Client Overview: Our client is a healthcare organization providing comprehensive medical and dental services to the local community. The organization is committed to providing quality patient care while maintaining efficient, accurate, and compliant revenue cycle operations. They are currently expanding and looking to bring on a Medical Biller/Revenue Cycle Specialist to join their team.   Salary/Hourly Rate: $21/hr - $23/hr   Position Overview: Our client is seeking a temporary Medical Biller/Revenue Cycle Specialist for a temporary assignment with potential for permanent placement. This position will support the full revenue cycle process, from patient registration and eligibility through claim submission, denial resolution, payment posting, reconciliation, and AR follow-up. The ideal candidate will have strong end-to-end medical billing and revenue cycle experience, particularly with Medicaid and Managed Medicaid. Candidates should be analytical, detail-oriented,...

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the healthcare industry? Use Dreambound to find a Medical Billing and Coding program that will prepare you for this high-demand, entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : Complete in as short as a few weeks to a few months Online and in-person options available Payment plans and financial aid may be available for those who qualify Cost : This program is an educational opportunity that requires a financial investment. Cost varies per partner school, but payment plans and / or financial aid may be available to...

Datavant is hiring experienced inpatient coders for a fully remote role. The position focuses on ICD-10-CM/PCS coding with a target of 95% accuracy and adherence to MS-DRG standards, while mentoring Level 1 & 2 Coders where applicable. The role requires at least 3 years of inpatient coding experience, AHIMA credentials preferred, and strong communication skills. Competitive hourly pay and comprehensive training are offered. #J-18808-Ljbffr