Guidehouse

A leading consulting firm is seeking a Revenue Integrity Coding and Billing Specialist to join their remote team. The role involves reviewing and resolving Medicare claims, ensuring compliance with billing guidelines, and applying appropriate medical codes. The ideal candidate will have over three years of relevant experience and certification in coding. Competitive compensation ranges from $49,000 to $81,000 annually, alongside a rich benefits package that includes health insurance and retirement plans. #J-18808-Ljbffr

Job Family: Patient Account Representative, PFS Billing, PFS General Travel Required: None Clearance Required: None What You Will Do: The Healthcare - Medical Biller is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers. Has an extensive knowledge of billing requirements mandated by payers and / or governmental regulations. This position will perform any and all related job duties as assigned. Individuals must be able to work an eight hour shift between the hours of 8:30 AM CT - 5:30 PM CT, with no remote work initially but opportunity for some hybrid (in office/remote)...

Job Family : Strategy & Transformation Consulting Travel Required : Up to 25% Clearance Required : None Is life sciences in your DNA? Breakthroughs in pharma are helping people live healthier lives, while medical devices enable patients to proactively maintain health - this is undoubtedly a transformative time for health care companies. Guidehouse's Life Sciences practice is an engine of innovation, helping pharmaceutical, biotech, medical device, and diagnostic companies develop custom solutions that tackle today's challenges, while anticipating tomorrow's. You will have an immediate impact by partnering with our clients, across all levels, to deliver product planning, pricing, reimbursement, product commercialization, and regulatory and compliance solutions. Do you think you are up for the challenge? We continuously strive to foster an inclusive and diverse work culture and thoughtfully develop our people through challenging work, valuable learning...

Job Family : Strategy & Transformation Consulting Travel Required : Up to 25% Clearance Required : None Is life sciences in your DNA? Breakthroughs in pharma are helping people live healthier lives, while medical devices enable patients to proactively maintain health - this is undoubtedly a transformative time for health care companies. Guidehouse's Life Sciences practice is an engine of innovation, helping pharmaceutical, biotech, medical device, and diagnostic companies develop custom solutions that tackle today's challenges, while anticipating tomorrow's. You will have an immediate impact by partnering with our clients, across all levels, to deliver product planning, pricing, reimbursement, product commercialization, and regulatory and compliance solutions. Do you think you are up for the challenge? We continuously strive to foster an inclusive and diverse work culture and thoughtfully develop our people through challenging work, valuable learning...

Job Family : Strategy & Transformation Consulting Travel Required : Up to 25% Clearance Required : None Is life sciences in your DNA? Breakthroughs in pharma are helping people live healthier lives, while medical devices enable patients to proactively maintain health - this is undoubtedly a transformative time for health care companies. Guidehouse's Life Sciences practice is an engine of innovation, helping pharmaceutical, biotech, medical device, and diagnostic companies develop custom solutions that tackle today's challenges, while anticipating tomorrow's. You will have an immediate impact by partnering with our clients, across all levels, to deliver product planning, pricing, reimbursement, product commercialization, and regulatory and compliance solutions. Do you think you are up for the challenge? We continuously strive to foster an inclusive and diverse work culture and thoughtfully develop our people through challenging work, valuable learning...

Job Family : Strategy & Transformation Consulting Travel Required : Up to 25% Clearance Required : None Is life sciences in your DNA? Breakthroughs in pharma are helping people live healthier lives, while medical devices enable patients to proactively maintain health - this is undoubtedly a transformative time for health care companies. Guidehouse's Life Sciences practice is an engine of innovation, helping pharmaceutical, biotech, medical device, and diagnostic companies develop custom solutions that tackle today's challenges, while anticipating tomorrow's. You will have an immediate impact by partnering with our clients, across all levels, to deliver product planning, pricing, reimbursement, product commercialization, and regulatory and compliance solutions. Do you think you are up for the challenge? We continuously strive to foster an inclusive and diverse work culture and thoughtfully develop our people through challenging work, valuable learning...

Job Family : Strategy & Transformation Consulting Travel Required : Up to 25% Clearance Required : None Is life sciences in your DNA? Breakthroughs in pharma are helping people live healthier lives, while medical devices enable patients to proactively maintain health - this is undoubtedly a transformative time for health care companies. Guidehouse's Life Sciences practice is an engine of innovation, helping pharmaceutical, biotech, medical device, and diagnostic companies develop custom solutions that tackle today's challenges, while anticipating tomorrow's. You will have an immediate impact by partnering with our clients, across all levels, to deliver product planning, pricing, reimbursement, product commercialization, and regulatory and compliance solutions. Do you think you are up for the challenge? We continuously strive to foster an inclusive and diverse work culture and thoughtfully develop our people through challenging work, valuable learning...

