TEKsystems

*Description* The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. Your Responsibilities: Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy, completeness, specificity and appropriateness of...

Description Risk Adjustment Coding Auditor The Impact you will have The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. Your Responsibilities Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy, completeness,...

TEKsystems is seeking a Risk Adjustment Coding Auditor to ensure accurate and compliant coding across risk adjustment programs. The role applies coding standards, audits records, and mitigates regulatory risk while improving data integrity. Responsibilities include chart reviews, validation of CMS HCC-based diagnoses, and guiding others on coding errors. Requires strong CRC certification, 7+ years of experience, and a production environment background. #J-18808-Ljbffr

TEKsystems is seeking a Risk Adjustment Coding Auditor to ensure the accuracy of coded clinical data and compliant reporting for risk adjustment programs. The role supports improved data integrity and safer reimbursement across Medicare, ACA, and Medicaid models. The candidate will review charts, verify providers’ diagnoses, and apply CMS HCC guidelines while maintaining regulatory compliance and strong data governance in a remote contract setup. #J-18808-Ljbffr

*Description* Risk Adjustment Coding Auditor The Impact you will have The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. Your Responsibilities Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy,...

*Description* Coding surgeries directly use PMD Pull up auto note and fill out work 13-15 cases an hour The Coding Specialist performs all medical record coding activities. Assigns appropriate diagnostic codes to patient charts and reports as assigned. *Skills* Surgery Coding, General Surgery coding, breast surgery coding, Gastro surgery coding, GYN coding, Clinical COding *Top Skills Details* Surgery Coding,General Surgery coding,breast surgery coding,Gastro surgery coding,GYN coding,Clinical COding *Additional Skills & Qualifications* Detail Oriented Confident Good at collaborating with team Not afraid to ask questions *Experience Level* Entry Level *Job Type & Location*This is a Contract to Hire position based out of Dallas, TX. *Pay and Benefits*The pay range for this position is $25.00 - $28.00/hr. Eligibility requirements apply to some benefits and may depend on your job...

TEKsystems in Rochester, NY seeks an Entry Level Medical Billing Specialist to ensure full reimbursement for clinical services and accurately manage receivables. You will resolve edits, denials, and payer requests while working with Epic, EMRs, and CRM systems onsite in Rochester. The role requires at least one year in a Medical Office environment, knowledge of UBO4/1500F05, and strong problem-solving and communication skills. #J-18808-Ljbffr

*Description* The ideal candidate for this role will have experience in Healthcare Accounts Receivable (AR) and collections, as well as proficiency in Epic. This individual will be responsible for performing advanced coding and appeals activities, investigating payer issues, ensuring the timely filing of appeals to insurance companies, and managing charge corrections. The successful candidate will demonstrate strong analytical skills, attention to detail, and the ability to resolve complex reimbursement issues effectively. REQUIRED: Certification as a Certified Procedural Coder (CPC) required or RHIT/RHIA certification. * Responsible for appealing claims denied by third-party payers. Creates appropriate letters and compiles documentation to substantiate the validity of claims. * Investigates and problem solves reimbursement issues in collaboration with other coding staff and faculty. Works directly with physicians and other clinical staff as needed to provide documentation...

*Job Description* The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. *Your Responsibilities* * Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices * Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements * Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting * Verifies and ensures the accuracy, completeness, specificity and appropriateness of...

*Job Description:* The ideal candidate for this role will have experience in Healthcare Accounts Receivable (AR) and collections, as well as proficiency in Epic. This individual will be responsible for performing advanced coding and appeals activities, investigating payer issues, ensuring the timely filing of appeals to insurance companies, and managing charge corrections. The successful candidate will demonstrate strong analytical skills, attention to detail, and the ability to resolve complex reimbursement issues effectively. *Job Duties:* * Responsible for appealing claims denied by third-party payers. Creates appropriate letters and compiles documentation to substantiate the validity of claims. * Investigates and problem solves reimbursement issues in collaboration with other coding staff and faculty. Works directly with physicians and other clinical staff as needed to provide documentation feedback and to develop appeals. * Research payer policies and processes. * Review...