Job Family : PFS Billing Travel Required : None Clearance Required : None What You Will Do : The Medical Biller is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers. Has an extensive knowledge of billing requirements mandated by payers and / or governmental regulations. This position will perform any and all related job duties as assigned. This position is a hybrid schedule working two days in the El Segundo office and three days from home. Essential Job Functions Hospital Billing Emphasis Correcting and billing electronic and hardcopy claims...

Job Family: General Coding Travel Required: None Clearance Required: None What You Will Do: The Remote Hospital Inpatient Coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 and PCS Diagnosis codes, as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager-the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS and any other official coding guidelines established for use with mandated standard code sets. This position is 100% remote. Duties and Responsibilities: Demonstrates the ability to perform quality hospital coding on Inpatient accounts including Medicare/Non Medicare, Surgical, Medical, Cardiac, moms/babies, and trauma cases. Maintains a working knowledge...

Job Family : Operational Effectiveness Consulting Travel Required : Up to 25% Clearance Required : Ability to Obtain Public Trust What You Will Do: Guidehouse is seeking a Revenue Integrity Analyst (Medical Biller) with strong billing, coding, and revenue cycle expertise to support the modernization of MHS GENESIS, the DoD's enterprise EHR. The role ensures accurate billing, compliant charge capture, and efficient claim resolution by analyzing data, auditing documentation, and collaborating with clinical, coding, IT, and financial teams across the Military Health System. Responsibilities of this role are as follows, to include but not limited to: Revenue Integrity & Charge Capture Optimize and validate MHS GENESIS / Cerner charge capture workflows, CDM logic, billing rules, and revenue cycle configuration. Conduct charge capture validation, reconciliation of clinical activity to billing outputs, and identification of DNFB risks and...

Job Family : Operational Effectiveness Consulting Travel Required : Up to 25% Clearance Required : Ability to Obtain Public Trust What You Will Do: Guidehouse is seeking a Revenue Integrity Analyst (Medical Biller) with strong billing, coding, and revenue cycle expertise to support the modernization of MHS GENESIS, the DoD's enterprise EHR. The role ensures accurate billing, compliant charge capture, and efficient claim resolution by analyzing data, auditing documentation, and collaborating with clinical, coding, IT, and financial teams across the Military Health System. Responsibilities of this role are as follows, to include but not limited to: Revenue Integrity & Charge Capture Optimize and validate MHS GENESIS / Cerner charge capture workflows, CDM logic, billing rules, and revenue cycle configuration. Conduct charge capture validation, reconciliation of clinical activity to billing outputs, and identification of DNFB risks and...

Job Family: General Coding Travel Required: None Clearance Required: None What You Will Do: Code Physician Plastic Surgery charges Communicate coding rationale to physicians Code IP and OP Plastic Surgery charges What You Will Need: High School Diploma/GED (Relevant experience may be substituted for formal education) 3+ years of experience coding for Plastic Surgery CPC from AAPC Trauma surgery coding experience related to Plastics What Would Be Nice To Have: ENT facial plastics coding experience Multispecialty surgical coding experience Other coding credentials from AAPC The annual salary range for this position is $38,000.00-$64,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. What We Offer: Guidehouse offers a comprehensive,...

Job Family: General Coding Travel Required: None Clearance Required: None What You Will Do: Code Cardiothoracic Surgery physician charges Communicate coding rationale to physicians Code inpatient and outpatient Cardiothoracic charges What You Will Need: 3+ years of surgical coding with E/M experience Proficiency in Cardiothoracic Surgery Coding Ability to communicate official source coding rationale to physicians AAPC Certification - CPC What Would Be Nice To Have: Multi-specialty surgical coding experience The annual salary range for this position is $49,000.00-$81,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. What We Offer: Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible...

Job Family: General Coding Travel Required: None Clearance Required: None What You Will Do: The Remote Hospital Inpatient Coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 and PCS Diagnosis codes, as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager-the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS and any other official coding guidelines established for use with mandated standard code sets. This position is 100% remote. Duties and Responsibilities: Demonstrates the ability to perform quality hospital coding on Inpatient accounts including Medicare/NonMedicare, Surgical, Medical, Cardiac, moms/babies, and trauma cases. Maintains a working knowledge...

Job Family: General Coding Travel Required: None Clearance Required: None What You Will Do: The Remote Inpatient Coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 and PCS Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager-the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS and any other official coding guidelines established for use with mandated standard code sets. Maintains a working knowledge of ICD-9-10 PCS and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing. Assures that all services documented in the patient's chart...

Job Family: General Coding Travel Required: None Clearance Required: None This position is fully remote What You Will Do: The Digestive Office Pro Fee Coder must be proficient in Evaluation & Management & simple GI scopes in the outpatient setting. The coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager-the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials...

Job Family Coding IP (India) Travel Required None Clearance Required None What You Will Do Strong knowledge and experience in ICD-10-CM and ICD-10-PCS coding systems Proficiency in assigning DRGs (Both MS & APR DRG) and ensuring compliance with regulatory standards Excellent attention to detail and accuracy in reviewing patient records Effective communication and collaboration skills with clinical staff Familiarity with EHR systems and coding software Ability to work independently and adhere to deadlines What You Will Need Minimum 2 years of experience in IP DRG coding specialty. Mandatory certifications like CIC, CCS, CPC. Must be a Graduate Good communication and analytical skills are required ICD-10-PCS coding systems, ensuring accuracy and compliance with all regulatory and reimbursement requirements Day-to-day tasks include reviewing patient records, assigning appropriate DRGs, collaborating with clinical staff to gather accurate documentation, and...

A healthcare services company in Indiana is seeking a candidate with strong ICD-10 coding expertise. Responsibilities include reviewing patient records, assigning DRGs, and collaborating with clinical staff. The ideal applicant will have at least 2 years of experience in IP coding specialty, along with certifications in CIC, CCS, or CPC. Competitive compensation and flexible benefits are offered. This role supports quality improvement and compliance in patient care. #J-18808-Ljbffr

Job Family :General CodingTravel Required :NoneClearance Required :NoneThis is a remote position.What You Will Do :Code OB / GYN office and hospital chargesReview and code properly per documentation and coding guidelinesWork remotelyWhat You Will Need :3 or more years experience coding OB / GYN clinic and hospital chargesCPC from AAPCExperience working claim edits and denialsAbility to multitaskGood communication skills - written and oralWhat Would Be Nice To Have :Specialty OB credential through AAPCExperience coding in EPIC#LI-DNIThe annual salary range for this position is $44000.00-$74000.00.Compensation decisions depend on a wide range of factors including but not limited to skill sets experience and training security clearances licensure and certifications and other business and organizational needs.What We Offer :Guidehouse offers a comprehensive total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to...

ENT Surgery Pro Fee CoderThe ENT Surgery Pro Fee Coder must be proficient in surgical coding for high complexity ENT surgery cases.The coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT / HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance.Under the direction of the coding managerthe coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS / MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets.The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines.This position is full time and 100% remote.Maintain...

Job Family :General CodingTravel Required :NoneClearance Required :NoneThis position is a fully remote positionThis position is a part-time roleWhat You Will Do :Code Neurosurgery Operative notes for Physician ChargesCode Neurosurgery rounding chargesWhat You Will Need :Experience coding Neurosurgery - Brain and SpineMinimum 3 years experience coding NeurosurgeryCPC credential from AAPCMust maintain credentials during employmentWhat Would Be Nice To Have :Experience coding OrthoExperience coding Trauma#LI-AS1The annual salary range for this position is $51000.00-$85000.00.Compensation decisions depend on a wide range of factors including but not limited to skill sets experience and training security clearances licensure and certifications and other business and organizational needs.What We Offer :Guidehouse offers a comprehensive total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and...

Job Family :General CodingTravel Required :NoneClearance Required :NoneThis role is fully remote.What You Will Do :The Remote Inpatient Coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 and PCS Diagnosis codes along with CPT / HCPCS codes as defined for the service type for coding billing internal and external reporting research as required and regulatory compliance.Under the direction of the coding managerthe coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting CMS and any other official coding guidelines established for use with mandated standard code sets.Maintains a working knowledge of ICD-9-10 PCS and CPT coding principles governmental regulations official coding guidelines and third-party requirements regarding documentation and billing.Assures that all services documented in the patients chart are coded with...

Job Family :General CodingTravel Required :NoneClearance Required :NoneThis position is full time as and fully remote.What You Will Do :The Remote Outpatient Multi-Specialty Surgery Coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate codes as defined for the service type for coding billing internal and external reporting research as required and regulatory compliance.The success candidate will have multi-specialty surgical coding experience in but not limited to any Trauma Urology ENT Plastics General Surgeries OB / GYN Cardiovascular etc.Under the direction of the coding managerthe coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting CMS / MAC rules and the CPT rules established by the AMA and any other official coding guidelines established for use with mandated standard code sets.What You Will Need :RHIA RHIT CCS or CPC...