TEKsystems is seeking a Senior Risk Adjustment/Coding Specialist to evaluate and ensure accuracy of risk adjustment reporting. The role involves reviewing both inpatient and outpatient records, ensuring CMS/HCC alignment, and protecting patient privacy under HIPAA. This contract position is based out of Jacksonville, FL, but offers full remote work. Ideal candidates have 7+ years in risk adjustment coding, CRC certification, and strong MS Office skills. #J-18808-Ljbffr

****MUST HAVE ACTIVE CRC**** Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy, completeness, specificity and appropriateness of providerreported diagnosis codes based on medical record documentation Reviews medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories Maintains knowledge of relevant regulatory mandates and ensures activities are in compliance with requirements Contributes to audit and production efforts to meet business demand and workload priorities Provide written and verbal guidance on coding errors to others Meets audit deliverables within established timelines and deadlines Assists...

****MUST HAVE ACTIVE CRC**** Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy, completeness, specificity and appropriateness of providerreported diagnosis codes based on medical record documentation Reviews medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories Maintains knowledge of relevant regulatory mandates and ensures activities are in compliance with requirements Contributes to audit and production efforts to meet business demand and workload priorities Provide written and verbal guidance on coding errors to others Meets audit deliverables within established timelines and deadlines...

Risk Adjustment Coding Auditor (Remote) Location: 100% Remote (Approved U.S. States Only) Employment Type: Contract (5 Months) Schedule: First Shift Overview We are seeking experienced Risk Adjustment Coding Auditors to support a growing healthcare organization during a high-volume operational period. This role is ideal for professionals with deep expertise in HCC coding, risk adjustment auditing, and regulatory compliance who thrive in a production-driven environment. This position offers the opportunity to work remotely while contributing to the accuracy, integrity, and compliance of risk adjustment programs that support quality healthcare outcomes and reimbursement processes. Key Responsibilities Audit risk adjustment codes for accuracy, consistency, and compliance with coding guidelines and best practices Perform retrospective and prospective medical record reviews Validate diagnosis coding based on provider documentation and CMS-HCC requirements...

*Risk Adjustment Coding Auditor* Overview We are seeking a detail-oriented *Risk Adjustment Coding Auditor* to support the accuracy, integrity, and compliance of clinical coding data across risk adjustment programs. In this role, you will conduct audits, review medical record documentation, identify coding opportunities, and provide guidance on coding accuracy to help support compliant reporting and appropriate reimbursement. The ideal candidate will bring extensive HCC coding and risk adjustment auditing experience, strong analytical skills, and a thorough understanding of Medicare, Medicaid, and ACA risk adjustment models. Key Responsibilities * Perform retrospective and prospective chart reviews to evaluate risk adjustment diagnosis coding accuracy. * Audit medical records to verify the completeness, specificity, and appropriateness of reported diagnoses. * Review clinical documentation to ensure accurate HCC capture and risk adjustment reporting. * Evaluate coding...

Job Description Our client is looking to fill the role of a Medical Biller. A qualified applicant will be autonomous, conscientious, meticulously organized, and able to meet the requirements below. Job Duties Working knowledge of Medicare, Medicaid and familiarity with commercial insurance billing and their respective plans Experience working on denials and AR with various insurance payers Accurately post insurance payments to open A/R balances in EPIC, and make follow up calls as required to promptly resolve incorrect payments or to collect delinquent balance. Review and process insurance refunds in compliance with payer and regulatory guidelines. Check claim status using online provider portals or calling insurance company to ensure timely payment received. Qualifications Must haves: 3-5 years of Hospital Medical Billing(Surgical billing) 3-5 years of EPIC Exp. Basic knowledge of CPT ICD-10 codes Schedule...

Medical Biller About the Role We are seeking an experienced and detail-oriented Medical Biller to join a growing healthcare support team. This role is responsible for managing insurance billing, accounts receivable follow-up, payment posting, claim status reviews, and denial resolution to ensure timely reimbursement and accurate account management. The ideal candidate will have a strong understanding of healthcare billing processes, insurance payer requirements, and revenue cycle management, along with the ability to work independently in a fast-paced environment. Key Responsibilities Accurately post insurance payments and reconcile accounts receivable balances within the billing system. Investigate and resolve denied, underpaid, and outstanding claims with Medicare, Medicaid, and commercial insurance payers. Follow up with insurance carriers regarding claim status, payment discrepancies, and delinquent balances. Process insurance refunds in accordance with...

*Description* Coding surgeries directly use PMD Pull up auto note and fill out work 13-15 cases an hour The Coding Specialist performs all medical record coding activities. Assigns appropriate diagnostic codes to patient charts and reports as assigned. *Skills* Surgery Coding, General Surgery coding, breast surgery coding, Gastro surgery coding, GYN coding, Clinical COding *Top Skills Details* Surgery Coding,General Surgery coding,breast surgery coding,Gastro surgery coding,GYN coding,Clinical COding *Additional Skills & Qualifications* Detail Oriented Confident Good at collaborating with team Not afraid to ask questions *Experience Level* Entry Level *Job Type & Location*This is a Contract to Hire position based out of Dallas, TX. *Pay and Benefits*The pay range for this position is $25.00 - $28.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change...

Description The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. Your Responsibilities: Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy, completeness, specificity and appropriateness of...

Risk Adjustment Coding Auditor (Remote) *Location:* 100% Remote (Approved U.S. States Only) *Employment Type:* Contract (5 Months) *Schedule:* First Shift Overview We are seeking experienced Risk Adjustment Coding Auditors to support a growing healthcare organization during a high-volume operational period. This role is ideal for professionals with deep expertise in HCC coding, risk adjustment auditing, and regulatory compliance who thrive in a production-driven environment. This position offers the opportunity to work remotely while contributing to the accuracy, integrity, and compliance of risk adjustment programs that support quality healthcare outcomes and reimbursement processes. Key Responsibilities * Audit risk adjustment codes for accuracy, consistency, and compliance with coding guidelines and best practices * Perform retrospective and prospective medical record reviews * Validate diagnosis coding based on provider documentation and CMS-HCC requirements * Identify...

TEKsystems is seeking a Billing Medical Coder for a contract role based in Dallas, TX. The coder will manage day-to-day coding and billing for services billed under grants, Medicare, Medi-Cal, managed care and private insurances, using Epic and other systems. Experience with FQHC, Epic, AAPC, ICD-10, CPT-4, 340B, AHIMA, HCC, and HIPAA compliance is expected. This fully remote position offers benefits eligibility and pay of $29-$39 per hour. #J-18808-Ljbffr

Medical Biller Location: • Baltimore, MD Pay: • $23.00-$25.00/hr Work Environment Large office environment, back-office setting. This position is fully onsite. Schedule • Monday-Friday • 8:30 AM-5:00 PM Compensation and Benefits Pay Rate: • $23.00-$25.00/hr Duration: • 6-Month Contract-to-Hire If eligible, benefits may include: Medical, Dental, Vision Critical Illness, Accident, and Hospital coverage 401(k) Retirement Plan (Pre-tax and Roth post-tax contributions available) Voluntary Life & AD&D (employee + dependents) Short-term and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program (EAP) Time Off / Leave (PTO, Vacation or Sick Leave) About the Role This Medical Biller position is focused on managing assigned accounts receivable balances, processing claims, resolving denials, and ensuring timely reimbursement from commercial insurance...

Medical Biller About the Role We are seeking an experienced and detail-oriented *Medical Biller* to join a growing healthcare support team. This role is responsible for managing insurance billing, accounts receivable follow-up, payment posting, claim status reviews, and denial resolution to ensure timely reimbursement and accurate account management. The ideal candidate will have a strong understanding of healthcare billing processes, insurance payer requirements, and revenue cycle management, along with the ability to work independently in a fast-paced environment. Key Responsibilities * Accurately post insurance payments and reconcile accounts receivable balances within the billing system. * Investigate and resolve denied, underpaid, and outstanding claims with Medicare, Medicaid, and commercial insurance payers. * Follow up with insurance carriers regarding claim status, payment discrepancies, and delinquent balances. * Process insurance refunds in accordance with payer...

*Job Description* * Our client is looking to fill the role of a Medical Biller. A qualified applicant will be autonomous, conscientious, meticulously organized, and able to meet the requirements below. *Job Duties* * Working knowledge of Medicare, Medicaid and familiarity with commercial insurance billing and their respective plans * Experience working on denials and AR with various insurance payers * Accurately post insurance payments to open A/R balances in EPIC, and make follow up calls as required to promptly resolve incorrect payments or to collect delinquent balance. * Review and process insurance refunds in compliance with payer and regulatory guidelines. * Check claim status using online provider portals or calling insurance company to ensure timely payment received. *Qualifications* Must haves: * 3-5 years of Hospital Medical Billing(Surgical billing) * 3-5 years of EPIC Exp. * Basic knowledge of CPT ICD-10 codes *Schedule* Monday-Friday 8 hour shift some...